20040887.pdfDATE RECEIVED
1 PERMIT EXPIRES
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CITY OF EDMONDS NUMBER,
JOB SUITE/�PT#
CONSTRUCTION PERMIT APPLICATION ADDRESS
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NEW RgSIDENTIAL
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REMODEL MULTIFAMILY
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPLICATION: 180DAYS
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC-
TION: AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND FIC W 18,27.
SIGN7
,)RE (OWNER ��G`ENT),) DATE SIGNED
.ZIA
REMARKS
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
EERING REVIEWED BY DATE
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ALLOWED PROPOSED FRONT SIDE REAR FRONT,, LIRSIDE REAR
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PARKING I LOT AREA PLANNING R VIEW 0 Y DATE
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Receipt #
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Total Amt. Due
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Receipt #
APPLICATION APPROVAL 1
CALL
This application is not a permit until signed by the
Building Official or his/her Deputy: and Fees are paid, and
FOR INSPECTION
receipt is acknowledged in space provided.
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OF -IC-IALTSIGYATUPE DATE
(425)
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771-0220
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A77ENTION t:A I
IT IS UNLAWFULTO USE OR OCCU PYA BUILDING OR STRUCTURE UNTILA FINAL
INSPECTION HASBEEN MADE AND APPROVALOR A CERTIFICATE OF OCCU-
PANCY HAS BEEN GRANTED. UBC109/IBC110/IRC110.
09/03 PRESS HARD -YOU ARE MAKING 4 COPIES
ORIGINAL -FILE YELLOW' INSPE?tTC
PINK - OWNER GOLD - ASSESSOR
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SHORELINE SUBSTANTIAL DEVELOPMENT PERMIT
EXEMPTION
Project Location: 336 Admiral Way
Applicants: Robert Yeager for tile Port of Edmonds
Project Description: Replacement of fuel float gangway with one (1) new gangway.
Replacement of kayak float gangway with gangway from fuel float. Floats
to rei-nain in same location; no new over water coverage proposed.
See Attached: R1 Site Plan 0 Elevation
lber: PC-04-0466
Plan Check Nun
Date Issued: October 18, 2004
SEPA Determination: Exempt
Issued by: Ross Beckley, Planner
The above project has been determined to be. exempt from the requirement to obtain a Shoreline
Substantial Development Permit under WAC 173-27-040(2)(b), which states:
Normal maintenance or repair of existing structures or developments, including damage
by accident, fire or elements. "Normal maintenance" includes those usual acts to prevent a
decline, lapse, or cessation from a lawfully established condition. "Normal repair" means
to restore a development to a state comparable to its original condition, including but not
limited to its size, shape, configuration, location and external appearance, within a
reasonable period after decay or partial destruction, except where repair causes substantial
adverse effects to shoreline resource or environment. Replacement of a structure or
development may be authorized I as repair where such replacement is the common method
of repair for the type of structure or development and the replacement structure or
development is comparable to the original structure or development including but not
limited to its size, shape, configuration) location and external appearance and the
replacement does not cause substantial adverse effects to shoreline resources or
environment;
This exemption is not being sent to the Department of Ecology because it appears to City staff
that it is not subject to U.S. Army Corps of Engineers section 10 pernlit under tile Rivers and
Harbors Act of 1899 (tile provisions of section 10 of the Rivers and Harbors Act generally apply
to any project occurring on or over navigable waters. Specific applicability information should
be obtained from the Corps of Engineers.) Nor does the project appear to City staff to require a
section 404 permit under the Federal Water Pollution Control Act of 1972. (The provisions of
section 404 of the Federal Water Pollution Control Act generally apply to any project which may
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involve discharge of dredge or rill material to any water or wctland area. Specific applicability
information should be obtained from the Corps of Engineers.) Robert Fritzen has advised us that
per WAC 173-27-050, no letter is required to be sent to Department of Ecology.
While this letter provides ail exemption from the need to obtain a Shoreline Substantial
Development Permit from the City of Edmonds, it does not evaluate whether other State and
Federal approvals arc required and leaves that responsibility to the applicants.
Ross Beckley October 18, 2004
Name Signatur Date
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cc: Street file for 336 Admiral Way
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02/24/2005 15:13 FAX 425 774 7837 PORT OF EDMONDS 002/006
MEMORANDUM Z,
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Date: Inuary 21, 2005 C
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To: Mr. Michael Snook 0 C
Senior Combination Building Inspector
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City of Edmonds M z
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Rayjohnson
From:
1.)ioject InspectOt of Record
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Subiect: Inspection Report —G-angway Replacement
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r5en Construction CompvLny removed the old. gangway Z r-
on November 30, 2004, S. L. La 9.y at the Kayak f102t All Biltj anchor bolts
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from the fuel dock- and re -installed the old X
were jnstalled as per specifications at the Kayak- float gallgway' --I
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CITY OF EDMONDS
SPECIAL INSPECTION AND TESTING AGREEMENT
The projectat 9 a (—�/,r z
number , — 4,�� — requires special ins'pecti4
complete list of special inspections is attached to this document.
issued undel- building permit
and/or testing per IBC Chapter 17. The
BEFORE A PERMIT CAN BE ISSUED: The owner and contractor and special inspector sliall complete
this agreement and the attached structural test(s) and inspections schedule including the required
acknowledgenients.
APPROVAL OF SPECIAL INSPECTORS: Each special inspector sliall be approved by the Building
Official prior to performing any duties or inspections. Each special inspector sliall submit Statement of
Qualifications to the Building Official for review. Special inspectors sliall display identification when
performing special inspections on site. Special inspection and testing shall meet the mininitin, requirements
of IBC Chapter 17 and the following:
A. Duties and Responsibilities of the Special Inspector
1. Observe Work
The special inspector shall observe the site work for conformance with the approved (stamped) plans
and specifications and applicable workmanship provisions of the IBC. Architect or Engineer
reviewed shop drawings may be used only as an aid to inspection. Special Inspections are to be
performed on a continuous basis—ineaning that the special inspector is on site at all times observing
the work requiring special inspection. Periodic inspections, if any, must have prior approval by the
City based on a separate written plan reviewed and approved by the Building Official and the
engineer or architect of record.
2. Report Non -conforming Items
The special inspector sliall bring non -conforming items to the immediate attention of the contractor
and note all such items in the daily field report. Any iteni not resolved in a tiniely manner sliall be
immediate cause of the special inspector to notify the Building Official of the plan deviation, error,
change or oinission. It sliall also be the duty of the special inspector to promptly iioti�y the engineer
or architect.
3. Complete Daily Reports
Each special inspector shall complete and sign both the special inspection record and the daily report
form for each (lay's inspection. These records shall remain at the jobsite with the contractor for
review by the City Building Inspector.
4. Furnish Weekly Reports
The special inspector or inspection agency sliall furnish the City with weekly reports of tests and
inspections. The project engineer or architect, and others as designated sliall also be copied on
reports. Weekly reports must include the following:
Description of daily inspections and tests made Nvith applicable locations
List of all non-conforining items
Report on status of non -conforming items (resolved or unresolved)
Itemized cb.-i, 7es authorized by the Architect, Engineer and City if not included in non-
conformance items.
-5. Furnish Final Construction Report
The special inspector or inspection agency shall submit a final signed report to the City stating that
all items requiring special inspection and testing were fulfilled and reported. And, to the best of
L:\'I'EMP\BUILDING\SpecialliispectioiiAgreeiileiitIBC.doc 7/04
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his/her knowiedge tile project is in conformance with the'approyed plans and specifications,
approved change orders and the applicable workmanship provisions of tile IBC- Itell's 'lot in
conformance or unresolved items or any discrepancies in inspection coverage, (i.e., missed
inspections, periodic inspection Whell continuous inspections were required, etc.) shall be specifically
itemized in this report.
13. Contractor Responsibilities
Notify the Special Inspector
it is tile duty of tile contractor to notify the special inspector when work is ready for special
inspection. Note, the items listed oil the attached schedule and as noted on the approved plans and
specifications are required to have special inspections. Adequate notice shall be provided by the
contractor so that the special inspector has time to become familiar with the project.
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2. Provide Access to Approved Plaits
The contractor is responsible for providing tile special inspector access to approved plans at the
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3. Retain Special Inspection Records
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The contractor is responsible to retain at the jobsite all special hispectio I
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special inspector. These records are to be provided to the City building inspector upon request.
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C. City of Edmonds Builditill Department Responsibilities
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1. Approve special inspectors or inspection agencies
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The building department shall approve all special inspectors and special inspection requirements.
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2. Monitor special inspection and approve weekly reports
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Work requiring special inspection and the performance of special inspectors shall be monitored by
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the City Building Inspector. His/Her approval must be obtained prior to placement of concrete or
other similar activities in addition to that of the special inspector.
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3. Issue Certificate of Occupancy after all weekly special inspection reports
The Building Official may issue a Certificate of Occupancy
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including the final report have been submitted and accepted.
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D. Owner Responsibilities of record acting as the owner's agent shall fund
The project owner or the engineer or architect
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special inspection services.
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E. EnIzineer or Architect of Record ResngR�!� the plans and
The engineer or architect of record sliall include special inspection requirements on
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specifications.
ACKNOWLEDGENIENTS
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Owner
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Special Inspector
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Date
City Building Official
-77-
L:\TEMP\BUILDING\SpcciallilspectioiiAgreciiieiitIBC.doc 7/04
FINAL PROJECT APPROVAL FORM
TO:
DATE:
'MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE_4�::_�(�:�)s
PLEASE GN
ENGINEERING DIVISION DATE
PLEASC SIGN
PLANNING DIVISION DATE
PLEASESIGN
PROJECT
SITE ADDRESS _�3 6., A
PERMIT # ADB# DATEINSPECTED
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DESCRIPTION OF WORK TO BE INSPECTED
A field inspection was conducted to determine compliance with -approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
>�--GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
0 Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fom1s:ocaprv1 3/25/04
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FINAL PROJECT APPROVAL FORINI
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: e- FIRE DEPARTMENT DATE2—,2--V =0
P UKX.9 E �1 G N
ENGINEERING DIVISION DATE
PLEASESIGN
PLANNING DIVISION DATE
PLEASUSIGN
PROJECT
SITEADDRESS A_-�XaA
PERMIT # —9-(1 , �t. 0 kK 7 ADB#__________�DATE INSPECTED —2— —6-5
DESCRIPTION OF WORK TO BE INSPECTED L,-Q 01- 7--
A field inspection was conducted to determine compliance with -approved plans. Final approval
denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GIANT PROJECT APPROVAL WITH CONDITIONS NOTED
El Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor.by inpector
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2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fonns:ocaprv1 3/25/04
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -In ...................
Commercial Final ......
HEATING:
GasTest ....................
Gas Piping .................
Equipment .................
Commercial Final .......
EXTERIOR SHEATHING
NAILING..........................
FRAMING........................
FIRST FLOOR FRAMING ...
INSULATION ...................
Floor Insulation .........
Wall Insulation ...........
Ceiling Insulation .......
SHEETROCK NAILING ...
SPECIAL INSPECTION ...
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY ..................
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