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Date
PermitNumber
Address
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Inspector_
Average Gi-ade_11111
Max Height (25', -Ave
Actual. Height (A -1 -BI -C)_
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Elevation of transit above Datum (B)
Datum Elevation (A) jo
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NOTICE
TO IIIERMITIIT AND/OR OWNER
DO NOT REMOVE
El 1"ARTIALAPPROVAL CORRECTION Rl',QUIRED Ll ENFOR("EMEN"I'vioi.ArION
..-...Permit Number_�?,IUL�.'
,Job ...:Site C:`ontact
Ll WORK DESC.'RIBED BELOW HAS BEEN INSPECTED AND IS APPROVED
U AlPROVI,,I)H�'IANSANI)J()B(_."ARI�)MtIS'rBl,,AVAII.,Alll.ti.,E'l"0I.NSPIE(-'l'OlR0?qSf-rE
CORRECTIONS 1ASTEM BELOW MUST BF, MADIE: BEFORE WORK CAN BE APPROVED AND/OR TUE NEXTPHASE
OF'WORB, is s,rARTED
SIRECAL1, FOR INSPECTION LJ Rl,,INSPE("T.'IONIa'l+,Emt.➢s,rii,iI,IIARRA Pl?,RIOR"[.'OINSi.Rl,C-.['IONREQL�ES,i'
Lil saw, WORK- UNTIL AurHRBBB ZEDTO CONTIN 11 EBY C, I'll'Y INSPECTOR
Ll NO PE'RMIT-STOP WORIK-REVIOVE CONSTIUX,71'1110N 011Z OBTAIN PERMITAND MAKE, WORK COMPI.,Y ITI-1
ALL APPLICABLE CITY CODES
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L1____
'THE ACTIONS 0R,. CORRE'(71ONS lNDV.,ATlF,'lDABOVE� ARE, REMARED'I"O BE C.ORRECTFI) WITHIN
CALENDAR ll.')AYS OR PENALTIES MAY BE APPLIED, FOR, INSPEC'FlON CALL 425-771-0220
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Inspector