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BE DONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON THE PUBLIC
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1 1 INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
14 NTEREST. AGREES TO
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IT IS UNLAWFUL TO USE 01, OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
INSPECTION MADE AND APPROVAL OR A CERTIFI-
ORIGINAL -FILE - YELLOW INSPECTOR
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DESCRIPTION OF WORK TO BE INSPECT
A field inspection was conducted to determine compliance with approved plans. Final approval. denotes that
there are no objections from the above signed Department to the granting of:
inal approval of the described work
erformance Bonds associated with the project may be released
—GRANT FINAL PROJECT APPROVAL
—GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
AILED FINAL INSPECTION - OUTSTANDING ISSUES
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Final approval denotes that
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the granting of:
there are no objections from the above signed Department to
approval ofth. describ.dwork
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DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOUIREMENTOF ANY CITYORDINANCE
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TOTAL AMOUNT DUE
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RECEIP �S/ ly�J42�_/Jqp
I HEREBY ACKNOWLEDGE THAT: H E READ THIS APPLICATION; THAT THE NFO MATI
APPL ICATION APPROVAL
GIVEN IS CORRECT; AND THAT AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
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THE OWNER, I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING C.NSTRUC-
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IN VIOLAT ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION pI Mlldged I-p- pw,dld.
WORKMEN'S COMPENSATION.INSURANCE AND FICW 1IL27.
DATE
St N -UR�E"'o AD N'. DATE SIGNED
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(425)
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771-0220
�COFFICIAL
, - DA
EtEASED Y TE
S Y
ATTENTION i
EXT 333
. �'T IS UNLAWFULTO USEOR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
NAL INSPECTION,, HAS BEEN MADE AND APPROVAL OR A CERTIFI-
E OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109 FAX
11111NAL- FILE YELIOW INSPECTOR
PINK -OWNER GOLD -ASSESSOR