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DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS. MARQUEES, ETC.) WILL REQU RE
SEPARATE PERMISSION.
STATE SURCHARGE
PERMIT APPLICATI N; 180 DAYS
PERMIT LIMIT. I YEAR � PROVIDED WORK IS STARTED WITHIN 180 DAYS
END. REVIEW FEES
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
FEE
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THAT E READ THIS APPLICATION. THAT THE INIORMATION
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FINAL PROJECT APPROVAL FORM
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
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PLANNING DIVISION DATE—
PROJECT —
SITE ADDRESS # 1� INSPEC
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DESCRIPTION OF WORK TO BE INSPECTED —
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 the granting of
approval of the described work
GRANT FINAL PROJECT APPROVAL
PROJECT APPROVAL WITTI CONDITIONS NOTED
JFAILED FINAL INSPECTTON - OUTSTANDING ISSUES
2.
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
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7-6
TOTAL AMOUNT D
I HEREBY ACKNOWL QGE - AVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL
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C EGULATING CONSTAUC. �,ndl
THE OWNER. I AGREE TO T MpLy WTH.CT, AND SEATENL.A�l R CALL B.lid, g Off.-- h,Lne, DeFuly. and Fea*
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IN VIOLATION OF THE LABOR CpDE a F THE STATE OF WASHINGTON RELATING TO FOR 4NSPE TION
WORKMEN'S COMPEN�ATION INSURANCE AND RCW 18,27 1 IAL� S. NATUV DATE
7/A6
Nt- ti ]Z t�a�� DATE SIGIfID
W EVjt,�Olt
r 0 - I Lz oo 771 -0220
. ASED By
ATTENTION EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 7,71-0221
ORIGINAL -FILE - YELL -INSP CTOR
INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- a
X
A FINAL
HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER - GOLD - ASSESSOR
CATE OF OCCUPANCY
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