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PERMIT APPLICATI N: 180 DAYS
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ENG. REVIEW FEES
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TOTAL AMOUNT DUE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION, THAT THE INFORMATION
GIVEN IS CORRECT. AND THAr I AM THE OWNER. OR THE DULY AUTHORIZED AGENT 01
THEOWNER I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
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ENG. REVIEW FEES
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0 HIS OR HER SPOUSE. HEIRS. �SIIINS NDSUCCESORS
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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 AUTHOR ZED AGENT OF T I t .1 . t .III 1�glld by -
A NG CONSTSUC; CALL B, go DapltY:lldFsa,ed.and
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ON. AND ICING A. FIZEDT.EA ;E No PER '. pl.... -0-d
T' V"'T "' OF T THE C UTH RELAFING To FOR INSPECTION
IN ION HE L= E 01 THE STATE 61 WASHINGTON (425) OF 11 SIG ATURE
SIGNED
771-0220 E EASED By DATE
ATTENTION EXT 1333
IT IS UNLAWFULTO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 ORIGINAL -FILE - YELLOW -INSPECTOR
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
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