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t: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTR CTION ON THE PUBLIC
Grading
0 MAUS (CURB$, SIDEWALKS. DRIVEWAYS, MARQUEES. ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PERMIT APPUCAMON: IBUDAYS
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P18MITLIM IY�R-PR.IIDMIIO�KISSIARTEDWITH18 110DAYs
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
Engr. Inaleclion
'APPLICANT, ON SEPAL - F HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Fire Review
PlanChk.Deposl
IN INTEREST AGREES 10 INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY 01
EDMOND WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fireinspection
Receipt #
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ALLCLIJMS FO DAMAGES OF WHATEVER NATUSE� ARISING DIRECTLY OR INDIRECTLY
FROM THE I SUANCE OF THIS PERMIT. ISSUANCE F THIS PERMIT SHALL NOT BE
DEEMED To MODIFVWA E OR SEDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
Landscapeinsp.
Total Amt. Due
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
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I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
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GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
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771-0220
RECEASED BY
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTiFl-
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CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWES - GOLD -ASSESSOR
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Exist'Bld Pad: 1899 sf. (constructed prior to 1977)
Proposed Garage: 624 sf.
Proposed Bedroom: 288 sf. /00-rk AVIF. W
Proposed Driveway: 892 sf. AD TTERSWM/D SPOUTS
1p, to 101011 slope -west D SPLASI IBLOCKS
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FINAL PROJECTAPPROVAL FORM
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MEMO TO: PERNUT COORDINATOR, BUILDING DIVISION
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a Copy of CORRECTION NOTI CE given to owner/contractor by inspector
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Date Sign_
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FINAL PROJECT APPROVAL FORM
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DATE:
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denotes that there are no objections from the above signed Department to the release of
PERFORMANCE BONDS and the granting of:
GMANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
cl Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
(3 Copy of cORRECTION NOTICE given to owner/contractorby inspector
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ..................
FOUNDATION:
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Wall ..........................
Pier/Porch .................
Retaining Wall ...........
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Slab Insulation ..........
PLUMBING:
Underground .............
171,
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Rougirl-In ............
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Commercial Final
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