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PERMIT APPLICATION: 180 DAYS
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ENG� REVIEW FEES
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'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCES.AS
ENG, INSPECTION FEE
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RECEIPT
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Rom THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
DEEMED TOMODIFY. WAIVE OR REDUCE ANY REQUIREMENTOF ANY CITY.RDMANCE
NOR LIMIT IN ANY WAY THE CITY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION'
RECEIPT
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATI N
APPLICATION APPROVAL
GIVEN I S CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
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771-0221
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ORIGINAL - FILE - YELLOW - INSPECTOR
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RECORD OF INSPECTIONS
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DATE APPROVED
SETBACKS ....................
FOUNDATION:
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wall..........................
Pier/Porch .................
Retaining Wall ...........
Slab Insulation ..........
PLUMBING:
Underground .............
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commercial Final
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Ga. Test
Gas Piping .................
Equipment .................
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING........................
FIRST FLOOR FRAMING
INSULATION
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Wall Insulation ............
Ceiling Insulation
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URC ARGE
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P
�NG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
-APPLICANT ON BEHALF 0 HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCSSORS
ENG. INSPECTION FEE
ININT EST. AGREES TO :ND MNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
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PLAIN CHECK DEPOSIT
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PROVISI N
0 N OR LIMIT IN, ANY WAYTHE CITY'S ABILITY TO ENFORCE ANY ORDINANCE
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INIORMATION
GIVEN ISCORRECT�,A 0 THAT I AM THE OWNER. OR THE DUSLYRAUTHOTAIINZGED AGNSETIRT OF
THE OWNER. I AGREE TO COMPLY WITH CITY AND STAT LAW ECULA CO UC.
CALL
lION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
WASHINGTON RELATING TO
FOR INSPECTION
IN VIM CODE OF THE STATE OF
�O OF THE L
WOR S COMPENSATION INSURANCEANDRCW 18.27.
VA�� D Ell NID
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(425)
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771-0220
EXT1333
ATTENTION
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-
CATE OF OCCUPANCY HAS BEEN GRANTED. USC SECTION 109
FAX
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