20060291.pdfDATE RECEIVED
CITY OF EDMONDS
CONSTRUCTION PERMIT APPLICATION
MAILING ADDRESS
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CITY
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NAME
ADDRESS
11 NEW
ZIP TELEPHONE
[PERMITEXPIRES
NUMBER
.IUB ' SUITE APTa
ADDRESS C"�'
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PLAT NAME, SUBDIVISION NO, LOT NO. IL, LID NO.
LID FEE 5
PUBLIC RIGHT OF WAY.PER OFFICIAL STREET MAP TLSCI1 APpm+ea ❑
FW Perma Regalred ❑
Street Uso Perms negmred ❑
EXISTING _ ""_ PROPOSED ___ _ -- inspection Rooulrea ❑
Sotlenaik Required ❑
REQUIRED DEDICAT ION _ FT _ _ Unaoigrowd ❑
Wirinri renwrea ❑
ME1ER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
YES 0 NO ❑
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REMARKS z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
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61 DATE
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EPH NE PUBLIC WORKS REVIEWED BY
7 r7 �ql Z:2V r FIRE REVIEWED BY DATELu
rq EXPIR TION TE hu
VARIANCE OR CU SHORELINE OR ADBq INSPECTION SEPA
J T AR EL �. O REO'D COMPLETED EXEMPT0 YES 13 No
CA# ZONE SIGN AREA HEIGHT
❑ RESIDENTIAL • PLUIdBIN / MECH [3WAIVER ALLOWED PROPOSED ALLOWED PROPOSED
COMMERCIAL COMPLIANCE OR ❑STUDY
❑ CHANGE OF USE LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.)
MIXED USE ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR
❑ MULTIFAMILY ❑ SIGN
❑ GRADING 13 FENCE X FT.)
CYDS IJ PARKING LOT AREA PLANNING REVIEWED BY DATE
REO'D PROVIDED
❑ TANK ❑ OTHER I
RETAINING WALL FIRE SPRINKLER REMARKS
❑ ROCKERY ❑ FIRE ALARM
LESS O VI Y) E
NUMBER OF
j DWELLING TYVtfftp CTION �ft£i OCCUPANT
UNITS GROUP
DESCRIBE WORK TO BE DONE OCCUPANT
SPECIAL INSP CTION CONSULTANT LOAD
7 REQUIRED 0 YES
ry REMARKS
GEOTECH REPORT
BY:
STRUCTURAL DESIGN
BY*
AA1) 12 ad
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11 /fig
$VALUATION
11 DescriptioniFEETDescription FEE
Plan Chockrcharge
HEAT SOURCE LOT SLOPE°o VESTED DTEBuilding Permit harge
PLAN CHECK NO:
Plumbing Base Fee
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO Mechanical
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC,) WILL REQUIRE Grading
.j SEPARATE PERMISSION,
wPERMIT APPLICATION: SEE ECDC 19.00,005(A)(5) Engr• Review Recording Fee
a PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection Plan Chic. Deposit
w•APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Receipt #
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF. Fire Review p
f EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
a ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY Fire Inspection Total Amt. Due
= 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 Receipt #
s
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Landscape Insp. p
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIOQH
INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULZED AGENT OF CALL This application is not a permit until signed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWSG CONSTRUC• FOR INSPECTION Building 011iaal or hrslher Deputy and Fees are paid. and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PEBE EMPLOYED receipt Is acknowl ged rn space providetl
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WARELATING TO O 1 SIG A UREATEWORK EN'S COMPENSA N INSURANCE AND RCW 18:27.(425)
SIGN 44 U WNE AGEN D 771 =02ryol�U L RELEA D Y DA
EXT. 1333
ATTENTION
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
6/05 PRESS HARD = YOU ARE MAKING 4 COPIES
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❑ ADDITION
❑ REMODEL
❑ REPAIR
❑ DEMOLISH
GARAGE
❑
CARPORT
z
fo
(TYPE OF USE, E
U
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,NUMBER
OF
p
STORIES
ZIP TELEPHONE
[PERMITEXPIRES
NUMBER
.IUB ' SUITE APTa
ADDRESS C"�'
v (
PLAT NAME, SUBDIVISION NO, LOT NO. IL, LID NO.
LID FEE 5
PUBLIC RIGHT OF WAY.PER OFFICIAL STREET MAP TLSCI1 APpm+ea ❑
FW Perma Regalred ❑
Street Uso Perms negmred ❑
EXISTING _ ""_ PROPOSED ___ _ -- inspection Rooulrea ❑
Sotlenaik Required ❑
REQUIRED DEDICAT ION _ FT _ _ Unaoigrowd ❑
Wirinri renwrea ❑
ME1ER SIZE LINE SIZE NO. OF FIXTURES PRV REQUIRED
YES 0 NO ❑
L7
REMARKS z
OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROUDRAINAGE
w
w
z
c�
z
W
• • HCG70LC riCvrCWVCU o,
61 DATE
ZI q
EPH NE PUBLIC WORKS REVIEWED BY
7 r7 �ql Z:2V r FIRE REVIEWED BY DATELu
rq EXPIR TION TE hu
VARIANCE OR CU SHORELINE OR ADBq INSPECTION SEPA
J T AR EL �. O REO'D COMPLETED EXEMPT0 YES 13 No
CA# ZONE SIGN AREA HEIGHT
❑ RESIDENTIAL • PLUIdBIN / MECH [3WAIVER ALLOWED PROPOSED ALLOWED PROPOSED
COMMERCIAL COMPLIANCE OR ❑STUDY
❑ CHANGE OF USE LOT COVERAGE REQUIRED SETBACKS (FT) PROPOSED SETBACKS (FT.)
MIXED USE ALLOWED PROPOSED FRONT SIDE REAR FRONT UR SIDE REAR
❑ MULTIFAMILY ❑ SIGN
❑ GRADING 13 FENCE X FT.)
CYDS IJ PARKING LOT AREA PLANNING REVIEWED BY DATE
REO'D PROVIDED
❑ TANK ❑ OTHER I
RETAINING WALL FIRE SPRINKLER REMARKS
❑ ROCKERY ❑ FIRE ALARM
LESS O VI Y) E
NUMBER OF
j DWELLING TYVtfftp CTION �ft£i OCCUPANT
UNITS GROUP
DESCRIBE WORK TO BE DONE OCCUPANT
SPECIAL INSP CTION CONSULTANT LOAD
7 REQUIRED 0 YES
ry REMARKS
GEOTECH REPORT
BY:
STRUCTURAL DESIGN
BY*
AA1) 12 ad
J7 r
11 /fig
$VALUATION
11 DescriptioniFEETDescription FEE
Plan Chockrcharge
HEAT SOURCE LOT SLOPE°o VESTED DTEBuilding Permit harge
PLAN CHECK NO:
Plumbing Base Fee
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO Mechanical
t BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC,) WILL REQUIRE Grading
.j SEPARATE PERMISSION,
wPERMIT APPLICATION: SEE ECDC 19.00,005(A)(5) Engr• Review Recording Fee
a PERMIT LIMIT: SEE ECDC 19.00.005(A)(6)
SEE BACK OF PINK PERMIT FOR MORE INFORMATION Engr. Inspection Plan Chic. Deposit
w•APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSORS Receipt #
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF. Fire Review p
f EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
a ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY Fire Inspection Total Amt. Due
= 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 Receipt #
s
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.* Landscape Insp. p
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIOQH
INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT; AND THAT I AM THE OWNER, OR THE DULZED AGENT OF CALL This application is not a permit until signed by the
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWSG CONSTRUC• FOR INSPECTION Building 011iaal or hrslher Deputy and Fees are paid. and
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PEBE EMPLOYED receipt Is acknowl ged rn space providetl
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WARELATING TO O 1 SIG A UREATEWORK EN'S COMPENSA N INSURANCE AND RCW 18:27.(425)
SIGN 44 U WNE AGEN D 771 =02ryol�U L RELEA D Y DA
EXT. 1333
ATTENTION
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
6/05 PRESS HARD = YOU ARE MAKING 4 COPIES
O
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0 .
IT!
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Facility Name:
Address: �� w G 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. - z
• Dishwashers are not allowed to be connected to a Grease Trap.
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• Food disposers are not allowed in a facility served by a Grease Trap and must be disabled or m
removed. Solids must be screened out and placed in the solid waste container.
Snook A
s Number of Fixtures Connected to a Grease Trap 23 4
Grease Trap Size in m 0 25 4 35 50
wr
Fixture
Capacity
in Cubic
Fixture Capacity
Drainage Load
Flow
Rate for
Inches
in Gallons
(75%of Total
a 2 -Minute
L x W
x D x no.
of sinks
Cu. In. _ 231
f
Capacity)
s Number of Fixtures Connected to a Grease Trap 23 4
Grease Trap Size in m 0 25 4 35 50
wr
Fixture
Capacity
in Cubic
Fixture Capacity
Drainage Load
Flow
Rate for
Inches
in Gallons
(75%of Total
a 2 -Minute
L x W
x D x no.
of sinks
Cu. In. _ 231
Capacity)
Drain
Period
#1x
x
1'1. x =
c.i:
-
231= O al.
x
.75 = jX.
al.
- 2 =
(.1, m
#2
x x
x =
colo
=
231 = al.
x
.75 =
al.
- 2 =
m
#3
x x
x
colo
=
231 = al.
x
.75 =
al.
= 2 =
m
#4
x x
x =
c.i.
-
231 gal.
I x
.75
gal.
- 2
gpin
Grease
Trap #1 — Total
drainage flows
from maximum
of 4
fixtures
I
• I gpm '
#1
x x
x =
c.i.
-
231 gal.
x
.75
gal.
- 2
gpm.
#2
x x
x =
colo
—
231 gal.
x
.75
gal.
— 2
gpm
#3 .
x x
x _
colo
—
231 — al.
x
.75 =
aL
— 2 _
m
#4
x x
x =
c.i.
=
231 gal.
x
.75
gal.
_ 2
gpm
Grease
Trap #2 - Total
drainage flows
from maximum
of 4
fixtures
gpm
MINIMUM SIZE OF GREASE TRAPS) REQUIREDgpm
s Number of Fixtures Connected to a Grease Trap 23 4
Grease Trap Size in m 0 25 4 35 50
wr