20060423.pdfPERMIT EXPIRES:#;�j
CITY OF EDMONDS
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THIS PERMITAUTHORIZESONLY THE WORK NOTED, THIS PERMITCOVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
Mechanical
DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
Grading
PERMIT APPLICATIONI SEE ECDC 19.00.005(A)BB
Eng, Review
Recording Fee
PERMIT LIMIT, SEE ECDC 19.00,005(A)(6)
Engr. Inspection
Plan Chk. D.p..11
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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
;APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESSOR
N INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
2 EDMONDS, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
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
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Fire Review
Receipt #
]�&Sd
Fire Inspection
Total Amt. Due
03,
Landscapeinsp,
Receipt #
I HEREBY ACKNOWLEDGE THAT I HAVE REA. THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
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
IN VIOLATION OF THE LABOR CODE OF TH E STATE OF WASHINGTON RELATING TO
FEW I
WORKMEN'S COMPEN 8;27,
CALL
FOR INSPECTION
(425)
APPLICATION APPROVAL
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.771-0220
BY
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-
FICATE OF OCCUPANCY HAS BEEN GRANTED. UBC109 I IBC110 I IRC110.
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F-1 SEATTLEDIVISION
24113 56TH AVE W.
MOUNTLAKE TERRACE, WA 98043
(425) 248-2400 - FAX (4251248-2401
TACOMADWISION
IOD25 SO. TACOMA WAY. SUITE Hi
TACOMA WA 98499
fP�S.11 589�1804 - FAX (253) $89-2136
FR 55262
PORTLAND DIVISIoN
6032 NO� CUTTER CIR. SUITE 480
PORTLAND, OR 97217
(503) 289-1778 - FA� (5D3) 289-1918
CLIENT
PROJECT NO.
712-60041 DATE Me 24,2006
ADDRESS
728 134th Street S.W. Suite #120
PERMIT NO.
____ W.01 -_ 70998
Everett, WA 98204
MUNICIPALITY
Edmonds
ENGINEER
ATTENTION
Mr. Jack Jones
ARCHITECT
Collins - Woerman
P.O. NO.
CONTRACTOR
CBI
PROJECT
Stevens Facie
PROJECT ADDRESS .
21700 HYW 99 Edmonds, WA 98026
M FIELD REPORT
ONSITE TO VERIFY AND INSPECT STRUCTURAL ERECTION, BOLTING AND WELDING OF NEW ENTRY CANOPY.
VERIFIED WABO CERT OF JIM H. DAYALID AND RICHARD L. COLDWELL.
WORK AND REINFORCING STEEL WAS IN ACCORDANCE WITH APPROVED PLANS, SPECIFICATIONS AND AWS DIA TO THE BEST OF MY
KNOWLEDGE.
1UN 9 - 200r,
ENGINT-,�-pjp4e 9
EQUIPMENT IDENTIFICATION AND SINM FILLET GAUGE
COPIES TO:
INSPECTOR: DATE:
EDBAUMAN May24,2006
ITEMS INSPECTED TO
APPROVED PLANS ARE:
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NONCONFORMING rl
CLIENT CONTRACTOR
ENGINEER BUILDING DEPT.
ARCHITECT SUPPLIER
FIELD CON DATE:
NAME ON OFF ST OT MILES
TOTAL HOURS
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PROJECT NO.
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.L19,2
ADDRESS
728 134th Street S.W. Suite #120
PERMIT NO.
W.O. 70940
E�Verett, �A A 982L4
MUNICIPALITY
ENGINEER
ATTENTION
Mr. Jack Jones
ARCHITECT
P.O. NO.
CONTRACTOR
PROJECT
Stevens Radia
PROJECT ADDRESS
21700 HYW 99 Edmonds, WA 98026
SAMPLELD.
SIZE (IN,j
AREA (SQ. IN.)
DATE TESTED
AGE AT
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SAMPLE AND TESTED FIELD SPECIMENS SLUMP SAMPLING AIR TEMP FIREkK NEOCAP OTHER
IN ACCORDANCE WITH; A TM ASTM ASTA ASTM ASTM ASTM ASTM ASTM
C�31 C,1,13 0 C-'72 0 C-231 C3 C.106" 0 C.39 0 C,1231 0
TIME, TEMP. & 11:00 DATE MIXING DESIGN SAMPLE
WEATHER PT. CLOUDY CAST 19-May-06 PLANT RINKER STRENGTH 3000 TYPE CONCRETE
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TYPE OF CEMENT 1 11 CONC. TEMP. 62* SLUMP 4 1- AIR NA % QUANTITY 3 OF 3 CU. Yd.
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POUR LOCATION AND NOTES: DATE RECEIVED:
REINFORCING STEEL WAS CHECKED AND FOUND TO BE IN COMPLIANCE WITH THE PLANS AND SPECIFICATIONS. TOOK A SAMPLE OF CONCRETE
FOR A CONTROL TEST FOR THE CLIENT ABOVE. EVERYTHING WAS IN SPEC. ACCORDING TO THE DESIGN DRAWING,
EQUIPMENT IDENTIFICATION AND SINM
COPIES TO:
INSPECTOR:— DATE.
ITEMS INSPECTED TO
APPROVED PLANS ARE:
CONFORMING
NONCONFORMING
CLIENT CONTRACTOR
ENGINEER BUILDING DEPT.
ARCHITECT P SUPPLIER
FABIAN FERNANDEZ May 19,2006
DATE:
NAME ON OFF ST OT MILE S
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FR 55262
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Engineering Consulting Testing
Ma),9,2007
File No. 712-60041
CITY OF EDMONDS
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Edmonds, WA 98020
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Subject: Project Name Stevens Radin
Project Address 21700 Highway 99
Permit No. 2006-0423
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We have completed the requested special inspections on the subject project. Our last report, dated May 24,2006, is
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bered FR55262. All work requiring special inspection.was, to the best ofthis agency's knowledge, inspected
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and reported as specified on project documents.
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WORK INSPECTED
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Reinforced concrete (cast in place)
Structural steel erection
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Sincerely,
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PROFESSIONAL SERVICE INDUSTRIES, INC.
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Niki Dirk
Project Manager
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RECEIVED
cc: Couslanine Builders
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DEvELopmr-N r SERVICES CTR.
CITY OF EDMONDS
Pfolesslonal Service Indusides, Inc. 24113 561h Avenw West Mountlake Tattoos, WA 98043 Phone: 425i248,2400 - Fax 425t248-240i
Permit Inspection Details
Permit: BLD20060423
PERMITTzX
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Total Time: 26
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05103/2007 Clugston 15 PLANNING SIGNED OFF ON 513107.
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Total Time: 15
Total Inspections: 2
Total Time: 40
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Page I of I
7r—T n
RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
Retaining Wall
Commercial Final
Commercial Final
EXTERIOR SHEATHING
FIRST FLOOR FRAMING
Floor Insulation
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
FINAL APPROVAL FOR
-7
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