BLD20110760.pdfSTATUS: ISSUED 9/26/2011
Expiration Date: 3/26/2012
Parcel No: 00451900100401
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
Permit #: BLD20110761
Project'Address: 23632 HIGHWAY 99°#2200,1
EDMONDS
ANGEL PET HOSPITAL - GARY GREGORY SUPREME PLUMBING COMPANY
WA AURORA MARKETPLACE LLC FW 23928 80TH PL W 608 Lake Washington Blvd E
PO BOX 790830 EDMONDS, WA 98026 Seattle, WA 98112
SAN ANTONIO, TX 78279-0830
( ) - EXT: (206) 380-4865 EXT: (206) 730-2947 EXT:
LICENSE #: SUPREPC892KW EXP:5/16/2013
DESCRIPTIONJOB
MED GAS FOR ANIMAL HOSPITAL. 3 OXYGEN OUTLETS T'Elomk
VALUATION: $0.00
COMPLIEm
PERMIT TYPE: Commercial
PERMIT GROUP: 47 - Plumbing
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N 0 X 0 FT.)
CODE: 09
OTHER: N ----- OTHER DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNITS: 0
LOT #:
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
BASEMENT: 0 1 ST FLOOR: 0 2ND FLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER. 0
13RD FLOOR. 0 GARAGE. 0 DECK. 0 OTHER. 0
FRONTSETBACK
ZEQUIRED: PROPOSED:RE UIRED: PROPOSED: I REQUIRED: PROPOSED:
4EIGHT ALLOWED:O PROPOSED:O I REQUIRED: PROPOSED:
iETBACK NOTES:
1 AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION 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 WORKMEN'S
, II COMPENSATION INSURANCE AND RCW 18:27,
IS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDWG OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID.
zc. - l
Print Name
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBCI09/ IBCI10/ IRC 110.
Ll uz ' F \Vi VdY J..6 R
= ONLINE = APPLICANT = ASSESSOR = OTHER
STATUS: ISSUED
BLD20110760
• THIRD PARTY INSPECTIONS ARE REQUIRED FOR VERIFICATION OF THE MED GAS SYSTEM ACCORDING
TO UPC CHAPTER 13
• Final approval on a project or. final occupancy approval must be granted by the Building Official prior to use or occupancy of
the building or structure. Check the job card for all required City inspections including final project approval and final
occupancy inspections.
• Any request f6r alternate design, modification, variance or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Processing
fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable.
• Approval of any plat or plan containing provisions which do not comply with city code and for which a variance has not been
specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision
of city code or state law does not approve any items not to code specification.
• Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays,
excluding Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must
comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
• Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold
harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance for this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance nor limit in any way the City """"s ability to enforce any
ordinance provision.
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT: SEE ECDC 19.00.005(A)(6)
BUILDING (425) 771-0220 EXT. 1333 1 ENGINEERING (425) 771-0220 EXT. 1326 1 FIRE (425) 775-7720 1
PUBLIC WORKS 425) 771-0235 1 PRE-TREATMENT, 425 672-5755 1 RECYCLING 425 275-4801
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection
being requested, Contact Name and Phone Number, Date Prefereed, and whether you prefer morning or afternoon.
• B -Plumb Rough In
• B -Plumbing Final
OV E°M Inspection
Comments
BLD20110760
47 - Plumbing
Applied: 09/13/2011
Issued: 09/26/2011
Expires:
03/26/2012
/"C. I R9Z
Address: 23632. HIGHWAY 99 #2200, EDMONDS
'INSPECTIONDATE
INSPECTOR
ACTION
1126 - B -Plumb Rough In — ^`
09/30/2011
LAWLER
CMP
Comment:
1128 - B -Gas Test/Pipe
09/30/2011
LAWLER
CMP.
Comment: 24 hour test verified @150psi
1152 - B -Plumbing Final
12/20/2011
LAWLER
CMP
Comment:
J
12/21/2011 11:22:25 AM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 1 of 1
of ED-41o��
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
��c, 1890
PHONE: (425) 771-0220 - FAX: (425) 771-0221
Tuesday, September 13, 2011
This Application has been accepted by the City of Edmonds for review. More information and changes may be
required during this process. The review target date is: Tuesday, September 20, 2011
Your City Contact is: MARIE HARRISON
Application Number: BLD20110760
Project Address: 23632 HIGHWAY 99 #2200, EDMONDS
PROP ERTY OWNER APPLICANT
ANGEL PET HOSPITAL - CHRISTOPHER BUTTERLY
WA AURORA MARKETPLACE LLC FW 608 LAKE WASH. BLVD
PO BOX 790830 SEATTLE, WA 98112
SAN ANTONIO, TX 78279-0830 (206) 730-2947 EXT:
( ) - EXT:
Work Description:
OXYGEN PIPE. THREE STUB -OUTS AND ONE MAIN FEED. ALL PIPE WILL BE 3/4 ".
Outstanding Items at Time of Submittal:
I HEREB AC OWLEDGE THAT 1 HAVE READ THIS APPLICATION THAT THE INFORMATION GIVEN IS CORRECT
AND THE PROPERTY OWNER, OR THE DULY AUTHORIZED AGENT OF THE PROPERTY OWNER TO SUBMIT
A BUILDING PERMIT APPLICATION -10 THE CITY. % ,
SIGNATURE (OWNER OR AGENT) PRINT NAME
DATE
To view up to date information about your application please visit the City of Edmonds Development Services
website at http://www.ci.edmonds.wa.us.
STATE OF WASHINGTON
DEPARTMENT OF LABOR AND INDUSTRIES
PO BOX 44470, OLYMPIA WA 98504-4470
September 06, 2011
} CERTIFICATE: GREGOGL970DS
FILE NUMBER: 86-39-22
GARY L GREGORY
23928 80TH PL W
EDMONDS WA 98026
GOOD NEWS! CONGRATULATIONS!!
This is to inform you that you have passed the Washington Medical Gas examination given on 9/1/2011 in
TUMWATER.
Your score was as follows: 91%
To obtain your certificate, please send $77.00 for the certificate fee and a copy of this letter to the Department of
Labor and Industries at the above address. If the payment is not received within 90 days of the examination date
on this letter, you will be required to RETAKE THE EXAMINATION. Your current certificate will expire on,
11/24/2012. Renewal of your certificate is required every two years on your birthday.
Under WAC 296-400-045...
Every person who passed the examination for the Medical Gas certificate of competency, and has paid the
certificate fee, shall be issued a certificate of competency that will expire on his or her birthdate.
You will be sent a renewal notice approximately sixty (60) days prior to the expiration date of your certificate to
the address we have on file. IF YOU DO NOT RECEIVE THE RENEWAL NOTICE, IT IS YOUR
RESPONSIBILITY TO PAY THE RENEWAL FEE ON OR BEFORE THE EXPIRATION DATE. IF THE
RENEWAL FEE IS-NOT--REC-EIV-ED-PRIOR T -O -THE RENEWAL•DA-T-E; Y -OU Vtq-L-L BE-REQUIREE--TO------ --
PAY A DOUBLE FEE. IF YOU DO NOT RENEW WITHIN 90 DAYS OF THE RENEWAL DATE, YOU
WILL BE REQUIRED TO RETAKE THE EXAMINATION.
Sincerely,
r_MTIF1,I;ID AS TRriTV' odi
I:UMBER Jl� WM �t q
CERT`. # tXR: i5A1t -
PL01 GREGOGLWLG ;11%24/2012
EFFECTIVE DATE 01.2001 •
GREGORY, G�RY L '
23928 80TH PL;W
EDMONDS
Signature, -- --- --
t.p�ued by P OP XAPIGR:
/A&:2, `"� United Association
;Gary Gregory
ID #:'1232472 LU #: 0032�°'��'�
' Certificate of Medical Gas Qualification
Certification Expires
ASME IX Brazer 11/19/2011
ASSE 6010 Installer 06/16/2014 RECEIVED
NT RA 99-2006
SEP 13.2011
DEVELOPMENT SERVICES CTR.
CITY OF.EDMONDS