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CONSTRUCTION PERMIT APPLICATION
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PLAT NAMEISUBDIVISION NO. LOT NO, LID NO.
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REMARKS
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REMARKS
PROGRESS INSPECTIONS PER USC 108/FINAL INSPECTION REaD
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Description FEE Description FEE
Plan Check State Surcharge
HEAT SOURCE LOT I %
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Building Permit City Surcharge
PLANCHECKNO��Z& VESTED DATE
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THISPEFIMITAUTHORIZESONLYTHEW RKNOTED.THUSPERMITCOVER WORKTO
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Mechanical
8 DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTIO14 ON THE PUBLIC
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Grading
(CURB%SIDEyVALKS,DFhVEWAYS
SEPARATE PERM; MARQUEES, ETC.) WILL REQUIRE
SSIO&
PERMIT
Engr. Revim
APPUCATION: 180 DAYS
PERMIT LIMM I YEAR -PROVIDED WORK IS STARTED WITHIN 180DAYS
SEE K OF PINK PERMIT FOR MORE INFORMATION
Engr. Inspection
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS,A SIGNS AND SUCCESORS
IN INTEREST, AGREES TO
Fire Review PlanChk,Deposft Z
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INDEMNIFY, DEFEND AND 110 D HARM1111 THE CITY OF
EDMOND WASHIN N. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection Receipt
ALL CLAIMS' FOR DAGMTAO 'ES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL HOT
DEEMED TO MOMFY� RED CE ANY REQUIREMENT OF ANY CITY ORDINANC1,1
WA
Landscapeinsp. Total Amt. Due —
NOR LIMIT IN ANY WAY TIHVEECOIRTYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee Receipt If
I HERESY ACKNOWLEDGE THAT � HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT A TH. OWNER. OR THE OULY AUTHOR IED AGENT .1
APPLICATION APPROVAL
THE MINES. I AGREE TO COMPLY WITH CI AND STATE LAWS REGULATING CONSTRUC.
This appli,stion is rot a pe-ft UMA signed by Me
CALL
TION, 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
B.IIMnq 0"16.1 .1 hisMs' Dep.1y: Mel Fee. M. Mile, MxJ
FOR INSPECTION —.1,1 I—R-1,x1god lesp—p—id.d
WORKMENS COMPENSATION INSURANCE AND RCW 18.27.
K3.1e, on AGf_ I 1113NIII
(425) 0 DATE
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Re' By I DATE
ATTENTION
EXT 1333 MED
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING 08 STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK -OWNER COLD -ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES GREEN - ACCOUNTING
FINAL PROJECT APPROVAL FORM
TO:
DATE.
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: _FIRE DEPARTMENT DATE—
C, ENGINEERING DIVISION DATI�__ 16'?,
PLANNING DIVISION DATE—
PROJECT—
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DESCRIPTION OF woRK ToEE lNsPEcTFD__t _(L)A
A. field inspection was conducted to determine final compliance with approved plans. FInal approval
denotes that , there are no objections from the above signed Department to the release of
IEja�QRMANCE BONDS and the granting of:
GRANT FINAL PROJECTAPPROVAL
GRANT PROJECT APPROVAL WrrH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPEC11ON -OUTSTANDING ISSUES
u Copy of CORRECTION NOTICE given to owner/contractor by inspector
I
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign_
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ....................
FOUNDATION:
Footing ........... ..........
Wall..................
Pier/Porch ............
Retaining Wall ...........
Stab Insulation
PLUMBING:
Underground .............
Rough -in ...............
Comm arcial Final
HEATING:_
Gas Test ....................
Gas Piping .................
Equipment ..........
Commercial Final
EXTERIOR SHEATHING
NAILING .................
FRAMING ........................
FIRST FLOOR FRAMING
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INSULATION ...............
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Floor Insulation
Wall Insulation
Coiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
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OCCUPANCY ..................
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