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�APPLICANT. ON BEHALF OF HIS OR HER SPOUSE. HERE. ASSIGNS AND SUCCESONS
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AND STATE LAWS REGULATING CONSTRIC
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THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
FOR INSPECTION
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(425)DATE
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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PERMIT APPLI.ATIONZ 1.a.AYS
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YE 0
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ENG. INSPECTION FEE
SSIGNS SUCCESORS
PLICANT. ON BEHALF OF HIS OR HER.SIOUEE. HEIRS. A A
LANDSCAPING
INSPECTION FEE
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FR M THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
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TOTAL AMOUNT DUE
EIPT
0 N OR LIMIT IN ANY WAYTHE CITY�S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFO RMATION
N APP
APPLICATIO OVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
gld by the
Thl. application ia 1 . PaInhi `liF 1
THE OWNER. TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC
JACRES
CALL
.
Buildhh, 011n,iml .1 h,.Ih.: D-p-ty: ... ... P id. and
TiON; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
Or WASHINGTON RELATING TO
FOR INSPECTION
d ad In ,.P. p—id.d.
IN VIOLATION OF THE LABOR DE OF THE STATE
Co
WORKMEN'� COMPENSATION INSURANCE AND RCW 18.27.
lA09;1
OFFICIA IGNATU DATE
ER R GENT) DATE SIG ED
I //) -,-, - I I I -ur-40 RtLEASED By
AT-fENTION EXT1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL -FILE YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER GOLD - ASSESSOR