20041059.pdf[PERMIT
DATE RECEIVED/
7
EXPIRES
CITY OF EDMONDS
PERMIT
NUMBER
JOB UITE/ArT!
ADDRESS. mn r
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEiNAME OF BUSINESS
PLAT NAMEISUBDIVISION NO,
LOT NO
LID NO
MAILING ADDRESS
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LID FEE S
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP
TESCP Approved [3
RW Permit Required 0
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Street Use Permit Required 13
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CITY ZIP
TELEPHONE
EXISTING PROPOSED
inspection Required
0
SiduAalk Required
0
7.7;e
REQUIRED DEDICATION FT
Underground
Waing required [3
NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
PRV REQUIRED
YESM NOM
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ADDRESS
REMARKS
OWNERiCONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE
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NAME
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DATE
ENGINEERING REVIEWED BY
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ALLOWED OSED
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NEW RESIDENTIAL PLUMBING I MECH
ACOMPLIANCE
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ALLOWED PROPOSED
REQUIRED SETBACKS (FT.)
FRONT SIDE REAR
PROPOSED SETBACKS (FT.)
FRONT LIRSIDE REAR
COMMERCIAL OR
ADDITION 1:1
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CHANGE OF USE
MIXED USE
REMODEL SIGN
PARKING
REQ'D PROVIDED
LOTAREA
PLANNING REVIEWED BY DATE
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GRADING Ei FENCE
REPAIR CYDS I X FT.)
REMARKS
DEMOLISH TANK OTHER
GARAGE Ei RETAINING WALL E:] FIRE SPRINKLER
FIREALARM
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NUMBER OF
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LOAD
DESCRIBE WORK TO BE DONE
REMARKS
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GEOTECH REPORT
BY
T-7—
s 6—
STRUCTURAL DESIGN
BY:
VALUATION
Description
FEE
Description
FEE
Plan Check
State Surcharge
HEAT SOURCE
LOTSLOPE%
VESTED DATE
Building Permit
City Surcharge
2
PLAN CHECK NO:
Plumbing
Base Fee
Mechanical
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
Grading
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Engr. Review
PERMIT APPLICATION: SEE ECDC 19.00.05(A)(5)
Engr. Inspection
pu
PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
(n 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk. Deposit
V)
W IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
_1
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES. AND AGENTS FROM ANY AND Fire Inspection Receipt #
< ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
FROM THE Insp. Total Amt. Due
DEEMED TO MODIFY. WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape
01 NOR LIMIT IN ANY WAY THE CITY's ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
x
- Recording Fee . A Receipt il
. . . . . . .
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF This application is not a pernut until signed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC- CALL Building official or his/her Deputy and Feesare paid,and
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED receipt is acknowledged it) space provided
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION I
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27. OFF1 ALS SIGNA URE DAT
SIGN,ATURE (OWNER AGENT.,k DATE SIGNED (425) /A
771-0220 R - E S By DATP( -7—
vATTENTION EXT. 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTI- ORIGINAL FILE YELLOW INSPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 / IBC110 / IRC110. PINK -OWNER GOLD - ASSESSOR
10104 PRESS HARD - YOU ARE MAKING 4 COPIES
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Grease Trap Sizing Worksheet
Facility Name: NC) I- 6h /7 / ,
__CLAn,_& j_ta, (A rn r,
Address: 22ff Jq 100t, Ave'. 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 1) x no. of sinks)—
Fixture Capacity
in Gallons
(Cu. In. + 231)
Drainage Load
(75% of Total
Capacity)
Flow Rate for
a 2-Minute
Drain Period
#1
prexw a� h XY1 rj<,
+ 231 = gal.
x.75 = gal.
- 2 0 gpni
#2
ck-o- x c.i.
-.- 231 = gat.
x .75 = gal.
--.2= /0 gprn
#3
x X X c.i.
-- 231 = gal.
x .75 = gal.
2= gpm
#4
x x x c.i.
+ 231 = gal.
, x.75 = gal.
2 gpm
Grease Trap #1 - Total drainage flows from maximum of 4 fixtures
gpin
#1
x x X c.i.
231 = __gal.
x.75= i!al.
2 gpm.
#2
X x x c.
23 1. = gal.
x.75 = __Kal-
2
#
x x x c.i.
231 = gal.
x .75 = ga 1.
2= gpm 1
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#4]
x x x c.i.
I + 231 = gal.
x.75 = gal.
2
Grease Trap #2 - Total drainage flows from maximum of 4 fixtures
gpm
MINIMUM SIZE OF GRE ASE TRAP(S) RE QUIRED
gp
Number of Fixtures Connected to a Grease Trap
1
2
-3
4
Grease Trap Size (in gpm)
20
25
35
50
Upsize for factors such as high volume dishwashing, high oil/grease content on tnenu, etc.
----------- ---------------------------- (F or City use only below this line) -----------------------------------------------
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Remarks: DLAk-- -Lo Zibz, re -ELL QL00 2-2
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Size Approved: 2-0 gpm Approved by: qZjjL4 -
� Date: 12-j 7- 0
Pretreatu I iefi7e-elinician
[Rev. Feb. 2W41
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FINAL PROJECT APPROVAL FORM
RECEIVED TO:
JA'N� '�.' 4 20,35 DATE:
ENGINEERING DIVISION
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: PRETREATMENT DATE- 3
PLEASE SI
ENGINEERING DIVISION DATE_�
PULASE SIGN
PLANNING DIVISION DATE__�
I'LEASE SIGN
PROJEC 0,
SITE ADDRESS__2.Ln4 /Oql� Ave�.
PERMIT # 2-0014 - /059 ADB#---------PATF, INSPECTED--L2-----ZO----(D-�-'i--
DESCRIPTION OF WORK TO BE INSPECTED 1mlin 110-tiOn Of C' 20 - Lran
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
PERFORAlANCE 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:fomis: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,
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
OCCUPANCY ..................
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