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LAN CHECK NO: -Zj VESTED DATE In
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THIS PERMIT AUTHORIZES ONLY THE WO K NOTED. THIS PERMIT COVERS WORK TO
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k: HE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC Grading
1 g
2 R U
3 DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) W ILL SQUIBB
t: SEPARATE PERMISSION. Engr. Review
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PE MITAPPLICATION: INDAYS
PERMIT UMPR I YEAR - PROVID D WORK IS STARTED WITHIN 180DAYS Engr. Inspection
SEE SACK OF PINK PERMIT FOR MORE INFORMATION
T.ff'C ffm.U.
'APPLICANT, ON BEHALF 0 HI OR HER SPOUSE, HE'RSF ASSIGNS AND SUCCESORS Traffic Mitigation
FtNDSEMNIFY,
IN INTEREST. AGREES TO DEFEND AND HOLD HARMLESS THE CITY OF -
50MOND1, WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Review
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
FROM THE ISSUANCE OF THIS PEAMM ISSUANCE OF THIS PERMIT SHALL NOT 'I* Fire inspection
DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY C TY ORDINANCE
NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDI NANCE PROVISION. -
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
rINSPECTION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNER. I AGREE TO COMP WITH CITY AND STATE LAWS REGULATING CONSTRUC. CALL
TION; AND IN DOING THE WORKAUTHORiZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO FOR
WORKMENVE,�D�, RATION INSURANCE AND RCW 1OL27.
SIGNED (425)
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�OLr.'j 771-0220
AT'ttNTION EXT 1333
IT IS UNLAWFUL To USE OR O/CUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFt,
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX
10/01
City Surcharge
State Surcharge
Plan Chk Depo it
Total Amount Due
Receipt #
APPLICATION APPROVAL
t_"' 22'&j0z-
16INAL-FILE - YEU_6W,rNSPECTOR
PINK -OWNER - GOLD -ASSESSOR
FINAL ROJECT APPROVAL FO
TO:_
DATE:_
MEMO To: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE—
D. (L ja jEj:2Z ENGINEERINGDIVISIONDATE—�4�0
PLANNING DIVISION DATE —
PROJECT
SITE ADDRESSL2�
PERMIT # 2- - 0'--7 -2-L.. ADB#______--PATE INSPECTEZD 2-
DESCRIPTION OF WORK TO BE INSPECTED---�—�����
A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are noobjections from the above signed Department to the release of
P RFX A W.-T? R an 9
E d the grantin of
"GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WrIH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
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FAILED FINAL INSPECTION - OUTSTANDING ISSUES
cl Copy of CORRECTION NOTICE -given to owner/contractor by inspector
2,
3.
RE_]NSpECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date_ Sign_
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIR DEPARTMENTDATE—
A ENGINEERING DIVISION DATE-
4&--,d---1�1PLANNING DIVISION DATE.
SITE ADDRESS
PERMIT# DATEINSPECTED
DESCRIPTION OF WORK TO BE INSPECTE D
A field inspection was conducted to determine'rinal, compliance with approved plans. Final approval
denotes that there are no objections from the� above signed Department to the release of
PERFORMANCE BONDS and the granting of:
GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
u Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
c3 Copy of CORRECTION NOTICE given to owner/contractor by inspector
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Si
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RECORD OF INSPECTIONS
INSPECTOR DATE APPROVED
SETBACKS ..................
FOUNDATION:
Footing ......................
wall ...............
Pier/Porch .................
Retaining �Vall
Stab Insulation ..........
PLUMBING:
Underground .............
Sough -in ...................
Commercial Final
HEATING:
GasTest ....................
Gas Piping .................
Equipment
Commercial Final
EXTERIOR SHEATHING
NAILING ..........................
FRAMING . .......................
FIRST FLOOR FRAMING
INSULATION ...............
Floor Insulation
Wall Insulation ...........
Ceiling Insulation
SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS
FINAL APPROVAL FOR
07--
OCCUPANCY ..................
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