20050640.pdfDATE RECEIVED
PERMIT EXPIRES C
CITY OF EDMONDS NUMBER )
CONSTRUCTION PERMIT APPLICATION JOBYG�C� I' SUITE/APT#
ADDRESS
OWN'j
�
ER NAMEINAME OF BUSINESS /
So �eea Na f rman i�G{ �Pp PLAT NAME/SUBDIVISION NO. LOT NO LID NO
MAILING ADDRESS 1 i� 2YGe �'T LID FEE S
I O '•^t � �� y 9 1 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved
.! RW Permit Required O
Street Use Permit Requited 0
CITY ZIP TELEPHONE EXISTINGL> PROPOSED...,... Inspection Required
r m o S l -- — Sidewalk Required
Sb 2U �ZS - y 3 - 5 a� REQUIRED DEDICATION _ FT __ Undmitiound 13
Wiring rn uired Q
NAME / METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
YES NO CI i
w
ADDRESS REMARKS tu
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE a
CITY ZIP TELEPHONE
3&0.
NAME CBL#
UP) it n NA
E5i NA
E �NEERI G REVIEWED BY ~ DATE
iCITY ZIP TELEPHONE
LL
UL. Oy=rca W G1 37
ARIANCE R Cu O ADB# INSPECTION SEPA
STATE LICENSE NUMBER EXPIRATION QTE KED BY RECTI
C i „ O3 .^ . � V� COMPLETED E E6 T
rom `HT1 r(Jj L-; I "� ONO
CAH � /5 ZONE SI N AREA i HEIGHT
a PROPERTY TAX ACCOUNT PARCEL NO. If If ^r� �A : ORO _�'rr• �
-7 p y 'a G �/ v WAIVER i� ALL D tf�O W PROPOSED
STUDYG auk' -+ , 1�
❑ NEW ❑ RESIDENTIAL ❑ PLUMBING / MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR O
nQ COMMERCIAL COMPLIANCE OR >ADDITION " '` ❑ CHANGE OF USE i
❑ MIXED USE PARKING LOT AREA PLANNING REVIEWED BY DATE
REMODEL SIGN REO'D PROVIDED
❑ MULTIFAMILY ❑ 2ZI L
❑ REPAIR ❑
GRADINGFENCE❑ ENCS_ X FT.) REMARKS r!
❑ DEMOLISH ❑ TANK ❑ OTHER
GARAGE RETAINING WALL
Z ❑ CARPORT ❑ ROCKERY ❑ FSPRINKLER
IRE ALARM
a (TYPE OF USE, BUSINESS R ACTIVITY) EXPLAIN:
e 5 n TYPE OF CONSTRUCTION CODE OCCUPANT
U
GROUP
U NUMBERI NUMBER OF
OF DWELLINGO SPECIAL INSPECTION CONSULTANT OCCUPAk Iltt
p STORIES UNITS REQUIRED YES LOAD Z %/►;
DESCRIBE WORK TO BE DONE '
REMARKS _
0
SF 1T14.n1 ~I1GEOTECHREPORT 5
BY: in
SBYRUCTL1L DESIGN n I v 6 n
C VALUATION171542 % r
�L$
684ILIZEE(6, OLUMfoe Description FEE Description FEE
Plan Check A&L State Surcharge.5011 400
s �i
HEAT SOURCE LOT SLOPE% VESTED DATE
G Building Permit CL City Surcharge
PA CHECK NO:
Plumbing ' Base Fee ` ,,
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO Mechanical rte.
t- BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBIC
DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE Grading
t SEPARATE PERMISSION.
z _ r
Engr. Review — & A ���
Lu
PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
n PERMIT LIMIT: SEE ECDC 19.00.005(A)(6) Engr. Inspection t�
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
in Fire Review Plan Chk. Deposit �
to •APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS p
ui
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF n
:E EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection Receipt # C
a ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
T FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE �, /t 7��
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due -il ,
= NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' 1
Recording Fee Receipt # Z47 qLp
1 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 permit 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 Foes are paid, and
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 FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSAT URANCE AND RCW 18:27.
+�
.F G - RE DATE
f}G
SIGNATURE (OWNER OR ENT): DATE SIGNED (425) 7 j J
771m0220 EL ASED BY l ATTENTION EXT. 1333 jeDAT11
� A
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 -I SPECTOR
FICATE OF OCCUPANCY HAS BEEN GRANTED, UBC109 / IBC110 I IRC110. PINK -OWNER GOLD - ASSESSOR
10104 PRESS HARD To YOU ARE MAKING 4 COPIES
0
1
l
t
O
rz
�:
H
8Iflit� 1 r o
n
3jI�•! 1 '1 1I§ . 1
4nE i ze o -o
in.i e�
r
lit
•� �a $ito
9pyg2x fill
�
it Izt�$ I rpj o�� 111t� ilii j
.ili � I.
i
0c 70th..Avehue W• —
OG)
Z: Manholellnv.391
5
It A R 3 R s v m ' s S�s.evY
• s a s n r " c -.a
> ^ D
rn Z"T
OR z
D '! IJ.2 One St One Sty. One Sty.
In Pre Hse, Fr. Hse, Fr. Hse. Fr. Hse. p 1
t A ([ 9p
C YI.4Y % J9 �ti
OJJ] r,• AIwq 11NCF
7,7 .7 .
m 15
D s C0
11 _
m�F�9 �3R33 r' ; col �.4
3'b 0o u D Fg>yd /Z Z Z p� .I
I ( ImO,a
0 0 0 z''9. ° m _$��• ^- --�2.+��^ D 1 �� OnEr 1l. ���`d' r r tc
O u.�y " II II
3 o a 0 0. n p>! e z \ v W _ Tom: Fr• 9/drY.'r, 0 D z It
a�0m ^ O Evwm" 6 Y `Lr' I Y i g. G
?� ro, �, Om I w T �J1 }, O�Brn. 0 a g T 1 y n i
37 �RX3T �qi N g I/
00
m o nE n n r2t aD 3_ Z II ld�y,C+ =�4 7
C F1n n y I— 1M__ Z {� j 1 •; ,+ nvl s���!' IS It n� i I
gUx �Z C s m D (1 �, 1 s< a
IND 0
3m4,�y" D (p am
1T1 `� V• Jam.. ..�+�:t�' ""� + / 1 �`q ��. ' t i, %.� .. .'
N�'iLE A> i r1� Rvp `6. 1:1�1d } �» V 11 r11
r F �. T "• m u tr e u ni > A N =, O A Q� m
nn2 �p�p,L n �2 VSs 1� l�1C(` cf)a 2. I 'n j" }i l.i c3
F W ice^ upo°zmuN_^ 'z M,
p r L..
F c - nY abor229 i.Z� (7 Rl y A..� 4,. cy�,y .� v� P. tF e'_�., 43 i
Iri N "1 /off //y� IIj'
>.. r. 0 m+ Z •b \/ V/ .i... •'
v 4 _
O 0 0 G1 y D D y I- o m cT"_I ate`\. s i� L
V D U). r6 D v m // w•� ��•,D �� t
G oznczb0. X ... Y V ^'�. I' 'r y ,f..
IgD v Lbb�' on vuN tr. i
Ont vZ. mr�.�� /i/�'�LTI1�'' _, ( i
OC AfNfU �s.�.—_._ I - NO u! ACN4:n:•'� AY cv.
Ln Addition for KAFE NEO E S G D E S i `"' `�
UNAMN .___-- n _`/�tJ,ry1�_ �'{� / �\ U�/ �1 II l/q ,.y
r cl.rcvu• ._ _.. •-..... - 6207, 73R, PL41" 1 1 o Y • V D 1 ��..�1 , � �.�• '-v G �
" w,r ry•r7•ay_ 21106{Hiyhway99 MARv5vu.2.E.%VA 911MI
to Edmor.1s, WA (360)653- S
r I6)II111mallm.
ONE
�
` r zone Corner Flag
PARKING SPADES REMa --,.- `y Setbacks 1Ze1Zired Actual
1CZ Front
PARKING SPACES PROPS Sides
Rear.
BARRIER RUM AG BPV �..: ____ �'-s,..... Other
PA _.._
_N...r,.,.._.
Height l CQ Its,
i
0
i
L.
s
Poo
lip
00 .40
_�.�
it
�, �
� �
��
�
�
� �
��`
�
•
--�
LOP
- -
1p;
'e'
H
8Iflit� 1 r o
n
3jI�•! 1 '1 1I§ . 1
4nE i ze o -o
in.i e�
r
lit
•� �a $ito
9pyg2x fill
�
it Izt�$ I rpj o�� 111t� ilii j
.ili � I.
i
0c 70th..Avehue W• —
OG)
Z: Manholellnv.391
5
It A R 3 R s v m ' s S�s.evY
• s a s n r " c -.a
> ^ D
rn Z"T
OR z
D '! IJ.2 One St One Sty. One Sty.
In Pre Hse, Fr. Hse, Fr. Hse. Fr. Hse. p 1
t A ([ 9p
C YI.4Y % J9 �ti
OJJ] r,• AIwq 11NCF
7,7 .7 .
m 15
D s C0
11 _
m�F�9 �3R33 r' ; col �.4
3'b 0o u D Fg>yd /Z Z Z p� .I
I ( ImO,a
0 0 0 z''9. ° m _$��• ^- --�2.+��^ D 1 �� OnEr 1l. ���`d' r r tc
O u.�y " II II
3 o a 0 0. n p>! e z \ v W _ Tom: Fr• 9/drY.'r, 0 D z It
a�0m ^ O Evwm" 6 Y `Lr' I Y i g. G
?� ro, �, Om I w T �J1 }, O�Brn. 0 a g T 1 y n i
37 �RX3T �qi N g I/
00
m o nE n n r2t aD 3_ Z II ld�y,C+ =�4 7
C F1n n y I— 1M__ Z {� j 1 •; ,+ nvl s���!' IS It n� i I
gUx �Z C s m D (1 �, 1 s< a
IND 0
3m4,�y" D (p am
1T1 `� V• Jam.. ..�+�:t�' ""� + / 1 �`q ��. ' t i, %.� .. .'
N�'iLE A> i r1� Rvp `6. 1:1�1d } �» V 11 r11
r F �. T "• m u tr e u ni > A N =, O A Q� m
nn2 �p�p,L n �2 VSs 1� l�1C(` cf)a 2. I 'n j" }i l.i c3
F W ice^ upo°zmuN_^ 'z M,
p r L..
F c - nY abor229 i.Z� (7 Rl y A..� 4,. cy�,y .� v� P. tF e'_�., 43 i
Iri N "1 /off //y� IIj'
>.. r. 0 m+ Z •b \/ V/ .i... •'
v 4 _
O 0 0 G1 y D D y I- o m cT"_I ate`\. s i� L
V D U). r6 D v m // w•� ��•,D �� t
G oznczb0. X ... Y V ^'�. I' 'r y ,f..
IgD v Lbb�' on vuN tr. i
Ont vZ. mr�.�� /i/�'�LTI1�'' _, ( i
OC AfNfU �s.�.—_._ I - NO u! ACN4:n:•'� AY cv.
Ln Addition for KAFE NEO E S G D E S i `"' `�
UNAMN .___-- n _`/�tJ,ry1�_ �'{� / �\ U�/ �1 II l/q ,.y
r cl.rcvu• ._ _.. •-..... - 6207, 73R, PL41" 1 1 o Y • V D 1 ��..�1 , � �.�• '-v G �
" w,r ry•r7•ay_ 21106{Hiyhway99 MARv5vu.2.E.%VA 911MI
to Edmor.1s, WA (360)653- S
r I6)II111mallm.
ONE
�
` r zone Corner Flag
PARKING SPADES REMa --,.- `y Setbacks 1Ze1Zired Actual
1CZ Front
PARKING SPACES PROPS Sides
Rear.
BARRIER RUM AG BPV �..: ____ �'-s,..... Other
PA _.._
_N...r,.,.._.
Height l CQ Its,
i
1
MAYES TESTING ENGINEERS, INC, Ever a4th Office
SW "
'�:::` Suite A-1
Everett, WA 98204
ph 425.742.9360
tax 425.745.1737
MASONRY PRISM TEST REPORT Tacoma Office
10029 S. Tacoma Way
Suite E-2
Tacoma, WA 98499
Job No.: E5492 Permit No.: 2005-060 ph 253.584.3720
Project: KAFE NEO ADDITION Date Rec'd.: 1-20-06 fax 253.594.3707
Client s Kafe Neo Date Issued: 1-27-06
Portland Office .
7911 NE 33rd Drive
Contractor: Webb Construction Original X Revised Suite 190
Portland, OR 97211
ph 503.281.7515
FIELD DATA (ASTMC1314) fax 503.281.7579 21
OWNS
O
Date Laid: 1-19-06 Mortar Producer: Design Mix ' n
Type of Unit: Half Design fc128 days: (1800) Professional Mortar h
ASTM / UBC Spec: 2105 Mix Proportions: Type S mixed onsite
Size of Unit 8x8x8 Cement: �_
Unit PSI Required: 1900 Lime: CO
Sand: C m
Water: m
z OC
Design F'm: 1500 Grout Producer: Design Mix ic
Date Grouted: 1-20-06 Desi n fc128 days, Fine Grout/ 2000 = m t;-
9 y ( ) m Z
Mortar / Grout as spec: Mix Proportions: Mixed onsite in wheelbarrow p -� i=
Yes X No Cement: : y z
Sand: I r
Air Temp: 45°F Gravel:co
Mortar Temp: Water: O on.
Grout Temp: 50°F WRA:
M m
Remarks/ Locations. Sampled at front 8" CMU wall from top of stem wall to 6'-0" height. p.�
0 nt
CnMprnseinn Test Machine Infnrmatinn C N
Diameter of Spherical Seat:
Req. Upper Bearing Plate Thickness.: Provided Upper Bearing Plate Thickness: r tn•-
i
MUNI
Req. Lower Bearing Plate Thickness:, Provided Lower Bearing Plate Thickness:
COMPRESSION TEST RESULTS (ASTMc1314).TP
-
M
Lab #1
Date
Tested
Age
Grouted
Yes No
HIT
Factor
Total
Load/lbs
Net Area
S . In.
Strength
psi
PSI111Vith
HIT Factor
Type of
Fracture
2125
1-27-06
7
X
2.0911
1.007
202,200
57.75
3500
3530
C
2126
2-17-06
28
X
2.081
1.006
229,700
57.94
3960
3990
C
2127
2-17-06
28
X
2.083
1.007
230,060
57.88
3970
4000
C
M
MAYES TESTING ENGINEERS INC E17 -1 4
y 917 134th Street SW
Suite /
Everett
WA 98204
ph 425.742.9360
CONCRETE LABORATORY TEST REPORT fax 425.745.1737
Project Name: Kafe Neo Addition Project No: E5492
Site Address: 21108 Hwy 99 South Issued on: 01/30/06
Sample Set ID: 26112
Edmonds, WA
Client: Kafe Neo Permit # (s): a on S -O 6 C/o
Original•
Engineer:
Revised: El Z
Contractor:Webb Construction Services' O
FIELD DATA. — --- � rn
ASTM C31 and C172
Air Temperature: 460t=
Actual Mix Proportions: yr �� z
Weather: Rain v rn
Ingredient (per cu. C
Weight v
Product: Concrete g 9 (P d Y) to 0
Supplier: Rinker ASTM #57 11639.0 lbs 0 c
' Ticket Number: 80030862 ASTM #8 194.0. lbs
MixDesign ID : 1334262 Fine Aggregate 1,316,0 lbs m Z
i Water 237.0 lbs p .—t
Sample Temp. Initial Storage Temp. Entrained Air Cement --Type 1 563.0 lbs D
' E(ASTM C1064) (ASTM C31) (AS.TM C231)oz r =
MRWRA 22.6
62°F NR NR HRWRA 17.0 loz 0)
Water/Cement Ratio: Slump (ASTM C143) Sample(s) Recd:
A/E Admix 3.4 oz 0 �
00421 5-1/2" 12/31/05 Required Strength ft): rn.m
Placement Location and Notes: 4000 psi @ 28 days O
n m
Perimeter stem walls for new addition.Elm
COMPRESSION TEST RESULTS r ZZ -t ��
(ASTM C39, C1231, and 0617 when applicable) D
Date Made Sample # Lab # Date Tested Age Size (in) Load (lbs) Dia (in) Surface Strength (psi) Failure Code
12/30/05 00020094 01/06/06_ 4 x 8 57770 3.99 12.50 4620 NA a ,
12/30/050002 0095 01/27/06 28 4 x 8 82030 3.98 12.44 6590 NA
12/30/05 0002 0096 01 /27/06F 28 1 F�4 x 8 81010 3.98 12.44 6510 NA
12/30/05 0002 0097 01 /27/06 28 4 x 8 81550 4.00 12.57 6490 NA
O
Remarks:
0
Inspector(s): VanderPol Il, Reviewed by: ' ' M
Tested by: Harrington, C. Timothy G. Beckerle, P.E.
Branch Manager
R G IV
FEB 13
✓R,a
-
IDEVELOPMENt SERVICES CTR.
NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std, CITY OF EDMONDS
• NA = Not Applicable, S = Shear, C = Cone, CSp = Cone and Split, CSh = Cone and Shear, Col =Columnar, FC - Field Cure, NR = Not Recorde
All testing performed in accordance with applicable ASTM's except C-31, 10.1.2 - "recording field temperature
Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc.
MTE Form #150, Rev 3, 7.0
MAYES Everett Office
TESTING ENGINEERS( INC. 917 -134th Street SW
Suite A-1 !`
Everett, WA 98204
ph 425.742,9360
fax 425.745,1737
MASONRY PRISM TEST REPORT racoma office
10029 S. Tacoma Way
�)CYO Suite E-2
Tacoma, WA 98499
Job No.: E5492 Permit No.: 2005-060 ph 253.584.3720
iax 253.584.3707
Project: KAFE NEO ADDITION Date Rec'd.: 1-20-06
Portland Office
Client: Kafe Neo Date Issued: 1-27-06 7911 NE 33rd Drive
Contractor: Webb Construction Original X Revised Suite 190
Portland,' OR 97211
ph 503.281.7515 Z
fax 503,281.7579
FIELD DATA (ASTbtc1314) -�
n
Date Laid: 1-19-06 Mortar Producer: Design Mix m
Type of Unit: Half Design fc/28 days: (1800) Professional. Mortar
ASTM / UBC Spec: 2105 Mix Proportions: Type S mixed onsite ' -=I Z1
Size of Unit: 8x8x8 Cement: N '�
Unit PSI Required: 1900 Lime:
Sand: m
Water
O.0
Design F'm: 1500 Grout Producer: Design Mix - rn Z
Date Grouted: 1-20-06 Design f c/28 days: Fine Grout/(2000) A -�
t...
Mortar/ Grout as spec: Mix Proportions: Mixed onsite in wheelbarrow D Z
Cement:
i Yes X No Sand:
Air Tem 45°F Gravel: O m
p• an
Water:
Mortar Temp: —I
Grout Temp: 50°F WRA: rn m
Remarks / Locations: Sampled at front 8" CMU wall from top of stem wall to 6-0" height. n rn
C cn
Pnmpracainn Tact Machina Infnrmatinn ' N
r Mn
Diameter of Spherical Seat:
Req. Upper Bearing Plate Thickness: Provided Upper Bearing Plate Thickness:
Req.. Lower Bearing Plate Thickness: Provided Lower Bearing Plate Thickness:.
COMPRESSION TEST RESULTS (ASTM c1314) Z
PSI/W.ith
HIT Factor
Type of
Fracture
Lab #.
Date
Tested
Age
Grouted
Yes No
HIT _
Factor
Total
Load/lbs
Net Area
S . In.
Strength
si
57.75
3500
3530
C
2125
1-27-06
7
X
2.0911
1.007
202,200
2126
2-17-06'
28
X
2127.
2-17-06
28
X
I
--.,
MAYES Everett
TESTING ENGINEERSy' INC 917 -,34th Street SW
Suite A-1
Everett WA 98204
ph 425.742.9360
fax 425.745.1737
CONCRETE LABORATORY TEST REPORT
Project Name: Kafe Neo Addition Project No: E5492
Issued on: . . 01/13/06
Site Address: 21108 Hwy 99 South Sample Set ID: 25946
Edmonds, WA r_
Permit # (s): 2005=0640
Client: Kafe Neooriginal: �
Z
En Revised:
Ineer:
- g
Contractor: Webb Construction Services rn ?
— - FIELD DATA _
ASTM C31 and C172
CO
Air Temperature: 39°F Actual Mix Proportions: C m
Weather: Clear irn O
Ingredient Weight (per cu.yd) C
10
Product: Concrete
ASTM #57 1,650,0 lbs
lbs
Supplier: Rinker Z :.
ASTM #8 200,0 .
Ticket Number: 80031673 Fine Aggregate 1,449.0, lbs 10 -1
MixDesign ID: 1334271 Water 246,0 lbs D Z
Initial Storage Tem Entrained Air Cement--T e I & Il 470,0 lbs r
Sample Temp. 9 p' ASTM C231) Yp
x
(ASTM C1084) (ASTM C31) ( N
560
F NR NR -n R
;.
(�WaterlCement Ratio Slump (ASTM C143) Samples) Recd: m m
L pOca
0.523 4-3/4" 12/16/05 Required Strength (Vc):
Placement Location and Notes:
2500 psi @ 28 days C N
SET r. Z�
New perimeter wall footing. 5 gallons water, added to whole load on site, and 150 oz Calcium Chloride added per -�
cubic yard at plant.
COMPRESSION TEST RESULTS f D
(ASTM C391 C1231, and C617 when applicable) Z
Date Made Sample # Lab # Date Tested Age Size (in) Load (lbs) Dia (in). Surface Strength (psi) Failure Code ,h _
12/15/05 0001 21123 12/22105 4 x 8 36980 3 98 12.44 2970 NA CO)
12/15!05 0001 21124 01!12/06 28 6 x 12 119570 5.99 28.18 4240 NA
6 x 12 113520 6.00 28.27 4010 NA n
12/15/05 0001 21125 01/12106 28 ���
12/15/050001 21126 01/12/06 28 6 x 12 .119480 5.99 28.18 4240 ] NA J" m
Remarks:
Inspector(s): VanderPol II, Reviewed by:
Imothy G. Beckerle, P.E.
Tested by: Johnson, S. J: Branch MaRgE
CEIVED
JAN .2 6 2006
NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std,
DEVELOPMENT SERVICES CTR.
NA = Not. Applicable, S = Shear, C = Cone; CSp = Cone and Split; CSh =Cone and Shear, Col =Columnar,
FC -Field Cure, 60 R9, RAW
All testing performed in accordance with applicable ASTM's except Q-311 10.1.2 - "recording field temperature
Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc.
MTE Form #150, Rev 3, 7.0
MAYES TESTING ENGINEERS, INC Everett ;nth Street SW /
Suite A-1 V
Everett WA 98204
ph 425.742.9360
CONCRETE LABORATORY TEST REPORT fax 425,745 .1737o
Project Name: Kafe Neo Addition Project No: E5492
Site Address: 21108 Hwy 99 South Issued on: 12123/05
Sample Set ID: 25946
Edmonds, WA
Permit # (s): 2005-0640
Client: Kafe Neo original: Q
to,
Engineer:Revised: Z
Contractor: Webb Construction Services
n
FIELD DATA rn
ASTM C31 and C172
Air Temperature: 39°F
Actual Mix Proportions: _
Weather: Clear C rn
Product. Concrete Ingredient Weight (per cu.yd) m p
-� n
Supplier: Rinker ASTM #57 19650.0 lbs
Ticket Number : 80031673 ASTM #8 200.0 lbs m z
Fine Aggregate 1,449.0 lbs
MixDesign ID: 1334271C _
Water .0 lbs
246
Sample Temp. Initial Storage T meT p Entrained Air Cement --Type I & II 470.0 lbs r""' � `
(ASTM.C1064) (ASTM C31) (ASTM C231) 2
56°F INR NR 0 m i.
Water/Cement R la of Slump (ASTM C143) Sample(s) Recd: -�
i 0.523 4-3/4" 12/16/05 Required Strength (f c):
M
i Placement Location and Notes: 2500 psi @ 28 days n m
C
SET , Zvi
New perimeter wall footing. 5 gallons water, added to whole load on site, and 150 oz Calcium Chloride added per r Z
cubic yard at plant.
X
COMPRESSION TEST RESULTS
(ASTM C39, C1231, and C617 when applicable)
Date Made Sample # Lab # Date Tested Age Size (in) Load (lbs) Dia (in) Surface Strength (psi) Failure Code } Z
12/15/05 0001 21123 12/22/05 4 x 8 36980 3.98 12.44 2970 NA
12/15/05 000121124 01/12/06 28 6 x 12 0.00 0.00 NA o
12/15/05 0001 21125 01/12/Q6 28 6 x 12 0.00 .0.00 NA -�
12/15/05 0001 21126 01/12/0628 x 12 6 0.00 0.00 NA n
rn
Remarks _
Inspector(s): VanderPol, R Reviewed by:
Tested by: Revilla, Z. Timothy G, eckerle, P.E.
Branch Manager
1
NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std. a^ ►n�[[ 77�
o&rde
C�fd'NR�=4lt�l t3
NA =Not Applicable, S =Shear, C =Cone, CSp =Cone and Split, CSh =Cone and Shear, Col =Columnar, FC -Field ,
All testing performed in accordance with applicable ASTM's except C-31, 10.1.2 - "recording field temperature DEVELOPMENTS
Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Enginee"q�F SERV Corp:
P PP Y P EDMONDS
MTE Form #150, Roy 3.7.0
MAYES. TESTING ENGINEERS ' INC Everett ! 917 - 134th Street SW i.
Suite A-1
'k�sc;:..'w,. ,.'. Everett WA 98204
ph 425.742.9350
CONCRETE LABORATORY TEST REPORT fax 425.745.1737
Project Name: Kafe Neo Addition Project No: E5492
Site Address: 21108 Hwy 99 South Issued on: 01/10/06
Sample Set ID: 26112
Edmonds, WA
Client: Kafe Neo Permit # (s): 2 Co..)
�C6
Original: [V]
Engineer: Revised: Z
O
Contractor: Webb Construction Services n
M
---- FIELD DATA
ASTM C31 and C172 wn
Air Temperature: 460
F Mix Proportions.
v r=n
Actual M'
CWeather: Rain m
Ingredient Weight (Per cu.Yd)
nProduct: Concrete
Supplier: Rinker ASTM #57 19639.p lbs
Ticket Number: 80030862 ASTM #8 194.0 lbs m Z
- Fine Aggregate 11316.0 lbs
MixDesign ID : 1334262Water 237.0 lbs D Z
i Sample Temp Initial Storage Temp Entrained Air Cement --Type 1 563.0 lbs r_
(ASTM C1064)
In
C31) (ASTM C231)
MRWRA 22.6 oz —
HRWRA 17.0 Oz O m
$2°F NR NR
E A/E Admix 3.4 oz m
Water/Cement Ratio: Slump (ASTM C143) I Samples) Recd:
MM
0.421 5-1/2" 12/31/05 Required Strength (Pc): v CA
.O
i
Placement Location and Notes: 4000 psi @ 28 days C Mca
.
i
Perimeter stem walls for new addition. r Z I .
COMPRESSION TEST RESULTS
(ASTM C39, C1231, and C617 when applicable)
Date Made Sample # Lab # Date Tested Age Size (in) Load (Ibs) Dia (in) Surface Strength (psi) Failure Code E D
12/30/05 0002 0094
EQ1/06/0C 0 4 x 8 57770 3.99 12.50 4620NA y Z
12/30/05 0002 0095 01 /27/06 28
12/30/05 0002 0096E6:1:/:2=706 E28 4 x 8 �� 0.00 0.00 NA
12/30/05 0002 0097 01/27/06 28 4 x 8 C� 0.00 0.00 F`—] NA. � 0
Remarks: m
Inspector(s): VanderPol 11, Reviewed by:
Tested by: Johnson,. S. J. imot y G. Beckerle, P.E.
Branch Manager
RECEIVED
JAN 17 `006
DEVELOPMENT SERVICES CTR.
CITY OF EDMONDS !
NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std.
NA = Not Applicable, S = Shear, C = Cone, CSp = Cone and Split, CSh = Cone and Shear, Cot = Columnar, FC - Field Cure, NR = Not Recorde
All testing performed in accordance with applicable ASTM's except C-31, 10.1.2 "recording field temperature
Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc.
MTE Form 8150, Rev 3, 7-0
MAYES Everett
ENGINEER, INC 917.1341h Street SW
Suite A-1
tT Everett WA 98204
ph 425.742.9360
fax 425.745.1737
CONCRETE LABORATORY TEST REPORT
Project Name: Kafe Neo Addition Project No: E5492
Site Address: 21108 Hwy 99 South Issued on: 04120/06
Sample Set ID: 27329
Edmonds, WA
Client: Kafe Neo Permit # (s): 2005-0640
Original: QQ
Engineer' Revised: Z
Contractor: Webb Construction Services m
FIELD DATA
ASTM C31 and C172 -i mn
Air Temperature: 54°F N M
Actual Mix Proportions: v rtt
Weather: Overcast m 0
Product: Concrete Ingredient Weight (per cu.yd) n
Supplier: Rinker Coarse Aggregate 1,658.0 Ibis
Coarse Aggregate Ticket Number: 80044127 CAreate 1980 lbs m
Fine Aggregate 1,211.0 lbs f0
MixDesign ID : 1334266Water 244.0 lbs y z
Sample Temp. Initial Storage Temp. Entrained Air Fly. Ash 9400 lbs _
l (ASTM C1064) (ASTM C4: (ASTM C231)
Cement --Type I & II 519.0 lbs
64°F NR 2,5% WRA 2098 oz O 71
4 Water/Cement Ratio: Slump (ASTM C143) Sample(s) Recd: 'pf
A/E Admix 290 oz
jm
0.398 5" 04/12/06 Required Strength (f c):v0 ca
Placement Location and Notes: 2500 psi @ 28 days OC C4
M
Set 1 11 gallons water added at site. New inside slab on the North side, m n
COMPRESSION TEST RESULTS
(ASTM C39, C1231, and C617 when applicable)
Date Made Sample # Lab # Date Tested • Age Size (in) ' Load (Ibs) Dia (in) Surface Strength (psi) Failure Code
04/11 /06 0004 5502 04/18/06 � 4 x 8 64320 4.01 12.63 5090 NA
05/09/06 28 4 x 8' 0.00
04/11 /06 0004 5503 [� � C� � C�
04/11/06 0004. 5504 05/09/06 F278 F 4 x 8
04/11/06 0004 5505 05/09/06 28 4 x 8� 0.00 0.00 NA O
Remarks: m
—�--
Inspector(s): Evans, D. Reviewed by/: _
Tested by: Brooks, M. / y G. Beckerle, P.E.
Branch Manager
i
NOTES: Failure descriptions for samples tested with neoprene pads are not required per ASTM Std. '
NA = Not Applicable, S = Shear, C = Cone, CSp = Cone and Split, CSh = Cone and Shear, Col = Columnar, FC - Field Cure, NR = Not Records
All testing performed in accordance with applicable ASTM's except C-31, 10.1 .2 -"recording field temperature
Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc.
MTE Form #150, Rev 3.7-0
MAYES / /9 917 Everett
TESTING ENGINEERS ®NV - 134th Street SW
Suite A-1
Everett WA 98204
ph 425.742.9360
fax 425.745.1737
CONCRETE LABORATORY TEST REPORT
Project Name: Kafe Neo Addition Project No: E5492
Site Address: 21108 Hwy 99 South Issued on: 05/10106
Sample Set ID: 27329
Edmonds, WA
Client: Kafe Neo Permit # (s): 2005-0640
Original: rV
Engineer. Z
Revised: C� O
Contractor: Webb Construction Services
-- — — - n
FIELD DATA -- m
ASTM C31 and C172
Air Temperature: 54°F co
Actual Mix Proportions: C m
Weather: Overcast p
Product: Concrete Ingredient Weight per cu.yd) M0
Supplier: Rinker Coarse Aggregate 1,658.0 lbs c
Coarse Aggregate 198.0 lbs 2 m
Ticket Number 80044127 m
Fine Aggregate 11211.0 lbs
10 Wall P
MixDesign ID: 1334266 Water 244.0 lbs
aZ
i Sample Temp. Initial Storage Temp. Entrained Air Fly Ash 94.0 lbs �–
(ASTM C1064) (ASTM C31) (ASTM C231) Cement --Type I & II 519.0 lbs
i 2.5% W RA 20.8 oz
OM.
I
640F NR
A/E Admix 2.0 oz C
'Water/Cement Ratio: i Slump (ASTM C143)' Sample(s) Recd
M�
mm
0.398 1 5° 04/12/06 Required Strength (f'c): 0co
Placement Location and Notes: I 2500 psi @ 28 days C
Set 1 11 gallons water added at site. New inside slab on the. North side. m 0
n
j COMPRESSION TEST RESULTS
! (ASTM C39, C1231, and C617 when applicable)
Date Made Sample # Lab # bate Tested Age Size (in) Load (lbs) Dia (in) Surface Strength (psi) Failure Code t
04/11 /06 0004 5502 04/18/06 [ 7 ] 4 x 8� 64320 [-4.01 12.63 5090 NA
. > Z
04/11/060004 5503 05/09/06 28 4 x 8 79770 4=0 12.57 =350 NA
04/11/06 0004 5504F 05/09/06 F1281E4 x 8 85900 4.01 12.63 6800 NA Cn
Z
Z
04/1.1/06 0004 5505 05/09/06 28 4 x 8 82290 4.01 012.63 6520 NA
0
Remarks: n
Inspector(s): Evans, D.
Reviewed by: _.L-L—f%v_ m
IL
Tested by: Fernelius, C.
Timothy G. Beckerle, P.E. l
Branch Manager
00
'VII y
DEVELO +r
Pi,crv'7'>rrn"LICE-1
CITY ai:,, cr^
NOTES: Failure descriptions for samples tested with neoprene pads are not required per. ASTM Std. utt ,Ito;; ^ .
"recording field temperature
.71
All testing performed in accordance with applicable ASTM's except C-31, 10.1.2 - reco g p
Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc.
MTE Form #150. Ray 3, 7.0
aTaL1TiY i Y• i Lim• -1 ,-
FROM: C-�--- - FIRE DEPARTMENT DATE
ENGINEERING DIVISION DATE z
PLEASE slaty
0
PLANNING DIVISION. DATE n
M
PLEASE slaty
PROJECT
C�
q vm
SITE ADDRESS �D�' i ! M p
on
PERMIT ^ ioc `f P ADB# DATE INSPECTED 7 Z _
M
DESCRIPTION OF.WORK TO BE INSPECTED
T Dz
r -I
A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to. the release of p mn
PERFORMANCE BONDS and the granting of
MM
v 0,
GRANT FINAL PROJECT APPROVAL o
rk W
Q
zn
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED D
z
o Copy of CONDITIONS given to owner/contractor by inspector --�
co
1. z i
FAILED FINAL INSPECTION - OUTSTANDING ISSUES m I
o Copy of CORRECTION NOTICE given to owner/contractor by inspector.
1.. •
2.
3. .
-- — �TTr"INrTAXTTITTkT/"r TOOTTL'Q /113 AATTrnJAT 1D112nT1PrT APPRnVAT, d
. - -'--- --
�^--^••• �• rvvv VV1V VI rvvv-VI V1
Occupancy established by this certificate:
Dwelling Units: N/A
A2&S1
Type .C,gnstruction: VB
Basement: N/A
t
. - -'--- --
�^--^••• �• rvvv VV1V VI rvvv-VI V1
Occupancy established by this certificate:
Dwelling Units: N/A
A2&S1
Type .C,gnstruction: VB
Basement: N/A
I
Maximum Occupant Load,% 8Z injidj 6`12 outside (Per IBC 1004)
Room capacity signs, when:regalred, Vfiwst, remain posted at all times.
Owner of Building: Kafe Neo Address; 211'08 Fit"Iiwav-99
THE Kafe Neo HAS BEEN INSPECTED AND APPROVED AS CCWPL"•YING,°WITH'THE REQUIREMENTS OF THE 2003 EDITION OF
THE INTERNATIONAL BUILDING CODE AS ADOPTED`BY THE CITY FOR THEbROUPD DIVISION OF OCCUPANCY AND THE USE FOR WHICH
THE PROPOSED OCCUPANCY IS CLASSIFIED.
Issued this 8TH day -,.o f March 2007
CHIEF LDING OFFICIAL
BY:
This certificate shall be posted In a conspicuous public area and shall not be removed, mutilated or obscured and shall be mtalned in legible condition at all times. Any change of occupancy or use requires a building permit and a new
certificate of occupancy Issued by the City of Edmonds Building Official,
o111r1� .1W�1. � �1(►li. � 'Opso Yri' :• •�' :1U1l� �!i .1111lJ .YPl. �G �11�i �111�i U11UJ .1�i :00,
` f �►i �1W1� 4Wri • 0:0M3VlJ ; s�11V�i::�11Y�T '�1y►j •�j s� ::z0% •
(00
r��� •
i