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RECALL FOR INSPECTION L3 S45 REINSPEMON FEE MUST BE PAID PRIOR TO INSPECTION REQUEST
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RECEIPT
TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION: THAT THE INFORMATION
APPLICATION APPROvAL
GIVEN CORRECT. AND THAT I AM THE OWNER. OR THE DULY AUTHORIZED AGENT OF
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OF 11ALSSIGNATURE
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SIGNATURE (OW�MAGE�F DATE I GNYD
(425)
771 -0220
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IT IS UNLAWFUL TO USE OR dCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221
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