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CONSTRUCTION PERMIT APPLICATION JOB SUIT&PT#
ADDRESS I o o s MeqdOWL44/11 &Cltb
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CITY zip 111LIP"ONE EXISTING — PROPOSED— 1--ne..
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ADDRESS REMARKS
0 NERICONTRACTOR RESPONSIBLE FOR EROSION CONTROUD INAGE
W E 5' C L) ENGINEERING REVIEWEDIDATE
ADDRESS
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furt FIRE REVIEWED By DATE
CITY —zip TILIPHON1
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STATE LICENSE NUMBER EXPIRATION VARIANCE OR CU SHORELINE OR ADD4 BOND
POSTED
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$EPA REVIEW SIGN AREA HEIGHT
PROPERTY TAX ACCOUNT PARCEL NO. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROPOSED
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2 005m Ooo at go -t EXP I I ,
LOT COVERAGE REQUIRED SETBACKS (FT.) PROPOSED SETBAC 3 B`T)
NEW 52)1 PLUMBINTeM-ZH,) ALLOWED 1.01.... IFONT IM. REAR FRONT LJISIDI KFI..
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ADDITION COMPUAN�1 OR
HANDS OF USE
REMODEL 0 S PARKING LOT AREA PLANNING REVIEWED By DATE
IGN RECD I PROVIDED
REPAIR GRADING CYDS o FENCE
I _X_Fr) REMARKS
DEMOLISH TANK rl OTHER
RETPJNING WALL
I.IARPAO-RIT ROCKERY RENEWAL
UWE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
CHECKED BY 'E C T U N C CUP
OCUPAN;/�
NUMBER NUMBER 01 CRITICAL
OF FAR�A
DWELL NG �011 OCCU NT
AREAS T
STORIES
9 UNITS NUMBER LOAD
DESCRIBE WORK TO BE OUNe
REMARKS
R ISJ
P OGRE
Dpe..B or L vent connecjor�L_
iAf, (4 A I I'd 3AZ VC, tj v-1 - required on fuel -burning appliances in
/Az�m) unheated spaces. UNIC 815.7
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Description
FEE
Description
FEE
Plan Check
HEAT SOURCE GLAZING LOT SLOPE
Building
PLAN CHECK NO:
lumbing
-
Mechanical
THIS PERMIT AUTHOAUES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO
t: BE DONE ON PRIVATE PROPERTY ONLY AM CONSTRUCTION ON THE PUBLIC
a
Grading
Recording Fee
M DOMAIN JCURBS, SIDEWALKS, DRIVEWAYS, MAROU'sS.ETC.) WILL REQUIRE
SEPARATE PERMISSION.
PER ITAPPUCATION: INDAYS
Engc Review
City Surcharge
PERMIT UMm I YEAR - PROVID D WORK IS STARTED WITHIN IBODAYS
Engr. Inspection
State Surcharge
SEE BACK OF PINK PERMIT FOR MORE INFORMATION
'APPUCAK ON BEHALF OF HIS OR HER SPOUSE. HEIRS ASSIGNS AND SUCCESOnS
Traffic Mitigation
Plan Chk Deposit
IN INTEREST, AGREES To INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
E MONDS, WASHINGTON, ITS OFFICALS, EMPLOYEES. AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES 0 WHATEVER NATUHE� ARISING DIRECTLY OR INDIRECTLY
Fire Review
Receipt #
FROM THE I SUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT HE
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY C TY ORDINANCE
Fire Inspection
77-
Total Amount Due
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.-
Landscapefinsp.
Racept #
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT. AND THAT AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTAUC.
CALL
Thl-rapkaft. le rel. ppa.ft.pbI,Iga.d by Me
TION, AND IN DOING THE WORK AUTH RIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELkrING TO
FOR INSPECTION
1"Ilding Official., Inte/h., O.ply:.nd Fee, A,. paid, and
'ecolpt Isacka—ledged In space pewided.
WORKMEWS COMPENESuRANCE AND RCW 18,27.
OFFICIALS.
r SIGNATURE O�ER I E SIGNED
(425)
ILI,
I -IJA
D
EXT 1333
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI.
ORIGINAL -FILE - YELLOW -INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
PINK -OWNER - GOLD,ASSESSOR
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing.......... ...........
wall ................
Z
Pier/Porch ................. .
Retaining Wall ...........
Stab Insulation ..........
PLUMBING:
Underground
M
C
.............
0
M 0
Rough -In ...................
0
C
Commercial Final
:x 171
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HEATING:
LO 4
Gas Test � ...................
Gas Piping .................
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Equipment
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Commercial Final
M M
EXTERIOR S14EATHING
0
0
NAILING ..........................
F RAMING
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FIRST,FLOOR FRAMING
INSULATION ...................
Floor Insulation
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Wall Insulation ...........
Calling Insulation
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SHEETROCK NAILING
0
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SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ...............