20050753.pdfIDATE RECEIVED
CITE( OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
OWNER NAMEINA6IE OF BUSINESS
MAILING ADDRESSi_Tj
112 l oA r Ave, NF,
CITY ZIP L;705
HONE
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NAME
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ADDRESS
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CITY ZIP TELEPHONE
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NAME CBL#
ADDRESS
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J PERMIT EXPIRES
PERMIT
NUMBER
JOB SUITE/APT#
2AD RESS
Z i�'I' 11 w c1
PLAT NAME/SUBDIVISION N0. LO D. LID NO.
LID FEE $
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP TESCP Approved D
RW Permit Required 0
EXISTING PROPOSED Street Use Pormit Required D
Inspection Required D
Sidewalk Required D
REQUIRED DEDICATION FT Underground D
Wiring required 0
METER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
YES 13 NO O F
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W
REMARKS W
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE
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A
F ER=OED Y DATE
CITY ZIP TELEPHONE ll a
STAIE LICENSE NUMBER EXPIRATION DATE BY V LANCE OR C I SHO ELINE OR ADB# INSPECTION SEPAWWI
04 EQ'D
. COMPLETED EXELt T
YES NO m
PROPERTY TAX ACCOUNT PARCEL NO. CA#, ZONE SIGN AREA HEIGHT
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//--��,, ' L VIAIVER ALLOWED PROPOSED ALLOWED PROPOSED _
W Q"T O I STUDY O �G - 2� f. �' •-� 7�
❑ NEW ❑ RESIDENTIAL PLUMBING I MECH LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR
❑ADDITION COMMERCIAL COMPLIANCE OR
❑ MIXED USE ❑ CHANGE OF USE
PARKING LOT AREA PLANNING REVIEWED BY DATE g
REMODEL ❑ MULTIFAMILY ❑ SIGN REQ'D PROVIDED lit L� a
❑GRADING ❑ FENCE N
REPAIR 1:1CYDS ( X FT.) REMARKS
❑ DEMOLISH ❑ TANK ❑ OTHER
GARAGE y ❑ CARPORT ❑ ROCKERY RETAINING WALL FIRE ❑ FIREALARM LER
(TYPE OF USE, BUSINESS OR ACTIVITY) EXPLAIN:
% TYPE OF CONSTRUCTION CODE OCCUPANT
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CNUMBER + NUMBER OF ,/ rlh_•�"_ �•` •C
m OF I 1 DWELLING (Jj SPECIAL INSPECTION CONSULTANT OCCUPANT
O STORIES UNITS J� REQUIRED YES LOAD
DESCRIBE WORK TO BE DONEA
N e? nt''tA) e (YEN 1J ►� REMARKS t9
y
rri n GEOTECH REPORT
BY:
STRUCTURAL DESIGN C oG
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Ap
BY:. : -+U�So is
I n- l ti' n 51 �w VALUATION
1 i l S ( $ '57
.-f vp/)/rl� • Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE LOT SLOPE% VESTED DATE
Building Permit C City Surcharge
PLAN CHECK NO: 2 Plumbing Base Fee�� f
1 Mechanical - -
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO ff 1141Mr—
t BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBIC / .�w,�
f DONMAIN (CURBS, SIDEWALKS, DRIVEWAYS; MARQUEES, ETC.) WILL REQUIRE Grading /�y�
s
SEPARATE PERMISSION, Engr. Review
W PERMIT APPLICATION: SEE ECDC 19.00.005(A)(5)
IL PERMIT LIMIT: SEE ECDC 19,00.005(A)(6) Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
w *APPLICANT,, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Fire Review Plan Chk, Deposit
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF _
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Inspection �7 Receipt #�
a ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
_ FROM THE ISSUANCE OF THIS PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE �f
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE Landscape Insp. Total Amt. Due G N
= NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.•
Recording Fee Receipt #
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 permit until signed by the
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 CALL Building Oficial or hislher Deputy: and Fees are paid, and
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR INSPECTION receipt is acknowledged in space provided.
WORKMEN'S COMPENSATIN RANCE AND RCW 18;27,
ICI IG RE � DAT
K_WGNATURE(OWNER OR GENT r
"DATE SIGNED (425
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Ii� S 6 771 -0220 ELEASED BY AATF
ATTENTION EXT. 1333
-
ITIS 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 I IRC110. PINK -OWNER GOLD - ASSESSOR
10/04 PRESS HARD - YOU ARE MAKING 4 COPIES
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MEMORANDUM to FILE
Date: September 1, 2005
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To: Safeway Remodel File
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From: Jeannine L. Graf, Building Officiak%�
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Subject Safeway Underground Plumbing Permit o rn
23632 Highway 99''Mo.
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The Building Official met with Safeway officials today regarding the underground plumbing m z ?;
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work at the referenced Safeway project. c —
Background
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When the original remodeling permit was received on July 8, 2005 the architect of record was O`m
informed that if he chose to defer any portion of the project possible delays may occur. The 1.
h'••
j architect was told each deferral requires a separate permit and review time. The architect chose m m 11
to defer plumbing, refrigeration piping (permit issued #2005=0772), mechanical including Type II 0
hoods, hood suppression system, signs, parking lot restriping; and fire sprinkler alteration. c N
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Problem Z
The remodeling permit was issued on August 25`h, with work commencing immediately. When
the architect 'informed the building owner of the plumbing submittal plan requirements, the
building owner was informed by Hargis Engineering that plans cannot be prepared in a timely
manner (although the City offered to expedite the review once the plans were received) this was
not acceptable to Safeway. Field work is virtually stopped due to the necessity of obtaining the
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plumbing permit. zz
Resolution 0
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As Building Official for. the City of Edmonds I have decided to allow the following:
• The City shallissue a plumbing permit over the counter to the licensed plumber of record
on the project
• Hargis Engineering shall perform special inspection of the underground plumbing work
and shall submit all inspection reports to the City for this work before rough-in.plumbing
approval shall be granted
• all submit an as -built underground plumbing plan before final
Hargis Engineering sh}
rough -in plumbing approval shall be granted l .;
• The City Inspector shall inspect all rough -in plumbing work
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j City of Edmonds cza Development Services Department
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Job Number: 05-654 Report Number: 23441 Permit Number:. 2005-0753.
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Project: ' Safeway Store #1297 Client: Safeway, Inc.
Address: 23632 Highway 99, Edmonds Address: PO Box 85001, Bellevue A"
Date: 9/16/2005 Technician: Douglas Graham, Level II
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(Weld Location and IdenITEM INSPECTED on
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Performed Inspection at All Metal Fabricators T
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L, W14 x 22 to W14 x 22, 2 welds 52 X m v
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1AR, W14 x 22 to W14 x 22, 2 welds 52 X o c
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2AL, W24 x 86 to W14 x 53, 1 weld, top 37ange 52 +2 3 Y '/e' '/e 0 LOF X m Z
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2AL, W24 x 86 to W14 x 53, 1 weld, top fl52 PXange, y z
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2AL, W24 x 68 to. W14 x 53, bottom flange, 1
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2AR, W24 x 68 to W14 x 53,2 welds 52 X n m
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Governing Code: 0 AWS D1.1 [ I Other Instrument Mfg.: Krautkramer
Procedure No.: ® NDT-OP-03-01 [ ] Other Model #: USN50L Serial #: OOHTDHIORA 6012
Transducer Mfg.: Krautkramer
Deg, Size Frequency
Serial #:
Single/ Dual ZStraight 0 1.00 s/n OOK18F 2.25 Mhz. Z
® Shear 70 .625 x '.75 sln OODDB1 2.25 Mhz. "I
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Calibration Block Type: ® IIW I] DSC Couplant Type: ® Water Based I] Oil Based ❑ Other . M
This form is applicable to Statically and Cyclically Loaded Nondubular Structures.
Co ies to:.
X
Client
I Contractor
Architect
X
Building Dept.
X
Engineer
Technical Responsibility: _
alt C. ansen, Project Manager
Job Number: Permit Number,
Project: 1 eU�j�'� C- is 'r' Z Client: .�.N^ 64
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Address: 7 Address:
Date: -1- "-yT Inspector: i �� Ca✓,yc�£/�—
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:Ins ection Performa Please Chac all Ihat /k I Too
Reinforcing Steel Installation of Holdown System Structural Steel Fabrication, Z
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Anchor Bolt Installation Seismic Tie Installation Structural Steel Erection 4111111111
Epoxy-Grouted Anchor Bolts Lateral Wood Steel Decking rn ,
Epoxy Grouting (Rebar) Spray-Applied Fireproofing Other (specify)
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Refence Standatrds Used; Go , nforino : : D`• n
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i is this a re-inspection? ( yes 1 no )
Original inspection date:
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Inspected b �j ;' !n� Reviewed by:
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Start Time: _ Finish Time:
(1 This reporl applies only to the Items tested or reported and is the exclusive property of Otlo Rosenau & Associates, Inc. Reproduction of this report,
except in full, without written permission from our firm Is strictly prohibited.
Page i _ of
6747 M•L. King Way Sr, Seattle, Washington 98118 - Phone (206) 725.4600 or 1.888.OTTO-4-US — Fax (206) 723-7.221
Form No.. INSP•6.3-02 (Rov 05/04)
Sep 23 05 09:12a p.4
5tr-1� 16057206 448 4450 P.0Zi03
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ON -SITE OBSERVATION REPORT {
To: Elite Comm. Contra OSO No.: 1 By: Andy Zissermann 1
Attention: Ty Dennis Date: September 7. 2005
Project No. 05462 Weather: Fair b 63° F.
On Site Observation Relative To: Under slab piping inspection
Contractors: Elite Commercial Contractors — General, Contractor's Plumbing Service Inc: - Plumbing
WSlrk•I•• M�Daress _ Z .
1.01 Men's Restroom at storefront some Under slab waste piping has been laid out for water closet.
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urinal, lavatory, and floor drain. Under slab water piping has been laid out for the trap primer to
the floor drain. Piping installed per plan and with appropriate slope. All pipe openings have been _
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temporarily capped to prevent construction debris from entering the system, Piping is being tied
into existing 3" waste line at storefront,
1.02 Women's Restroom at storefront - Under slab waste plping has been laid out for tow (2) water C M
l closets, lavatory, and floor drain. Under slab water piping has been bid out for the trap primer to 171 "
the floor drain. Piping Installed per plan and with appropriate slope. All pipe openings have been C)
temporarily capped to prevent construction debris from entering the system. Waste piping has C
been told in 4" bed of compacted sand.. Piping Is being tied into existing 3" waste line at = 1�t1
1 storefront. m
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1.03 Starbucks Kiosk — Under slab.waste piping hes been laid out for two (2) floor sinks per plan, and D .Z
with appropriate slope. Under slab water piping hes been laid out to serve Kiosk from overhead.
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All pipe openings have boon'temporarlly capped to prevent construction debris from entering the
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system. Piping is being tied into existing 3" waste line at storefront.
1,04 Deli •- Under slab waste piping has been laid out for two (2) hand sinks and floor sink. Piping I
installed per plan and with appropriate elope. All pipe openings have been temporarily capped to
prevent construction debris from entering the system: The hand sink piping is tied into existingm M
3' grease waste line at deli, and floor sink piping is tied into existing 3" waste at dell. O N
Nen-Coniormino Work C m I
11' _ _
I 1.05 All waste piping except in Women's Restroom at storefront sum, Remove all rock points and t i.z
construction. debris, and provide 4" bed of compacted sand before covering with new slab, per
specification. H.A R G 1 S ; ;asof sawn SIMI L
gatinn•raa.00n s a. Iwo
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Sep 23 05 09:1 3a p o,7
40b.44t7'HHwJ
SEP -15-2605 22*01 ;
pN -SITE OBSERVATION REPORT
And Zissermann
To: Elite Comm. Contr. OSO No.: 2 6Y: Y .
Attention: TY Dennis
Date; September 13, 2005
Weather; Fair & 60" F.
Proiect No. 05#2 Z
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On•Site Observation Relative To: Under slab piping ins action
Contractors: Elite Commercial Contractors
-General, Contractor's Plumbing Service. Inc. -Plumbing n
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.1,01 Bakery - Under slab waste piping has been laid out for 12' over/ cake case and cake table m p
j case drains. Piping installed per plan and with approprbte slope. All pipe openings have been O
t ed to prevent construction debris from entering the system. Vent piping has C
temporarily capped M
been routed to above ceiling at well along grid G/16, Waste piping is being tied Into existing 4" M Z
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CM line at grid 15.8. D Z
1.02
Most -Under slab waste piping has been laid. out for relocated 3 -comp. sink & hand sink. Piping r
installed per plan and with appropriate slope. All pipe openings have been temporarily capped to -1 I.:
r v t construction debris from entering the system., Piping is being tied into existing 3' { N
peen.
rtment. y� I`
grease waste line serving meet dopa
1.03 Fish -Under slab waste piping has been laid out for floor sink and hand sink per plan, and with
appropriate slope. All pipe openings have been temporarily capped to prevent construction to nn
debris from entering the system. Piping Is being tied into existing 3" grease waste lino at new
ON
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iish department. N
floor
,1.04 Deli - Above slab waste/vent piping has been installed for three (3) hand sinks and two (2) i M o
sinks in well. Vent piping has been tied into existing vent, piping above calling: Domestic hot &
cold water piping has been installed in well with stops installed. All pipe openings have been
temporarily capped to prevent constriction debris from entering the system. i
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�lorrconforrnina Work 1
1.05 All waste piping - Remove all rock points and construction debris, and provide 4" bed of
compacted sand before covering with new slab, per specification. O
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nues1ions/Resoor4 H A R a 1. S
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1.06 Discussed with contractor plans for further plping to be.laid out in the remodeled floral S„i„000
department.
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