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THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
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MEMO TO: P T COORDIN OR, BUILDING DIVISION
FROM: AT ---FIRE DEPARTMENT DATE -
ENGINEERING DIVISION DATE —
PLANNING DIVISION DATE
PRojEcT—LLQ—Y,—/
SITE ADDRESS
PERMIT (7-2-6cJcl
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DESCRIPTION OF WORK TO BE INSPECT C—AR
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:
__4--Final approval of the described work
Bonds associated with the project may be released
GRANT FINAL PROJECT APPROVAL
GRANT FINAL PROJECT APPROVAL wITH CONDITIONS NOTED
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INSULATION ...................
Floor Insulation
Wall Insulation ...........
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PERMIT AUTHORIZES C
=1 THIS BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC
BE DONE ON PRIVATE P
DOMAIN (CURBS. SIDEWALKS, DRIVE S. MARQUEES, ETC.) WILL REQUIRE
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SEPARATE PERMISSION.
GR6DINGfFILL
IBIHIIIIIII! SUAFHARGE,
PERMIT APPLICATI N: 180 DAYS
PERMIT LIMIT'. 1 YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
C
FLLC�JMS
ENE. REVIEW FEES
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUCCESOAS
IN NTEREST. AGREES TO INDEMNIFY. DEPEND AND HOLD HARMLESS THE CITY OF
ONDS. WASHINGTON, ITS OFFICIALS. EMPLOYEES. AND ARENT5 FROM ANY AND
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FOR DAMAGES OF WHATEVER NATURE, ARISING DI ECTLYOR INDIRECTLY
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FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
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I OR REDUCEANY REQUIMEME.TOP ANYCITY ORDINANCE
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NOR LIMIT IN ANY WAYTHE CII Y'S ABILITY TO ENFORCE ANY ORLI-1-
0 OR I, MIT IN Y W Y
ENG. INSPECTION FEE
LANDSCAPING
INSPECTION FEE
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RECEIPT
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I HEREBY ACKNOWLEDGE THAT 111.1 READ THIS APPLICATION� THAT 'HE INFORMATION
Give. CO RECT, AND THAT I AM THE OWNER. OR THE CULY AU I HORIZED AGENT OF
IS A TOC CONSTRUC
TH E OWNER, I AGREE OMPLY WITH CITY AND STATE LAWS RE GULATING
TION; AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WAS14INGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27
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APPLICATION APPROVAL
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ATTENTION
EXT 333
IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
771-0221
1
ORIGINAL -FILE . YELLOW -INSPECTOR
A FINAL
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
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