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�Ap PLICA.T. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
N INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY 05
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FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
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I HERESY ACKNOWLEDGE THAT I HAVE REA. THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
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WITH CITY AND STATE LAWS REGULATING CONSTRUC
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DATE
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771-0221
FINAL I Ns P ECTION HAS BEEN MADE AND APPROVAL OR A CERTIFT
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DESCRIPTION OF WORK TO BE INSPECTED
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there are no objections from the above signed Department to the granting of:
____��Final approval of the described work
--Z—Performance Bonds associated with the project may be released
GRANT FINAL PROJECT APPROVAL
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TATE SURCHARGE
PERMIT APPLICATION; 100 DAYS
PERMIT LIMIT'. I YEAR . PROVIDED WORK IS STARTED WITHIN 180 DAYS
ENG. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
LICANT. ON BEHALF 0 HIS OR HER SPOUSE. HEIRS. ASSIGNS AND SUIC ESORS
ENG. INSPECTION FEE
;AP
N INTEREST AGREES TO �NDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
ANYAND
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TOTAL AMOUNT DUE
P1111 T 0 1)
-KNOWLEDGE THAT I HAVE HEAD THIS APPLICATION� THAT THE INF RMATION
APPLICATION APPROVAL
I HEREBY ORIZED AGENT OF
GIVEN I C ARECT AND THAT I AM THE OWNER. OR THE DULY AUTH
S C
N. �l ig by
THE OW ER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGU LAING CONSTRU E'.
D
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FOR INSPECTION
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IN VIOLATION OF THE LABO CO F THE STATE
KME PE A CE AND RCW 18.27.
'on N'SCUM MS.,.;
OFFICIALAN"TURE DATE
(425)
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771-0220
ELEASED By
ATTENTION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
If I _VIL� -
A FINAL INSP ECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI_
If
ORIGINAL � FILE YELLOW INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK OWNER GOLD -ASSESSOR
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