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CONSTRUCTION PERMIT APPLICATION JOB SUITEIAPT#
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OWNER NAMEINAME OF BUSINE '50')
PLAT NAMEISUBDIVISION NO, LOT NO. L NO,
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NAME METER SIZE LINE SIZE NO. 01 11-IIES PAV REOUIRED
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ADDRESS REMARKS
OWNER/CONTRACTOR RESPONSIBLE- FOR EROSION CONTROUDRAINA131;
ITY ZIP Rprinnifegit
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NAME I required on all hot water tanks
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VARIANCEORCHUR I LI BOND
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Description
FEE Description_ FEE
Plan Ch eck
state surcharge
HEAT SOURCE GLAZING % LOT SLOPE %
Building Permit
City Surcharge L5
PLAN CHECK NO: VESTED DATE
pIU,TbInq
-
Mechanical
THIS PERMIT AUTHORIZES ONLY THE ORK NOTED. THIS PERMIT COVERS WORK TO]
a
t BE DONE ON P"IVATE PROPERTY 11I.N- ANY CONSTRUCTION I" THE PI IC
Grading
G r'
a W L R C a
DOMAIN (CURSS, SIDEWALK% DRIVEWAYS MAN UEES, ETC.) WILL REQUIRE
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I= SEPARATE PERMiSSION. " I E
2
RE MITAPPLICATIOW INDAYS
Engr. RevIeW
ED
I AY
PERMIT LIMIT. I YEAR - PROVIDED WORK IS STARTED WITHIN IGO DAYS
S
En
Engr. Inspection
SEE MCIC OF PINK PERMIT FOR MORE INFORMATION
N
A N -C .S
'APPLICANT. ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCESORS
S E.-
Fire Revim
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PlanChR.Depasit
S I THE 'TY
IN INTEREST, AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF
G NY A
ED1101111, WAIHINGTON' ITS OFFICIALS, EMPLOYEES, AND AGENTS 1"I'M ANY AN"
Fee A
Fire Inspection
F'r
Receipt 0
TLY
ALL CLAIMS FOR DAMAGES OF WHATEVER NATURE, ARISING DIREC TLY Oil INDIRECTLY
IT ' I.E.
FRO THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT SHALL NOT HE
T GHALL No BE
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- TV .INANCE
DEEMED TO MODIF'0, WAIVE OR RED REQUIREMENT OF ANY CITY OR
UCE ANY I]
Landscape Insp.
La
Total ATI. Due
"ANCE P OVG'..
NOR LIMIT IN ANY WAY THE CITYS ABILITY To ENFORCE ANY ORDINANCE PROVISION. -
Recording Fee
THE INFORMATION
I HERE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT T
-.rI'ZED AGENT OF
WEN IS CORRECT, AND THAT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF
APPLICATION APPROVAI
-RNG CGNGT-UC
T E OWNER. I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC.
CALL
ThJppII,,.iI.A 1. n.i . G—R.Mil �igred b, M.
WILL BE EMPLOYED
TION; AND IN DING THE WORK AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED
T N BE,_, .
0 1 To
IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELA7ING TO
FOR INSPECTION
FC
Buildift Offmiiii .� h1oh., D.Puly: d F B.Id. ..d
aipt ia ackna,ladpd [,,p ... proAded.
WORKMENS COMPENSAI 101� INSURANCE AND RCW 18.27.
S TUBE DATE
ED
TJU R W'NL0 ILE, TE SIGNED
(425)
LA LO
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-RE1EASED'BY
A'fTENTIdN
EXT 1333
IT IS UNLAWFUL To USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL
I
A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI-
ORIUINAL - FILE YELLOW - INSPECTOR
CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109
PINK - OWNER G LD - ASSESSOR
04102 PRESS HARD -YOU ARE MAKING 5 COPIES GREGN- ACCOUNTING
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RECORD OF INSPECTIONS
INSPECTOR
DATE APPROVED
SETBACKS .................. . . .
FOUNDATION:
Footin6.":1 L..'
Wall ............. ............
Pier/Porch.
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Fie taining Wall
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0
Slab Insulation ..........
PLUMBING:
Underground
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IT
Rough -in ..........
0
0
t Commercial Final
C
HEATING:
171
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G . si'le sit ............
MIS
Gas Piping ...........
Equipment
4
Commercial Final
ITI ITI
EXTERIOR SHEATHING
0
NAILING ..........................
6 Fn
�%FRANIING
0
P.R!FRAMING.,i
;U
:INSULATIOl,l
Floor Insulation
Wall Insulation ...........
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Coiling Insulation
C0
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SHEETROCK NAILING
0
SPECIAL INSPECTION
J
IR
MISCELLANEOUS
FINAL APPROVAL FOR
C)
OCCUPANCY ..................