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3/2/2020 City of Everett Page <br /> 7:43:25AM <br /> INSPECTION ACTIVITY REPORT <br /> Permit No. P1911-030 Site Address 12902 19TH AVE SE#E <br /> Applied 11/13/2019 Applicant Lot <br /> Approved 11/25/2019 Owner LEE NORTHWEST INVESTMENT INC Block <br /> Issued 11/25/2019 Contractor ROBSON COMPANY INC THE Tract <br /> Parent Permit No. B1910-026 Description PLUMBING OF WATER,WASTE&MEDICAL GAS-DENTAL <br /> Notes <br /> Scheduled Completed Type Inspector Result Remarks Inspector's Comments <br /> 12/3/2019 12/3/2019 PLUMB SDP PARTIAL APPR jason:425-891-2922 <br /> 02-GROUND AM inspection requested <br /> (12/3/2019 2:35 PM SDP) <br /> Vacuum-ok tested at 10 PSI <br /> Insturment Air-ok tested at 30 PSI <br /> waste/vents-ok to cover <br /> 12/4/2019 12/4/2019 PLUMB SDP APPROVAL As noted: jay.425-891-2922 <br /> 02-GROUND <br /> (12/4/2019 2:00 PM SDP) <br /> Nitrous oxide-tested at 150# <br /> Oxygen-tested at 150# <br /> Left an affidavit to record a 24hour test <br /> reading. <br /> AS NOTED:Per NFPA 99 section N <br /> 15.4.5.5 <br /> Remove the crushed rock from the <br /> plumbing and med gas lines and replace <br /> with sand or pea gravel. <br /> Crushed rock can damage pipes. <br /> 12/9/2019 12/9/2019 PLUMB SDP APPROVAL 24hr test see <br /> 02-GROUND attachment <br /> 12/16/2019 12/16/2019 PLUMB SDP PARTIAL APPR (12/16/2019 2:38 PM SDP) <br /> 04-MEDICAL GAS Received the affidavit for the 24 hr testing <br /> of the oxygen and nitrous oxide. <br /> 12/16/2019 12/16/2019 PLUMB SDP APPROVAL Jay:425-891-2922 <br /> 03-ROUGH IN AM inspection requested <br /> 2/25/2020 2/25/2020 PLUMB DXW CORRECTION Jay 425-891-2922 <br /> 04-MEDICAL GAS <br /> (2/25/2020 2:45 PM DXW) <br /> complete all med gas hook ups at each <br /> station. <br /> copy of med gas test results req. <br /> 2/25/2020 2/25/2020 PLUMB 06-FINAL DXW CORRECTION (2/25/2020 2:35 PM DXW) <br /> complete grab bars. <br /> hot water tank relief line to have a 1 in.air <br /> gap. <br /> cap pan drain at tee. <br /> sterilization room sink has no water. <br /> 2/28/2020 2/28/2020 PLUMB 06-FINAL DXW APPRVD-PERN Jay 425-891-2922 <br /> (2/28/2020 11:55 AM DXW) <br /> plbg.final ok. <br /> as noted complete vert.grab bar. <br /> 2/28/2020 2/28/2020 ADMIN USE KLC APPROVAL <br /> ONLY** <br /> 2/28/2020 2/28/2020 PLUMB DXW APPRVD-PERIb <br /> 04-MEDICAL GAS <br /> INSP12 <br /> CRWS TEMS <br />