20000833.pdfFIN AL-P-R-0-1-E-C _1 AA P-P-R-0 V A -LF 0 RM
DATE: —
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FIRE DEPARTMENT DATE —
FROM:
ENGINEERING DIVISION DATE—
P LANNING DIVISION DATE ......... JA
JECT
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SITE ADDRESS —'6 ?
PERMIT #__S2M_J33 ADB# DATE INSPECTED
DESCRIPTION OF WORK TO BE INSPECTED___IedE��
A field inspection was conducted to determine compliance with approved plans. Final approval denotes that
ions from the above signed Department to the granting of
there are no object
Final approval of the described work
__K_GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
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—FAILED FINAL INSPECTION OUTSTANDING ISSUES
2.
3.
-RE-INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
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Stab Insulation ..........
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THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
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BE ONE ON PRIVATE PROPERTY ONLY, ANY CONSTRUCTION ON TH E PUBLIC
DOMAIN (CURBS,SIDEWALKS, DRIVEWAYS, MARGUEES,ETC.) WILL REQUIRE
GRADINGIFIUL
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SEPARATE PERMISSIOW
STATE SURCHARGE
RE MIT APPLICATION: 180 DAYS
PERMIT LIMIT'. I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
STORM DRAINAGE FEES
w. �ARRLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS ASSIGNS AND SUCCESORS
ENG, INSPECTION FEE
IN NTEREST AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY
m E MOND& WASHINGTON, ITSOFFICIALS. E PLOYEGS. AND AGENTS FROM ANY AND
A L CLAIMS FOR DAMAGES OFWHATEV R NATURE. ARISING DIRECTLYOR INDIRECTLY
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a FROM THE ISSUANCE OF 7 HIS PERMIT SSU NCE 01 THIS PERMIT SHALL NOT 11
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DEEMED TO MODIFY. WAIVE OR REDUCE AN Y REQUIREMENT OF ANY CITY ORDINANCE
PLAN CHECK DEPOSIT
NOR LIMIT IN ANY WAY THE CITY S ABILITY TO ENFORCE ANY ORDINANCE PROVISION
TOTAL AMOUNT DUE
4/15 �3 1 221
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION ;PPROVAL
IHEOWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
Th,sappl,..I,Oni,,,I,p,,,,tu�t�l,,g,,,dbyth,
TIONEANDIN OING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
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IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RE EATING TO
FOR INSPECTION
.ORKNIEN�S COMPENSATICko_L URANCE AND ROW 18,27.
DATE
SICWM�V ERG
(425)
771-0220
GFN
AT'ii0ION
�2 EAAWBY d
IT IS UNLAWFUL TO USE OR C(IY� BUILDING OR STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL FILE YELI INSPE OF
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK OWNER "DID, ASSESSOR