20020301.pdf0
FPERMIT
EXPIRES
PERMIT
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CITY OF EDMON S s E IZ51_�_ NUMBER
CONSTRUCTION PERMIT APPLICATION JOB SUITE/APT#
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ADDRESS LL)
OWNER NAMENAME OF BUSINESS
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A75DRESS REMARKS
OWNERICONTRACTOR RESPONSIBLE FOR EROSION CONTRO UDRAINAGE
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NAME Ftico ENGINEERING REVIEWEDIDATE
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FIRE REVIEWED BY DATE
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STATE LICENSE NUMBER EXPIRATION DATE VARIANCE R cu SHORELINE OR ADGW INSPECTION P..ND
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PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
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1:1 NEW RESIDENTIAL LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBACKS (FT.)
[3 PLUMBING I MICH ALLOWED FRONT REAR FRONT REAR
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PROPOSED SIDE URSIDE
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0 AD ITION COMMERCIAL COMPLIANCE OR
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CARPORT ROCKERY RENEWAL
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(TYPE OF USE. tUSINESS OR ACHVITY1
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UNITS Eau JAFIEA
NUMBER IT IRE [3 YES LOAD
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DESCRIBE WORK TO BE DONE
REMARKS
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PROGRESS INSPECTIONS PER UBC 11081FINAL INSPECTION REQ'D
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Description FEE Description FEE
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Plan Check
HEAT SOURCE GWINII I
Building
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PLAN CHECK !0'
Plumbing
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED, THIS PERMIT COVERS WORK TO
Mechanical
t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
2
Grading
Recording Fee
3 DOMAIN (CURBS, SIDEWALKS V:PWARYMj MA R 0 U E I* S * ETC.) Vill LL R ED U I A E
SE�XIT IS SSION.
Engr. Review
City Surcharge
PERMIT APPLICATION: IN DAYS
PERMIT LIMM I YEAR -PROVIDED WORK IS STARTED WITHIN ISODAYS
Engr. Inspection
State Surcharge
!EEBACKCFPINK PERMIT FOR MORE INFORMATION
. ...........
'APPLICANT, ON BEHALF 011111 OR HER SPOUSE, ..as. ASSIGNS AN. SUCCES.RS
IN INTEREST, AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Traffic Mitigation
Plan Chk Deposit
I� ..... a. WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Review
Receipt III
'LL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING 018ECTLY OR INDIRECTLY
!31 FROM THE I SUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORGINANCE
Fire Inspection
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
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I HERESY ACKNOVALE E THAT � HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT AM THE OWNEFL Oil THE Duty AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
This appliss Ion Is not a permit until signed by sho
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LA3%GQFDENOF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
thoding hisrho DtPuly: and F.so .. pilid, nd
WORKMENIS COMPENEATIO SU Ili CE AND ROW 16,27,
OFFICIALS $1 DAT
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771- v
RELEASED BY DATE'
ATTENTION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221 1
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
OFIRGINAL-FILE 7LL-W�INSIE.T..
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX
PINK - OWNER GOLD - ASSESSOR
10101
-iffNAL PROJECT APLROVAL FO
TO:—,
DATE:—
WMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —FIRE DEPARTNIENT DATE_�� �—?—Q�
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DIVISION DATE —
______________ENGINEERING
PLANNING DIVISION DATE—
PROJECT
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DESCRIPTION OF WORK TO BE INSPECTED—V—SE Z eLIA12z &Z"SC JLC'*_r-0
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A field inspection was conducted to determine final compliance with approved plans. Final approval
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denotes that there are no objections from the above signed Depa rtment to the release of
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PE L_MANCEBONDS and the granting of:
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GRANT FINAL PROJECT APPROVAL
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GRANT PROJECT APPROVAL wrrH CONDITIONS NOTED
u Copy of CONDMONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractorby inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES GRANT FINAL PROJECT APPROVAL
Date— Sign_
ocaprvi.doc.l:tenip:bldg:fonnsIO/OI
RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing.......................
Wall ....................
Pier/Porch
Retaining Wall ...........
§Iab Insulation ..........
PLUMBING:
Underground
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MID
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Commercial Final
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Gas Piping
Equipment
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Commercial Final
EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING ............
FIRST FLOOR FRAMING
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INSULATION . ...................
Floor Insulation
Wall Insulation
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Ceiling Insulation
SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS ..........
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FINAL APPROVAL FOR
OCCUPANCY
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