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IS70 .00
STATE SNF�.ARGE
IF PERMIT APPLICATION: 180 DAYS
PERMIT LIMIM I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPLICANT, ON IEHAL F HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
END. INSPECTION FEE
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ALLCL�AJMS FORDAMAGESOFWHATEVER NATURE. ARISING DIRECTLY OR INDIRECTLY
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I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION. THAT THE INFORMATION
GIVEN IS CORRECT, AND T14AT I AM THE OWNER. OR THE OULY AUTHORIZED AGENT OF
THE OWNS . I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CO�STRUC.
TION; AND IN DOING THE WORK AUTHORIZED THEREBY. NO PERSON WILL BE EMPLOYED
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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 I the granting of:
__!��—Final approval ofthe described work
Bonds associated with the project may be released
GRANT FINAL PROJECT APPROVAL
_GRANT FINAL PROJECT APPROVAL WITH CONDITIONS NOTED
FINAL INSPECTION - OUTSTANDING ISSUES
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____RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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a PE 11TAPPLICATION! 180 DAYS
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A. PERMIT LIMIT. I YEAR � PROVIDED Wo FIX IS STARTED WITHIN IBB DAYS
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'A PPUCANT, ON BEHALF OF His OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
ENG. INSPECTION FEE
:ND MNIFY, DEFEND AND HOLD HAR
IN INTE E MLESS THE CITY F
REST, AGREES To ENTS FROM ANY AND
OFFICIALS, EMPLOYEES. AND AD
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BOND C DIRECTLY
ALLCLAtMSFORDAIIAGESoFWHATEVER NATURE,ARISING OFECTLYOR INDIRECTLY
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FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
PLAN CHECK DEPOSIT
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,DUCI ANY REQUIREMENTOF ANY CITY ORDINANCE
DEEMED TO MODIFY, WAIVE OR RC
NOR LIMIT IN ANY WAY THE CITY 'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION.'
TOTAL AMOUNT DUE
RECEIPY/ 7,,5
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
APPLICATION APPROVAL
GIVEN IS CORRECT. AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
COMPLY WITH CITY AND STATE LAWS REGULATING CONSTHUC-
CALL
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THE OWNER. I AGREE TO
TION; AND IN DOING THE WORKAUDHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
RELATING TO
BuildII,g Off,.I.i b, hi.lh.,
FOR IN SPECTION aeo,pt 11 11k.—Ildged m spacO pid-
"I VIOLATION OF THE LABOR 0 E OF THE STATE OF WASHINGTON
WoFKMENB INSURANCE AND FICIN 18.27.
o I IALS SIGNATURE DATE
Lom!PE�KTION
DATE SI
(425)
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-RELIASEDB
771-0220
DATE
EXT/333
b"'ll
AMMN
6
IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
R
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIGINAL - PILE, -,YELLOW - INSPECT
ASSESSOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK - OWNE ." GOLD -
SIBS
-------------