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DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES. ETC.) Wl� REQUIRE
SEPARATEPERMISSION.
Engr. Review
City Surcharge
PERMIT UMM I Y PERMIT APPLICATION: 1. ..
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BAR � PROVI ED WORK IS STARTED WITHIN 18.DAYS
Engr. Inspection
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SEE 13ACK OF PINK PERMIT FOR MORE INFORMATION
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AND SU.-B .. S
'APPLICANT' ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
LESS THE CITY OF
IN INTE EST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF
Receipt #
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Fire Review
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FROM THE ISSUANCE OF THIS PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE
Fire Inspection
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DEEMED TO MODIFY, WAIVE OR REDUCE ANY REOUIREMENT OF _ CITY ORDINANCE
NOR LIMIT IN ANY WAY THE CITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION,
Landscape Insp.
Receipt #
1 HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
By
APPLICATION APPROVAL
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GIVEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
THE OWNS . I AGREE To COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
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This application is not , permit nol signed by Me
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N ON OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
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FOR INSPECTION
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WORKMENa ��BATION INSURANCE AND RCW 19-27.
0 DATE
SIGNATU E HER R AGENT) DATE SIGNED
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71-0220
.115I.AStO BY
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EXT 1333
IT It -UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
771-0221
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
ORIGINAL - FILE - YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. LED SECTION 109
FAX
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MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —WON FIRE DEPARTMENT DATE —
_ENGINEERING DIVISION DATE
PLANNING DIVISION DATE—
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DESCRIPTION OF WORK TO BE INSPECTED- —b\Wtf- LILL
A field inspection was conducted to determine final compliance with approved plans. Final approval
denotes that there are no objections from the above signed Department to Ahe release of
PE RFORMANCE BONDS and the granting of:
T FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
a Copy of CONDITIONS given to owner/contractor by inspector
FAILED FINAL INSPECTION - OUTSTANDING ISSUES
a Copy of CORRECTION NOTICE given to owner/contractor by inspector
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RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Sign_
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RECORD OF INSPECTIONS
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INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
Footing ..................
wall ............. I., ..........
Pier/Porch ... ..............
Retaining Wall ...........
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Slab Insulation
PLUMBING:
IT
Underground
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Rough -in ..........
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Commercial Final
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HEATING:
Gas Test ....................
Gas Piping ...............
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Equipment ............
Commercial Final
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EXTER OR SHEATHING
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0
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NAILING .......................
0)
0
FRAMING ........................
Q 0
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FIRST FLOOR FRAMING...
X
INSULATION ...................
Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
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SPECIAL INSF�CTION
MISCELLANEOUS
FINAL APPROVAL FOR...
OCCUPANCY ...............