BLD20120162.pdfOF E�
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STATUS: ISSUED 4/9/2012
Expiration Date: 4/9/2013
Parcel No: 00580700002208
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CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
Permit #: BLD20120162,
Project Address_ 21401 72ND AVE_ W, EDMONDS!
PREMIER ORTHOPEDIC GROUP - EDMONDS PATRIOT FIRE PROTECTION INC PATRIOT FIRE PROTECTION INC
MEDICAL 2707 70Th Ave E 2707 70Th Ave E
PO BOX 27165 Tacoma, WA 98424 Tacoma, WA 98424
SEATTLE, 0✓A 98125
(253) 926-2290 (253) 926-2290
LICENSE #: PATRIFP099CF EXP:10/5/2012
NEW FIRE SPRINKLER SYSTEM.
VALUATION: $96,000.00
PERMIT TYPE: Commercial
PERMIT GROUP: 30 - Fire Sprinkler
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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
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
FRONTSETBACK SIDE SETBACK REAR SETBACK
:E UIRED: PROPOSED: I REQUIRED: PROPOSED: I RE UIRED: PROPOSED:
(EIGHT ALLOWED:O PROPOSED:O RE UIRED: PROPOSED:
ETBACK NOTES:
I 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
COMPENSATION INSURANCE AND RCW 18:27.
THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID.
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NJ Signature 71 Print Name Date Released By mate
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/ BCI 10/ IRC 110.
ONLINE APPLICANT ASSESSOR MW OTHER
• 0
STATUS: ISSUED
BLD20120162
• 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 von prefer morning or afternoon.
• F -Fire Connection Installation
• F -Fire Sprinkler Acceptance
°Y°M�v Inspection Comments
V � d
BLD20120162 30 - Fire Sprinkler
Applied: 03/12/2012 Issued: 04/09/2012 Expires: 04/09/2013
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Address: 21401 72ND AVE W, EDMONDS
INSPECTION DATE
INSPECTOR
ACTION
1905 - F -Fire Connection Installation 07/16/2012
SMITHM
PAR
Comment: Valve Cluster, Pipe, Restraints, Thrust Blocks and Bedding Approved
1905 - F -Fire Connection Installation 07/19/2012
SMITHM
CMP
Comment: Hydro and Flush Approved
1930 - F -Fire Sprinkler Acceptance 07/16/2012
SMITHM
PAR
Comment: Hydro, Spacing, Bracing and Head location Approved
1930 - F -Fire Sprinkler Acceptance 12/03/2012
SMITHM
CMP
Comment: System Tested and Accepted
12/7/2012 9:20:13 AM 121 5th Ave, Edmonds Washington - Phone: (425) 771-0220 Page 1 of 1