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20030291.pdf� DATE RECEIVED PERMIT EXPIRES Ust ZONE PERMIT CITY OF EDMONDS NUMBER :j625!,'3'_ CONSTRUCTION PERMIT APPLICATION ADDRESS JOB I � [ I Ct C OWNER NAMEINAME OF BUSINESS 4 _) 1 PLAT NAMEISUBDIVISION NO. LOT NO. LID NO. MAiLING AbDRES19 LID FEE S AMCMOd TIESUr PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP nor PefrA Required sum Use Pwrit RoWd I CITY ZIP TELEPHONE EXISTING — PROPOSED ed REQUIRED DEDICATION— u FT wiring required I NAME METER SIZE LINE SIZE F FIXTURES PRV REQUIRED YESC3 NO 13 ADDRESS REMARKS OWNEWCONTRACTOR RESPONSIBLE FOR EROSION CONTROL/DRAINAGE ak�A Cytud a-r ZIP CITY TELEPHONE 0120 .......... IT Z�X_l M&A NAME ENGINEERING REVIEWED/DAT ADDRESS FIRE REVIEWED BY DATE Ul WE CITY ZIP ELEPHONE STATE LICENSE NUMBER EXPIRATION DATE CHECKED BY VARIANCE OR cu SHORELINE OR ADS# INSPECTION BOND POSTED [3yREQ'D ES A—O SEPA REVIEW SIGN AREA HEIGHT PROPERTY ACCO PARCEL'No. COMPLETE EXEMPT ALLOWED PROPOSED ALLOWED PROP OSED 7-R: -7 oL , i9ega-.4t) —&& EXP '-jb�-AEGIDENTIAL PLUMBING / MECH N LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR OMMERCIAL COMPLIANCE OR ADDITION CHANGE OF USE PARKING LOT AREA PLANNING REVIEWED BY DATE [3 REMODEL [3 APARTMENT SIGN REOD PROVIDED I 1 0-"-- __f - 4h 7 105, FENCE [j REPAIR GF'A-Q= CYDS A FT) REMARKS OTHER 1:3 DEMOLISH [3 TANK AmOlY AU�owel) Qbi T_91!a _EEor c3GARAGE c3 RETAINING WALL CARPORT ROCKERY 1:3 RENEWAL "L_ Keg-c- amntnr CA fuW(_ r2rpr_ t OWE OF USE, BUSINESS OR ACTfi90 gPW: CHECKED BY P 80 fF PD OCCUPA IMA Cq NUMBER JUBER OF CRITICAL OF DWEILLIN AREAS I U JAR Oif- AR SPECIAI INSPECTOW OCCUPANT - UNITS NUMBER, ? REQUIRED [3yES LOAD -STORIES DESCRIBE WORK TO BE DONE REMARKS PROGRESS INSPECTIONS PER UBC 1 08/171NAL INSPECTION REaD 1,91L AD *,X44t1j1 W4t ZUWJ -iUA IYMit- /D 4,Aif inx 7,w t.� 0- &e. d—, '�xf "IVA VALUATION Description FEE Description FEE Plan Check HEAT ZURCE GLAZING % LOT SLOPE % �BUllding_ Plumbing PLAN CHECK NOr'-j VESTED DATE Mechanical THIS PERMIT AUTHORGMS ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO 13E DOME ON PRIVATE PROPERTY ONLX ANY COMMUCTION ON THE PUBUC Grading Recording Fee DOMAIN (CURBS, SIDEWALKS, DRINIEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION. Engr. Review City Surcharge PERMIT APPILICATION: 150DAYS PERMIT UMrr I YEAR - PROVIDED WORK IS STARTED WITHIN 180 DAYS Engr. Inspection State Surcharge SEE BACK OF PINK PERMIT FOR MORE INFORMATION 'APPLICANT, ON BEHALF OF HIS OR HER SPOUSE, HEIRS, ASSIGNS AND SUCCESORS Traffic Mitigation Plan Chk Depos t IN INTEREST. AGREES TO INDEMNIFY, DEFEND AND HOLD HARMLESS THE CITY OF Receipt # EDMONDS, 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 PERMIT. ISSUANCE OF THIS PERMIT SHALL NOT BE Fire Inspection Total Amount Due DEEMED TO MODIFY, WAIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY THE CITYS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' Receipt # Landscape�Insp. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN IS RRE _T kT I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF Cc r: THE OWNER. I AGRI T COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUC CALL This application Is not a permit untH signed by the TION; AND IN DOI W09f AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED 10 HAS CODE OF THE STATE OF WASHINGTON RELATING TO IN I FOR INSPECTION Building Official or his/her Deputy: and Fees are paid, and receipt Is acknowiedged in space provided. VIOLATS=NT WORKMENS 95KINSURANCE AND RCW 18.27. '0 OFFIC IAL63IG NATURE All DATE SIGNATU�WNE AGENT) DATE SIGWD 1495) 12_Ll� z 771-0220 DATE "TT whort lee' xe<4. EXT 1333 Ll 7--., A BUILDING TRUCTURE UNTIL IT 1191UNLAWFUL TO USE OR OC UPY T, 771-0221 — A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI. ORIGINAL - FILE - YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FAX PINK - OWNER - GOLD - ASSESSOR 10101 A o MEMORANDUM Date: April 18,2003 To: File Plan Check 01-432 Street File 20902 Hillcrest Pl. From: Steve Bullock Senior Planner Subject: GRAD ING IN A CRMCAL AREA. . . . . . . . . . . . . in response to a complaint, the City confirmed the grading of approx 50 cubic yards within an area that may be a steep slope hazard area. In complying with the violation notice, the app licant has th th applied for a grading permit. Due to the passage of time, the amount of fill placed on e; slope, e natural revegetation of the soil that has taken place ah -eady and the question of whether or not this slope does in fact qualify as. a steep slope leads the Planning Division to make the following decision on this matter. Approve the grading permit as submitted with the condition that no fiirther activity take on the sloped area of the site without the completion of a detailed Critical Areas ...... Z place study to confirm whether or not there is a Steep Slope Hazard area on the property. In the mean i" J-;`� , 2XII; th h y the top of e Steep Slope time, the applicant has submitted a site plan t e City will use to identif area. b e slope to a greater This decision is made because requiring the fill to be removed could distur th y as a Steep Slope than it has been already. and because the slope may not even qualif :degree Hazard Area. Attachments: .. ........ . M A'ICROFILM City of Edmonds ca Planning Division 01432PC.DOC 04120/M. I a 131LOW aoqo(v dr w 4 9:29AM; Pegs 2/2 CRIT16ALA*e4 "rA*J" FiLL :DI)Akpfgo 7/0 1 Ilk r S Q9VWW MdW 4 : NOV SILl 67 #'W 41d A ��IQ-Sbu Ar a %mom A MAtW WM SY ME Ot OM 6 -'Ifiv L'� t Jilt I I If I i I I It I 13,2002 I I t I I I I I I I I I I I I I e I I I I August I t I I I 1 4 if ILI$ I If ff RECEIVED If I -3 2W2 Mr. Steve Bullock AUG 1 I f..' TZ, "Ivjlf'rr.� I I i 14. � it f Senior Planner I I I 1 4 p- I t 0 1 1 1 I I 'I I r I, i III If I JI It t i I - . I I I f I I I I 1 1 City of Edmonds DEVELOPMENT SEFIvICES It Ii .if ". I. I. Development Services Deparbuent I I I.. LIP L... Avenue North 1215 1... 4 0 1 1 1 1 1 1 1 1 1 1 1 1 1 Edmonds, WA 98020 � o� �"' I., 1 1 It I ILI Rem, Grading Permit Resolvc� 20902 Hillerest Ph Edmonds, WA 98026 tiI Dw Steves I I I In response to our mee i last weel; I am submitting a drswing showing the loc ..;.I f. jI bug ation of the top of ILI trust this will resolve any amb es you and the Ci might have for future development, the slope iguiti ity I 111 12 I t ilt I 1�4 0' I '�J� I t rnf, I I I L P1 utact me if you have further questions or reciture additional informfion. I I� :j I 1 :4 "ti. f`q I I 1 4 1 l S4 me IL it 4" 1 fi �dlz Jones, CM 9 1 Owner :I; I I I It e...� I I I. I ti, tl GAU4 I I I I. I I If I I I I I I It It, I ti I P, IL If t It I i It I LL It to 4 1 I I Lf If " ..w MP 9 ; �Dopw"v 6910 4 9: 29AM; .1 �Gkft I V. Al Or INIV S-7 r of V�� a 2f5 C14 '224. 219 12268 1201 205 1 I 8 131 1380 8 127 1200 1208 826 8 112 1212 f,' 115 212 — 9110 132 114 0 118 9126 3 20624 20625 co 20621 20621 201 % N 20710 20 20.7 20709 to cm co 0 co Go co 78 Ni!20710 s 20710 20725 9114 9110 20723 cb 00 co Go 0) CIS N Lo �s 00 At Go CD m co co CO N CD 20 % cm MAIN ST 20802 9018 9118 IL 8830 8820 8810 8730 8716 -20820 20815 00 co ro 20814 8718 Go 911 20828 w of 20821 Co r%. —j 20819 1 -to CC 10, 13. C4 &1 20826 8722 8706 20829 20828 iE 00 ?0903 __ 8724 co V3 20909 20832 8729 — — 209TH PL SW co et4 20926 co 8804 8738 8724 F-417 4�4 49 20931 8736 40 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT 121 5th Avenue North, Edmonds, WA 98020 (425) 771-0220 111 111! liq �1111 ��ilip Location of Violation (Address and Tax Account Parcel N 20902 & 20906 Hillcrest Place, Edmonds, WA 98020 Tax Account Parcel No. 3736-005-007-0304 Issued To: Greg & Wendy Jones, PMp Owners Address Of Person This Order Is Issued To: 20906 Hillerest Place, Edmonds, WA 98026 Code Section Violated:. Uniform Building Code A -C Mendix Chgpter 33, and Edmonds ommuni1y DeveloRment Code Chgpter 20.15. Description of Violation: Fill/Grading permit reguired for theplacement of fill on a stegp slgpe. Corrective Action Required: The golicant has filed a pennit ggRlication for the fi1YZ[@AmLg work. However, thgy have failed to regRond to outstanding Planning- Division corrections dated July 1. 2002 from Steve BullocL Senior Planner (gopy of corrections attachgd . Failure to submit all uired j M9 documents by the August 19, 2002 deadline shall -result in the issuance of a Notice of Civil Violation and fines of $100.00 per dgy shall be assessed. Please immediately contact Steve Bullock, Seni Planner to resolve this matter. Correction Is Required no later thaw. 5:00gm (time) August 19,2002 (date) If correction is not made by the date and time specified in the Order, a Notice of Civil Violation shall be issued. The Notice of Civil Violation shall assess fines of $100.00 per dal, or portion of a day, during which the violation continues. Date First Class Mailed: August 2. 2002 Date Certified Mailed- Auggst, 5. 2002 Issuing Party- Jeannine L. Graf Title Building Official Signature F--� cy '0� rr 1� MEMORANDUM I" I IM S-9 Date: June 28, 2002 To: Jeannine Graf, Building Official From: Steve Bullock, Senior 1`1=65D Subjed: Jones Grading Permit, Plan Check 0 1 -432 I've reviewed the submitted grading application and visited the site. Because the activity took place on a portion of property that appears to be a Critical Area, a Steep Slope Hazard Area, a grading penrnit is required even though grading of 15 cubic yards would typically be exempt from a permit. 'Me Planning Division also issued a Critical Areas Determination of Study �Lequired. This was to definitively confirm the presence of a Steep Slope area and to establish the top and toe of that steep slope. In this case, the grading has already occurred and it is a rather nominal amount. Also, removal of the soil would likely be a greater disturbance than allowing the soil to remain while making sure that the Engineering Division erosion control measures are in place to minimize impact. lberefore, the Planning Division will issue a Conditional Waiver from the Critical Area Study Requirement as long as the applicant is complying with the erosion control measures required by the Engineering Division and the applicant submit a survey drawing which accurately locates, using bearings and distances, the top of the slope. If the applicant chooses to complete the Critical Areas Study, surveying the top and toe of the slope and confirm the inclination of the slope, they may find that the inclination is less than 40% and not subject to Critical Areas limitations. Attachments c: File No. Plan Check 0 1 -432 City of Edmonds ca Planning Division 02061 PCO1432.DOC 0MV2002. lFf 13 11 CITY OF EDMONDS DEVELOPMENT SERVICES DEPARTMENT (425) 771-0220 . 121 5th Avenue North, Edmonds, WA 98020 ORDER TO CORRECT VIOLATION Location of Violation: 20902 & 20906 Hillcrest Place, Edmonds, WA 98020 Tax Account Parcel No. 3736-005-007-0304 Issued To: Greg& Wendv Jones, RW.=, Owners Address Of Person This Order Is Issued To: 20906 Hillcrest Place, Edmonds. WA 98026 Code Section Violatedt lim-ffinn Building Cod—e—A—Mendix Ch@Rter 33 and Edmqnds. Commumm:V Deve:122meant Code Chapter 20.15 Description of Violation: FilEgMding germit Mguired for'the Rlacement of fill on a stem slMe. Corrective Action Required: 1) Submit a critical areas checklist -(fee $45.0.1) Submit cg=lete WHcation for required filygrading nermit. (double fees shall be assgggd). Correction Is Required no later than: 5:00pm me) December 17,2001 (ti (date) If correction is not made by the date and time specified in the Order, a Notice of Civil Violation shall. be issued. The Notice of Civil Violation shall assess rmes of $100.00 vLr day. or portion of a day, during. which the violation continues. Date Posted: Date Mailed: Novem6er 28, 2001 Date Served Issuing Party---Le—am—njLXiej--fy_mf Tide— Building Official Signature .......... Msmc ulnurt PM 2.9, r- & IN 1 OF MW PROMTv OMOM EMU 400 0.25, N. chn Jim li vim S, was 141 - zea, FiL-c, IL 2.6cl tit PL PL MAPOO "ago's '97,11W Ivy. r-WTPIL- N I 0. 00 8 r f I CUT= 11r smil 3OC6 Vml&"T c 13LOW avio(v IL A %0.11 A SMW WW SY 69 q1t UMM it WARNING The failure to stop work, or the Pbsted this day Of r4eSUMing of work without Permis- sion from the Building Officials at a or the removal, mutilatiOnt Or jm concealment of this notice is SUM punishable y and imprison- ment. E�uildilg Official �'-n C. 189,11 CITY OF EDMONDS 1215TH AVENUE NORTH 9 EDMONDS.WA98M * (425) 771-M * FAX (425) 771-=1 Wabsb: deftwft.waus DEVELOPMENT SERVICES DEPARTMENT Planning e Building * Engineering November 28, 2001 mr. Greg & Wendy Jones 20906 Hillcrest Place Edmonds, Washington 98026 RE: Stop Work Order for Illegal Fill and Grading GARY HAAKENSON MAYOR The purpose of this letter is to follow-up on a Stop Work Order issued to your property on July 17, 2001 for illegal filling and grading of land including a critical area at and/or near 20906 Hillcrest Place in Edmonds. The Order requires that you obtain a fill and grading permit however, as of this date we have no record of your submittal of any application(s). General fill and grading work are governed by Uniform Building Code Appendix Chapter 33 which requires a permit when 50 or more cubic yards are placed. Fill and grading work on sloped properties is governed by Edmonds Community Development Code Chapter 20.15 which is much more restrictive and requires approval for any amount of grading or fill placement. Enclosed please find the City's public handouts that are applicable to the work that you have done. Also enclosed is an Order to Correct Violation Notice which is the first step in the City's, Civil Penalties process whereby compliance to the codes shall be secured. The Order requires that you make a complete submittal of all required forms, permit applications and fees by December 31, 2001. Failure to submit by this date shall result in the issuance of a Notice of Civil Violation whereby fines of $100.00 per day shall be assessed until this mittir is resolved to the satisfaction of the City. Note, it is not the City's intent to cause YOU undue hardship however, compliance to the codes is mandatory for the fair and equal treatment of all citizens. , After reading the handouts if you have any questions please feel free to contact me for assistance. If you wish to meet in person please call in advance to schedule a meeting day and time as I am frequently assisting other citizens. Also, I will be out of the office December 3-7h. Sincerely, Jeannine L . Graf Building Official Incorporated August 11, 1890 0 Sister City - Hekinan, Japan A z 0 i 0 m I. =i ---n m c m 0 -10 0 c --i C X M M Z (j) o -n n m m 0 0 o C K CO) M 0 Z-1 l7n 03� z z 9 0 m r 6 0 : . . I I I to,Al ..�)-� Ill.. - 'llil.r"tt 71 : V. - I � � i I '� I , � I �'.' , , I .I r -1. � . . 'f I, -- - I ON, IA I A te a' ,tele It, k , , I �� A A. I , I � I '. � -A - I '�"-! , ': I 'V el" A"Al I' , ".I I j , "!a� � J'-' 00-i-1 t v III &. ,,. - t - 0 I.'I I �p .1 I %� � I, -1 !, #'k� ,I .'� '. I .. I, , - . I .1 A I � 1:!" 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A I I tl � .#'�..' I " I e. I L k . , , : I � I I ' I * 0 A � A , . � A� rA � : L I L i \ 4 i � .j " � , l , I - L & � % � � . , : � I L I , , I - � l " j : � I I � k 1, I . . I I II I-ttIl . � I . I . I . I . I -It,- � I % -'�� I I "A lt ' L I L �" L . . I, 1 .lI��ir4 gIs � . I I . I . ttt`tto400`o"`�%,. I L . 4 4 ECEIVED _,U11ATE RE= fi ERMIT EXPIRES J P use PERMIT coff CITY OF EDMONDS FONE NUMBER --LA— JOB SjJITEIAPTfj V CONSTRUCTION PERMIT APP'LICATION ADDRESS Q Oq 2- 1� I I VI, OWNER NAMEINAME OF BUSINESS PLAT NAME/SUDDIVISION NO. LOT NO. LID NO. MAILING A(JDRES9 I LID FEE 111 PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP 'RIEWN=qUkred 41, S - 142LY — a Permit a— 0 CITY ZIP TELEPHONE EXISTING — PROPOSED Sid0*2* Roqvksd 6 W r— V— REQUIRED DEDICATION— FT undwwww VAMg recitAc6d 13 NAME METER SIZE LINE SIZE TNO, OF FIXTURES PRV REQUIRED YES CI NO 13 10—DES-8 REMARRS OWNER/CONTRACTOR RESPONSIBLE FOR EROSION CONTROLIDRAINAGE '-7LEPHONE A Pir CITY ZIP NAME ENGINEERING IDA ADDRESS WL ,,REVIEWED ; z FIRE REVIEWED BY DATE CITY PE ION —RATE LICENSE N UMW1 EXPIRATION DATE KED VARIANCE OR CU SHORELINE OR ADS# INSPECTION PSOND RED OSTED 3 ES Y &0 P!FERTY NT PARCEL' SEPA REVIEW COMPLETE EXEMPT ALLOWED SIGN AREA HEIGHT PROPOSED ALLOWED PROPOSED 7V. ek 0 , rn PLO" zoflx EXP C ITI N rif' PLUMBING I MECH LOT COVERAGE REQUIRED SETBACKS (Fr.) PROPOSED SETBACKS (FT.) ALLOWED PROPOSED FRONT SIDE REAR FRONT LIR SIDE REAR 0 C 13 AD ON COMMERCIAL COMPLIANCE OR CHANGE OF USE 5 PARKING LOT AREA PLA"W RE10JE&EELSY D ITE M M REM DEL APARTMENT 0 [3 SIGN F!4� PROVIDE PROV IDED '.2. _ _I 40 Lgj �L� 4 10 CYOS [3 FENCE REPAIR X FT) REMARKS z .[3 DEMOLISH 13 TANK [3 OTHER fig &110 'TY ALtowt�D ot4 14 (-tlg 'r, GARAG E c3 RETAINING WALL 0CARPORT ROCKERY [3 RENEWAL Lkt4TIt— K t inc CA -6� 0 71� MPE OF USEi BUSINESS OR ACTM CHECKED BY OCCUPANk 31 V. I f, =Lrlon ORO UPL M M "UMBER NUMBER OF CRITICAL OF DWELLING AREAS SPECIAL INSPECTOR7 AREA EQUIRED OCCUPANT LOAD 00) 0 Fn STORIES UNITS NUMBE [3YES 0 DESCRIBE WORK TO BE DONE C= co REMARKS PROGRESS INSPECTIONS PER UBC 108/FINAL INSPECTION REQtD M OL Cie. TT L6!�jfOlelr, Am/t Ale .7 Af 1pJe z 7- - VA LUATION $ Description FEE Description __]—FEE z Plan Check 0 ITI HEAT SOURCE, GLAZING % LOT SLOPE % Building PLAN CHECK NO-,Wl--. I VESTED -DATE Plumbing Mechanical. THIS P9RWAM#OR1kES ONIM THE WOMC NOffkD.'!!*S PERMYr COVERS WORK 76 t: USUC Grading (jgo Rkording Fee DCM14 (CURB% SIMWAUM DRn"AY% UARQUEES. FTC.) WILL REQUIRE SEPARATEPEMSSIOI& Eng�. Review City Surcharge PERMITAPPUCATIONt ISODAYS PERMIT UMM I YEAR - PROWDED WORK 18 STARTED WITHIN 100 DAYS Engr.Inspecflon State Surcharge SEE BACK OF PIINK PERMFT FOR MORE INFORMATION SL ,APPLICANT ON BEHALF OF HIS OR HER SPOUSE, HEIRS. ASSIGNS AND SUCCE ORB Traffic Mitigation Plan Chk Deposit IN INTEREST. AGREES TO INDEMNIFY. DEFEND AND HOLD HARMLESS THE CITY OF EDMONDS. WASHINGTON, ITS OFFICIALS, EMPLOYEES, AND AGENTS FROM ANY AND Fire Review Receipt # ALL CLANS FOR DAMAGES OF WHATEVER NATURE, ARISING DIRECTLY OR INDIRECTLY FROM THE ISSUANCE OF THIS PERMIT ISSUANCE OF THIS PERMIT $HALL NOT BE Firelrispectlon Total Amount Due DEEMED TO MODIFY, WNIVE OR REDUCE ANY REQUIREMENT OF ANY CITY ORDINANCE NOR LIMIT IN ANY WAY �NE OITTS ABILITY TO ENFORCE ANY ORDINANCE PROVISION.' # P�.l �,- 1 11 Landscapelnsp.- Receipt I k6EBY ACKNOWLEDGE THAT I HAVE READ THIS APPUCATION; THAT THE INFORMATION APPLICATION APPROVAL GIVEN is E I AM THE OWNER, OR THE DULY AUTHORIZED AGENT OF G% AWrriAT T14E OWN AMI A EWCOMINY WITH CRY AND STATE LAWS REGULATING CONSTRUC- CALL TWs applicallon Is not a pennit unto signed by the JIGN; AND I DOINd AUTHORIZED THEREBY, NO PERSON WILL BE EMPLOYED IN Building OMcW or his/her Deputy: and Foes are paid, and 1�11 VIOLATIOIN T LA CODE OF THE STATE OF WASHINGTON RELATING TO 0 =T FOR INSPECTION receipt Is acknovAedged In space provided. a WORKMEN' INSURANCE AND RCW 18.27. OKI OF GNATURE ATE DATE SIG mo (425) XI 771-0220 N' viia:UL Off 1333 R Y DATE AL" �/� IT TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL 771-0221 1 A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFI- ORIGINAL - FILE - YELLOW - INSPECTOR CATE OF OCCUPANCY HAS BEEN GRANTED. UBC SECTION 109 FM PINK - OWNER - GOLD - ASSESSOR 10/01