20020785.pdfDATE R'C ED
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I PERMIT EXPIRES
CITY OF EDMOND
USE ERMIT
ZONE 17_5_6PNUMBER Q��_
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CONSTRUCTION PERMIT APPI-91CATION
JOB EBB
ADOR Y16
SUITEIAPT-
VNER NIMIINIMI OF GIU10IN I
FLAT NAMEISUBDIVtSION NO I LOT NO,
11 NO,
MAILING ADDRESS
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PUBLIC RIGHT .1 WAY PER .111.IAL -FFET MAP
= 1— A.. 0
CITY ZIP TELEPHONE
EXISTING — PROPOSED�
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REQUIRED DEDICATION— FT
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METER SIZE LINE SIZ�E NO. 01 FIXTURES
PRV REQUIRED
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YES C3 No 0
ADDRESS
REMARKS
NERICONTRACTOR RESPONSIBLE FOR Be ION .NTF.L1.-INA.E
CITY ZIP ITELEPHONE
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A MUST BE PRESENT FOR
ENGINEERING'S
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REMOVFI., OR CAPE
IMOPILL,
FIRE REVIEWED By DATE
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VARIANCEORCU SHORE 11 EORADBH (NSPECPON 80 0
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DATE RED 0 POST
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BEIRA REVIEW SIGN AREA HEI HT
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Par Co..., ---- ALLOWEI) PROPOS 1) ALLOWED PROPOSED
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LOT COVERAGE RED HIED SETBACKS (Fr.) PROPOS SETBACKS (Fr.)
RESIDENTIAL PLUMBING I MECH ALLOWED PROPOSED FRONT SIDE REAR FRONT URSIDE REAR
COMPLIANCE a
.MEGGLAL CHANGEOFUSE
PARKING LOT AREA PLANNING REVIEWED BY A'.
MULTIFAMILY 0 SIGN REGO I PROVIDED
FENCE
I X FH
REPAIR rl CYDS rl _ X_Fn REMARKS
DEMOLISH rl TANK rl OTHER
'UNKLIR
oGARAGE 0 RETAININ13 WALL FRESPRINK R
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CHECKED BY ITY FOUP
(TYPE OF USE, BUSINESS =PLAIN: .UPA!;g2
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NUMBER NUMBER 0 CR' tCA
F A OCCU NT
DWELLING AREAS - SPECIALINSPECTION]AREA
OF S
Iq I LOAD
LIM.
UNITS NUMB REQUIRED [I YES
-STORIES
DESCRIBE WORK TO BE DONE
REMA KS ION REQ'D
PROGRESS INSPECTIONS PER UBC JOB/FINAL INSPECT
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Description
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FEE
Description
FEE
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Plan Check
P IT C h a
state Surcharge
LOT SLOPE
HEAT SOL OWING % LOT SLOPE %
Building Permit
u I Id`Gg Permit
City Surcharge
PLAN CHECK NO: VESTED DATE
Plumbing
'umbmg
Mechanical
echan'ca'
THIS PERMIT AUTHORIZES ONLYTHE WORK NOTED. THIS PERMIT COVERS WORK TO
t 11 DOME ON PRIVATE 111111 ONLY. ANY CONSTRUCTION ON THE PUBLIC
Grading
.MAIN (CURBS, SIDEWALKS, 0 RIVEWAYS, MARQUEES. FTC.., WILL .. URa
SEPARATE PERMISSION.
Engr. Revlw
PERMIT APPLICATION: 1. DAYS
PERMIT LIM t I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
"' I
Engr. Inspection
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF OF HIS 01 HER SPOUSE, HEIRS, ASSIGNS AND uco,,Os
Fire Review
Plan Chk. Depos
;APPUCANT,
. . a
N urr' AR LES, THE CITY Of
_REST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CI
EDMOND% WASHINGTON. ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
Fire Inspection
Receipt #
ALL CLAIMS FOR DAMLAGES OF WHATEVER NATURE ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PERMIT. SSUANCi OF THIS PERMIT SHALL NOT BE
Landscapensp.
Total Amt. Due
DEEMED TO MODIFY, WAIVE 08 REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PFIOVISIOW'
Recording Fee
I Receipt # 17,(2)jb'j
1 HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
By
I
P ICATION APPROVAL
L
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE OULf AUTHORIZED AGENT OF
CONSTRUC.
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING
WILL BE EMPLOYED
CALL Bw I G �11:.Ad .Pwd'.
ING PERSON
'ON A IN 0 -f_bFtWASHIN T N I-ING TO
IN OLNADT!GN OF g .. THET�UTE G G R
COMITE
FOR INSPECTION K
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OF I I
S SI NATU
2E ED
(425)
771-0220 SE..Y
ATTATION
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CEFITIFI-
08 G NAL FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
P�NK OWNER G LO-ASSESSOR
04/02 PRESS HARD -YOU ARE MAKING 5 COPIES
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, 13URDING DIVISION
FROM: -1-'1:;7 Cf, ---ME DEPARTMENT DATE,�2�—<J Z-
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE—
srrEADDREss
PERM[lT#)--00'7-02e�C ADB#i ---PATE INSPECTFD-ZIZ2�— 0 —2—
DESCRIPTIONIOF WORK TO BE INSPE (11A-�—
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
�P_ERFORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRAM PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
FARM FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Si
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS ...........
FOUNDATION:
Footing ... ............
wait..................
Pier/Porch .................
Retaining Wall
0,
Slab Insulation ..........
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PLUMBING:
Underground .............
Rough -In ................
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Commercial Final
0
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HEATING:
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Gas Test
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Gas Piping .................
Equipment ...........
Commercial Final
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EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING ..� ..............
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FIRST FLOOR FRAMING
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INSULATIO14 ...................
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Floor Insulation
Wall Insulation ...........
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Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
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OCCUPANCY ..................