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STATE SURCHARGE
PERMIT APPLICATION: 180DAYS
PERMIT LIMIT: 1 AR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
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ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCES.RS
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ATTENTION
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771-0221
A FINAL INSPECTiON HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
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CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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CONSTRUCTION PERMIT APPLICATION
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FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF
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PLAN CHECK DEPOSIT
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U MIT INANY A E 'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
W Y T. CITY
NOR LIMIT INANY WAYTHE CITY
T TAL AMOUNT DUE
JR.
CEIPT
THAT I HAVE READ T.IS APPLICATION; THAT THE INFORMATION
APPLICATION
APPROVAL
I HEREBY ACKNOWLEDGE
GIVEN IS CORRECT, AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT 05
"N'
T E OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
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CALL
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TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
WASHINGTON RELATING TO
FOR INSPECTION
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IN VIOLATION OF THE LABOR ODE OF THE STATE OF
0 TE
WORXM=. COMPENSATION INSURANCE AND RCW 18.21.
(425)
ol.
Sl..Al�.E I.-NER OR �G
771-0220('
—RELEA�BY-7 A 'fDATE
ATTENTION
EXI '333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
IN Sp ECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGiNAL-FILE YELLOW - INSPECTOR
A FINAL
CATE OF OCCUPANCY HAS 13EEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER GOLD -ASSESSOR
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