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THIS PERMIT AUTHORIZES ONLY THE ORKNOTED. THIS PERA417 COVERS WORK TO
I: BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ONTHE PUBU
Grading
MAIN (CURBS, SIDEWALKS. DRIVEWAYS MARQUEES, ETC.) WILL REQUI
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Recording Fee
SEPARATE PERMiSSION.
Engr. Review 50 city Surcharge
PE MITAPPLICATION: INDAYS
A. PEpGdYUMM.iYEAR�PROVID WORK IS STARTED WITHIN 180DAYS
Engr. Inspection State Surcha 6—
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SEE BACK OF PINK PERMIT FOR MORE INFORMATION
ON BEHALF OF HIS OR HER SPOUSE. HEIRS, ASSIGNS AND SUCCESORS
Traffic Mitigation Plan Chk Deposit
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
IOMONDI, WASHINGTON, ITS OFFICIALS, IMPWYEII, AND AGENTS FROM ANY AND
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY
Fire Review Receipt #
FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT BE
DEEMED TO MOD F% WMVE OR REDUCE
Fire Inspection TotalAmountDue
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ANY REQUIREMENT OF ANY CITY ORDINANCE
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I HERE ACKNOWLEDGE THAT I HAVE HEAD THIS APPLICATION; THAT THE INFORMATION
GIVEN IS CORRECT, AND THAT I AM THE OWNER, 08 THE DULY AUTHORIZED AGENT OF
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APPLICATION APPROVAL
THE OWNER, I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC�
CALL Thi-ppk.ti is net. resureft-11 signed by the
TION: AND IN DOING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELKrING TO
Building Official a, his/her Dmrmly� and Fees am paid, and
FOR INSPECTION —.1ra I...kn—l.d,.d ..P— P1.1d.d.
WORKMEN'$ COMPENSAgEMOPUSM01PE AND RCW 18.27.
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SIGN (OWN GEND) DATE SIGNED
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ATTENTION
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IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
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A FINAL INSPECTION HAS BEEN MADE AND APPROVAL 08 A CERTIFI-
ORIi YELLOW - INZE.T-04
CATE OF OCCUPANCY HAS BEEN GRANTED, USC SECTION 109
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FINAL PROJECT APPROVAL FORM
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MEMOTO: PERMIT COORDINATOR, BUILDING DIVISION
FROM: FIRE DEPARTMENT DATE�-
DIVISION DATE
ENGINEERING
PLODUNG DIVISION DATE -
PROJECT
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PERMIT # DATE INSPECTED L
DESCRIPTION OF WORK TO BE INSPECTED
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
a Copy of CONDMONS given to owner/contractor by inspector
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FARM 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
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RECORIj OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .....................
FOUNDATION:
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Pier/Porch ...............
Retaining Wall
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PLUMBING:
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Underground
Rough -in ...................
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Commercial Final
HEATING:
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GasTest ....................
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Gas Piping .................
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Equipment .................
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NAILING � .........................
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FRAMING .....................
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FIRST FLOOR FRAMING...
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INSULATION ................
Floor Insulation
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Wall Insulation ...........
Ceiling Insulation
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SHEETROCK NAILING
SPECIAL INSPECTION
MISCELLANEOUS ..........
FINAL APPROVAL FOR
OCCUPANCY .................