20040930.pdfDATE RECEIVED
PERMIT EXPIRES
USE PERMIT
ZONE 71
CITY OF EDMONDS NUMBER
JOB SUITE/API #
CONSTRUCTION PERMIT APPLICATION ADDRESS
OWNER NAME/NAME OF BUSINESS U In
7-1 _)7 _Z PLAT NAMEISUBDIVISION NO LOT NO LID NO,
cc MAILING ADD �ESS LID FEE S
W I
z I ESCP Approved 13
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP FiW Permit Hoquifod 13
30. 31('0 Street Use Permit Roq'd 0
CITY Inspection Reqwred C3
ZIP TELEP IONE EXISTING — PROPOSED Sicievalk Required 13
I Undeigrotind
/ L' - o �a) REQUIRED DEDICATION— FT Wiring required 13
&'0 226 1 ZT2 zr-
NAME METER SIZE LINE SIZE NO. OF FIXTURES PAV REQUIRED
YES 13 NO 13
W z
t: ADDRESS REMARKS z
x OWNER/CONTRACIOR RESPONSIBLE FOR EROSION CONIROL/DRAINAGE 3
U z
W
CITY ZIP TELEPHONE
NAME 'BL 4 k,
4 :11CII ENGINEERING REVIEWED By DATE
M ADDRESS
0
I` 7'� " 4f ?-,5
9-13110 FIRE REVIEWED BY DATE
M
k2 CITY ZIP TEIHOIE M
0
U j, A:_
V\w/o od 1 VARIANCE OR CU SHORELINE OR ADB# INSPECTION BOND
STATE LICENSE NUMBER DATE CH E"Y REO'D POSTED
Lj ** '�Sj p067 3/ cLo (.e 6-1 1 1 1 CIYES ONO S
01 1 r� t� SEPA REVIEW SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE , EXEMPT ALLOWED , PROPOSED ALLOWED , PROPOSED
ILI 00,_j3Lp-j0(600"5-0
EXP
LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (F-T.)
NEW RESIDENTIAL ff—PLUMBING / MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR 0
COMPLIANCE OR z
z
ADDITION COMMERCIAL CHANGE OF USE z
PARKING LOT AREA PLANNING REVIEWED BY DATE
E] REMODEL MULTIFAMILY SIGN REO'D I PROVIDED
GRADING FENCE
REPAIR CYDS ( — x —FT) REMARKS
DEMOLISH E] TANK OTHER
GARAGE RETAINING WALL FIRE SPRINKLER
z CARPORT E] ROCKERY El FIRE ALARM
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN: CH CKED VJT)IFIE OF CONSTRY9TION ICODE OCCUPANT
Fr GROUP
U)
Lid NUMBER NUMBER OF CRITICAL T OCCUPANT
OF DWELLING AREAS SPECIAL INSPECTION AREA
UNITS NUMBER LOAD
0 STORIES REOUIREDE] YES
DESCRIBE WORK TO BE DONE I
REMARKS
PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQ'D 5
26 C?m
VALUATION
Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE GLAZING % LOT SLOPE % Building Permit City Surcharge
PLAN CHECK NO: VESTED DATE Plumbing Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS wonK TO
t= BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2 Grading
DOMAIN JCURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
cc PERMIT APPLICATION: 1180 DAYS
w
IL PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANI, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Fire Review Plan Chk. Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMI ESS THE CITY OF
I EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt #
ir ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
x FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF IHIS PERMIT SHALL NOT BE
a DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscapeinsp. Total Amt. Due Z67-
_j
0 NOR LIMIT IN ANY WAY THE CITYS ABILITY 10 ENFORCE ANY ORDINANCE PROVISION.*
Recording Fee Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THAT THE INFORMATION
GIVEN IS CORRECT; AND THAT I AM THE OWNER. OR THE DU& AUTHORIZED AGENT OF APPLICATION APPR( AL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL I his application is not a p0tMit until signed by the
TION AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED Building official or his/hei Deputy. and Fees are paid, and
IN VI'6LATION OF THE LA13OR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSATION INSURA E AND R�jifl 27. 1)
cbt� V OFFICIALS SIQNAT�RE DA
SIGNATUR I& R -DATE SIGNED
V
771-0 RELEAsF6,'HY 'DATE
220
L
INER�LR EL/"' (425)
L
ATT ' E ION EXT 1333
IT IS U� USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 PINK OWNER GOLD - ASSESSOR
09103 PRESS HARD -YOU ARE MAKING 4 COPIES
z
0
1
0
M
zi --fi
U5
0 M
C
M 0
0
C)
0 C:
--j g
x M
M Z
10--I
C _z
CO)
0 -n
n
M M
0
0
0 M
W
M 0
Z
z
z
0
1
0
M
Grease Trap Sizing Worksheet
Facility Name: Ci��tereJJFJ Sp�-,rir4ji-W F�Od��
Address: /11al'n si, Suite No.:
• A Grease Trap plumbing permit is required ($165.00 fee). Contact the Pretreatment
Technician (425-672-5755) if you have any questions and also to get signature approval on
this form.
• Dishwashers are not allowed to be connected to a Grease Trap.
• Food disposers are not allowed in a facility served by a Grease Trap and must be disabled or
removed. Solids must be screened out and placed in the solid waste container.
Fixture Capacity in Cubic
Inches
(L x W x D x no. of sinks)
Fixture Capacity
in Gallons
(Cu. In. —, 231)
Drainage Imad
(75% of Total
Capacity)
Flow Rate for
a 2-Minute
Drain Period
#1 .
2-0 x 10 x/ 0 x #OOC> c.i.
-- 231= /7,3gal.
x.75= 13 gal.
—.- 2 = 7 gpm
92
x x x c.i.
+ 231 = gal.
x .75 = gal.
+ 2 = gpm
#3
x x X c.i.
231 = gal.
x .75 = gal.
--- 2 = gpm
#4
x X x c.i.
231 = gal.
I x .75 = gal.
+ 2 = gpm
Grease Trap #1 — Total drainage flows from maximum of 4 fixtures
— gpM
#1
x x x c.i.
231 = gal.
x .75 = gal.
-- 2 = gpM
#2
X x x c.i.
231 = gal.
x .75 = gal.
+ 2 = gpm
#3
x X x c.i.
231 = gal-
x.75 = gal.
+ 2 = gpM
#4
x x x c.i.
I + 231 = gal.
, x .75 gal.
--- 2 = gpm
Grease Trap #2 — Total drainage flows from maximum of 4 fixtures
� gpM
MINIMUM SIZE OF GREASE TRAP(S) REQUIRED 7-
gpM
Number of Fixtures Connected to a Grease Trap
2
3
1
Grease Trap Size (in gpm)
=2 0
25
35
1 50
Upsize for factors such as high volume dishwashing, high oil/grease content on menu, etc.
........................................ (For City use only below this line) -----------------------------------------------
Remarks: Re_rc)rm&-n� JSQOn L4,n 1* i 1� W P 7ei
\1 I
SizeApproved: 20 gpm Approvedby:
Date:
1'retreatmely Technician
[Rev. Feb. 2004]
Z
0
1
0
M
--4 -n
3:
M
C
M
0
--10
0 C:
--I K
3: M
M Z
JO --I
C
2cn;
0 -n
n
M M
0 US
0 r-
0 M
C Cn
9 Cn
M 0
Z r-
3:
Z
--I
3:
Cn
Z
0
M
FINAL PROJECT APPROVAL FORM
K1::LUZ1VED
JUN 18 2004 TO:
DEVELOPMENT SERVICES CTR DATE:
CITY OF EDMONris
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: PRETREATMENT DATE__L -J
PLEASESIG
ENGINEERING DIVISION DATE
PLEASESIGN
PLANNING DIVISION DATE
PLEASE SIGN
PROJEC
SITE ADDRESS 31G 86A SL
PERMIT —ADB# DATE INSPECTED 6 )7 - 0
DESCRIPTION OF WORK TO BE INSPECTED C-TCe.2D?_. -Tr-r'�)
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
1 .
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
0 Copy of CORRECTION NOTICE given to owner/contractor by inpector
1 .
2.
93
RE -INSPECTED OUTSTANDING ISSUE S_ - GRANT FINAL PROJECT APPROVAL
Date Signature
1:temp:b1dg:fbrms:ocaprv1 3/25/04
z
0
M
Zi --fi
U5 --I
0 M
C
M 0
0
0
0 C
M
M Z
—Z
cl)
o -n
n ;d
>
M M
0 5
0 r-
0 M
C Cn
9 C/)
M 0
Z
r
z
--i
M
Cn
z
0
M
�,A
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ......................
Wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
Rough -in ...................
Commercial Final ......
HEATING:
Gas Test . ........ ............
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 /,Of
OCCUPANCY ..................
40000
z
0
1
0
ITI
--i -n
0 M
C
M
0
0
0 C
M
M z
C
0 71
n
M M
0 —C/)
0 ITI
C C0
C U)
M 0
Z
z
--I
�5
z
0
0
M