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SEE RACK OF PINK PERMIT FOR MORE INFOGNIATION
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State Surcharge
'AIPLICANt. ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation
Plan Chk Deposit
IN INTE f IEST, AGREES TO INDEMNIFY, DEFEND AND HOLD 111- __ -,
IWASHINGTON ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES
Fire Review
Receipt #
IEDMON
OFWNATEVER NATURE. ARISING DIRECRY OR INDIRECTLY
2 FROM THE ISSUANCE OF -I$ PERMIT, ISSUANCE OF THIS PERMIT SHALL NOT BE
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DEEMED TO MODIFY, REDUCE ANY REQUIREMENT OF ANY C TY ORDINANCE
Fire Inspection
Total Amount Due
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NOR LIMIT IN ANY WAY THE CRY'S ABILITY TO ENFORCE ANY ORDINANCE PROVISION,'
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Receipt #
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION
GIVEN IS COARECT; AND THAT I AM THE OW14ER 'OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAL
THE OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
THIN', AND IN DOING TH[EjW--,'%T��A�T�E-614. IE.... WILL BE EMPLOYED
CALL
rule -Plllr.ti,n Is not a Permit until signed by the
IN V,..T,ON 0, THE T. ST F WASHINGTON RELATING TO
�MENS COMPENS/? HE NVE AND HOW 18,27�
Building Official or his/her Deputy: and Fees are must, sund
FOR INSPECTION mompt Is surim-ledg.d I-imse, rue,khm,
at CENT) DATE SIGNLEO�
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771-0220
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR
EXT 1333
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STRUCTURE UNTIL
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTWI�
771-0221
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
FAX
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FINAL PROJECT APPROVAL FORM
TO:
DATE:
MEMO TO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: —YIRE DEPARTMENT DATE 6 —Il-0
ENGINEERING DIVISION DATIE�—
LANNING DIVISION DATE
PROJECT
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PERmrr#2nQc�,)--,032.,4 ADB#--DATEiNspEcTED
DESCRIPTION OF WORK TO BE INSPECTED-/,LaaD V4f�e
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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 the release of
PERFORMANCE BONDS and the granting of:
--->—/--GRANT FINAL PROJECT APPROVAL
GRANT PROJECT APPROVAL WITH CONDITIONS NOTED
o 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
2.
3.
RE -INSPECTED OUTSTANDING ISSUES - GRANT FINAL PROJECT APPROVAL
Date Si
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACK$ ...........
FOUNDATION:
Footing ......................
Wall.......................
Plar/Porch
Retaining Wall ...........
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Slab Insulation
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PLUMBING:
Underground .............
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Commercial Final
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HEATING:
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Gas Piping .............
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EXTERIOR SHEATHING
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NAILING ..........................
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FRAMING ..., .................
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FIRST FLOOR FRAMING
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INSULATION ..........
10
Floor Insulation
Wall Insulation
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Ceiling Insulation
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SHEETROCK NAILING
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SPECIAL INSPECTION
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MISCELLANEOUS
FINAL APPROVAL FOR
OCCUPANCY ............