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RECEIPT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION
AUTHORIZED AGENT OF
APPLICATION APPROVAL
GIVEN I S CORRECT, AND THAT I AM THE OWNER. OR THE DULY
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
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CODE 01 THE STATE OF WASHINGTON RELATING T.
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ITISU LAWFUL TO USE 08 OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
HAS BEEN MADE AND APPROVAL OR A CERTIFI
ORIGINAL FILE - YELLO -INSPECTOR
FIN�A L INSPECTION
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Receipt Date:
Underground Wiring Required
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Plat/Subdivision Requirements
APR 2 6 2000
Street Dedications
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DATUM POINT ELEVATION-1
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FINAL PROJECT APPROVAL FORM
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE-
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PLANNING DIVISION DATE-
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SITE ADDRESS � b t 9- 1) t-,, %u So
PERMIT ADB#______pATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED
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:
____--Yinal approval of the described work
\A GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
2.
3.
RE-IN-SpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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THIS PERMIT AUTHORIZES Nl THE WORK NOTED. THIS PERMIT COVERS WORK TO
BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
DOMAIN (CURBS, SIDEWALKS. DRIVEWAYS . MARQUEES, ETC.) WILL REQUIRE
SEPARATE PERMISSION.
L
PERMIT APPLICATION: 180 DAYS
T PERMIT LIMIT. 1 YEAR . PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESORS
OF
;APPLICANT
IND MNIF DEF NO AND HOLD HARMLESS THE CITY
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. E E ANY F N CITY .. VINA.�.
GTo . "Y R CU. FE..'FE.ENT. A
D EEME o IS N�
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THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
I HEREBY ACKNOWLEDGE
GIVEN I CORRECT, AND THAT I A THE OVVNE��6 OTRATT-E "USLY AUTHOTRIN1.10 AGENT 01
S
A E LA. RE. ,
THE OWNER. I AGREE TO CO PLY WITH CITY S I, I CONSTALIC
WILL BE EMPLOYED
TION. AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON
CODE 0 THE STATE OF WASHINGTON RELATING TO
IN VWIPN OF THE LABOR
Wo N2 COMPENSATION INSURANCE AND RCW 18.27.
ATEJjIGNli�%D
,s URE WPNE 0 A, I 1A Ri
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
I CALL
FOR INSPECT11
(425)
771-0220
12
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ATTE�TION
IT IS U LAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
FiN�ND APPROVAL OR A CERTIFI-
L INSPECTION HAS BEEN MADE A
A . U FAX
CATE OF OCCUPANCY HAS BEEN GRANTED BIG SECTION 109
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