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CITY OF EDMONDS
wiso
STATUS: ISSUED 10/24/2011
Expiration Date: 10/24/2012
Parcel No: 00491100001302
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
Permit #:'BLD20110858
BUILDING IIERMIT
Project Address: 7929 LAKE BALLINGER WAY SW,
EDMONDS
PANERA, LLC RELIANCE FIRE PROTECTION INC RELIANCE FIRE PROTECTION INC
LLC SUZAN P 0 Box 428 P 0 Box 428
4025 196TH ST SW Preston, WA 98050 Preston, WA 98050
LYNNWOOD, WA 98036
(206)682-6636 (206)682-6636
LICENSE #: RELIAFP102LI EXP:7/12/2013
'
FIRE CONNECTION PERMIT.
VALUATION: $0.00 COMP.LLTED
PERMIT TYPE: Commercial
PERMIT GROUP: 56 - Fire Connection
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY: N
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: N 0 X 0 FT.)
CODE:
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
3RD FLOOR 0 GARAGE 0 DECK- 0 OTHER: 0
SETBACK
REQUIRED: PROPOSED: I REQUIRED: PROPOSED: RE UIRED: PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O I REQUIRED: PROPOSED:
SETBACK NOTES:
1 AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY, NO
PERSON WILL BE EMPLOYED M VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S
COMPENSATION INSURANCE AND RCW 18:27.
THIS APPJ,1QAJIOIJ IA NOT A PERMIT UNTIL SIGNED BY THE BUILING OFFICIAL OR HIS/HER DEPUT ND AL ES ARE PAID.
l0 -2
nat re'Print Name Date Released Br 1v Date
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. UBC109/ IBC110/ IRC110.
ONLINE APPLICANT ASSESSOR OTHER
STATUS: ISSUED
BLD20110858
• 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 for 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.
• E -Cross Connection Final
• E -Engineering Final
• F -Fire Connection Installation
• F -Fire Connection Thrust Blocking
• F -Fire Connection Pressure Test
• F -Fire Final
.�°F E°Mo Inspection
Comments
BLD20110858
56 - Fire Connection
.
Applied: =10/12/2011
Issued: 10/24/2011
Expires:
10/24/2012
Address: 7929 LAKE
BALLINGER WAY SW, EDMONDS
INSPECTION
DATE
INSPECTOR
ACTION
_
1076 - E -Cross Connection Final
12/14/2011
MCMURPHY
CMP
Comment: ok
1077 - E -Engineering Final
12/15/2011
ZULAUF
CMP
Comment: ok to final
1905 - F -Fire Connection Installation
11/17/2011
SMITHM
CMP
Comment: APPROVED
1908 - F -Fire Connection Thrust Blocking
11/17/2011
SMITHM
CMP
Comment: APPROVED
1910 - F -Fire Connection Pressure Test
11/17/2011
SMITHM
CMP
Comment: APPROVED
1985 - F -Fire Final
11/17/201.1
SMITHM
CMP
Comment: APPROVED
12/20/2011 9:39:54 AM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 1 of 1