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Home My WebLink AboutBLOOMINGTON AVE., 1510 -0 . \ .) N9 36130 /() 0 ... -...-- R . N .,,9\L' J?- Fee $_______________________.____. _________________________....__..._....... ecelpt o. ....___......__......_______..................____........ BUILDING PERMIT CITY OF BREMERTON BUILDING DEPARTMENT s Lot Block Additions F. E. IRISH, Building Inspector . ESsex 3.1411, Ext. 36 Owner's Value Bldg. Dept. Value DESCRIPTION: Address on Job .-m/....sL.~m~~tftf:~-.nm-.-.-..nn----.---mnmmmnn Date. __m.n.._ mn::!.;Z___n196~~:-' Building __n__._n__n_. x mm._m_.___ and _mm___.___n stories m_m__m__m_mn_ basement. Lo 0000. _'mm' X __mm.m.n. Front Yard ______mnm___m____ Rear Yard mmn_mmmmm Side Yard m.___.m___n___.m. Garage _m..n___.__..__.____m_m_. Occupancy - - - 'i/:- - - - - - - - - -. - -- - - - - - - - - - - -- - - - -. - 00 - - -. - - --...- - - n - -.. -.. n... - -. - -- - - - - - - - - -. - -...- 00 -- - - -. - - - 00 _ _ Zone. _ _ _. _ _ __ _. _ _ _ _ __ _ _ _. _.... _ __ _ _. n - .-- - - -- Owner .---.--n-€&.:(/:-J!~--:f.:n--&)~~!.L'Jf--.------------------n--- Address __._._____ __.__00_ _00________00___ __0000_ __. Phone____. .__________ Gon tractor 00 _ __ _ _ __ _ _ __. _ __ _ _ 00 _ _ _ _.. _ _ _ _ __ _ _.. _ _.. _ _ _ _ 00 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Add ress _ _ _ _ _ _ _ __. _ _ _. _ 00 _ _ _ _ _ _ 00 _ _ 00 _ _ _ _ _ _ 00 _ _ ~ _ _ __ Phon e_ 00 _ _ _ _ _ _ _. _ _ _ __ TAis permit is issued for: ~!~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~:=~:~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~:~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ All work to conform to all applicable building ordinances and amendments. Please note the following special instructions and requirements. DETACH HERE AND POST THIS SECTION ON JOB INSPECTION - Reinforcing steel must be inspected after placing and before covering. FORMS shall be inspected and approved before pouring. All plumbing, wiring and the frame of all buildings mu'st be inspected and appro'ved before covering. Wood preservative to be used on all wood against masonry. Ventilate fo,undation and attic. Sepa- rate permits required for plumbing, wiring and heating. See City Engineer before working on streets or sidewalks. . :~::~:~:::.:~:~.:.~~..~~..::.~::::::~~.:::~~~::.:~~.~~~~~.:.~~~~..~..::::~:::::~:~~~~:~~~~~~~:~::.~:~~ .-.................... --..............................-.............. --................-............................................ --.. --.................... -........ -.......... -................................ --.... --............ --..............-.............................._.... --.... -- -- --- -_oo.... _._.. __...... .............................. --.. -.. - -.. -- - - -- - - - - - - - - - - - -.. - - - - -.... - - - - -.. - - -.. - -- --........ --.. - -- -.. -.. -.. - -.. - -.. -.... -.. - -.. - - - -.. - -.................... -.... - -.. -.. - -.. -.......... -- - - -.... -.... -.. -.. -.. -.... ....- - -...... - -.......... - -........ .................. .... -.. - - - -.. -........ - -.. - -.. - -.. -.... - -.. - - -.. -.. -- - - -.............. - -.... -...... -.. - - -.. - - -.. - - -... - -.. -.. -................ -.. -.. - - -.... - -.... -...... - - - -.... - - - - - -...... -....- -.. -.. -.. -...... - - -.. -....-.. - -...-.. -.......... -.. -.. -.. -.. --.... - - -.. -.................... .... -.... -.......... -....- - - - -.. -...... -- -.... -.. -.. -...... -........ -...... - -.. - - - -.. - - - - -.... -...... -.. -- - -.... - - --.. - -.. - - - - - -.. - - - - - - - -.. - - - - - -.. -.. - -- - - -.. - - - - - - -.. - - - -.. - -.. - - -- - -.... -.. -.. -.. -.... ..-....- -.......... - -.... -.. -.... -.... -.. - -.. -- ........ -.. .._,_.. -...... -........ -.............. ........-...... -............ ......-.. - -.. -.... -.. -............ -........ -.. - -...... - -.. - - ""'.. -........ -.. - - -...... -.... - - -............................ .......... - --.. -...... -.... -.... -........ ....-.. ...... -.. ...... ................. ..-.... -.... -.. .................. ...... -.... -..-.... --........ -............. -...... - -.. -.......... -.. -.... .............. -................ -.... -.............. -.......... -.. - - -.. -.. -........ .. - -.. -............ -.... -............ -......-.. -...... -.... - .......... -.... --........... -................................ --.. --..... -.... -.. -...... -.......- -.. .. - -...... -.... -...... -.. -................ - --.. -.... - -.... -.................. -.......... -...... - - --.......... - -- - -- - -.......... -..... - -........ -.. -........ -........- -........ - -.. -.......... -.... - - - - -...................-.......... -........ ..-.. ...... - - -...... ,,-.. -........ ...... -........ ..-...... .............. -.. -.. -.. -.. -........................ -.... -...................... -........................ -................ - -........ -.............. -.......... -.... .... - -........ - -.......... -...... -...... -.............. - -.................... -.. -........ _.... -...... -....- -.... -.... -.. -.. ...... - -- -... - -.. -..-.. -.. .. .. _...... -...... -.... -.... -.. -........ -.... -.. -.. -.. -............ -.......... - - -........ _.......... -...... -.... - - -- -............-......-............ - - - -.. - - -.... -.. --.. - -.. -.. - --.. -.... -.......... -.......... -.... -.. _..................-............ -............................ - - - _.. -.... - - -........ ................................. -.................... -.. - -...... - .................. -........ -............ -.. - -........ -.... -.. -.............. -.. -..... -........ ............................... -...... -........ -.... -..- -...... - -.... -.. -.. -.. -- - -.... - - - - - - --........................ -.. -.... - - - - -..- - - --.. -.. ~ ...................................... _................................................................................................................................... _......... _........ _.. M"_ _...... _............ _.......... _ _ _ _........ _.... _ _ _.......... _ _ _ _ _ _ _.... _.... _.. __.. _.. _ _......_ _ _.......... _.. __ _ _.... -......................o... -.. ,",- -.................. -............ M" -...... - -...... ..t;.-OO.:'.............. _.. -................ - - - -...... _.. -i"" - .. -.. -.. - - - - - - - -;.. - - - -- - -.. - - - -- - - - - -.... - - _.. - - -.... -.. - - - - - -.. - - - - - --.. -.... - - -.. - - - - - - -- -.. - --.. -_ - -.. - - -.... - - __ O ' s' 7~c-?€~.</C.,-e. ;;:.a-z:;a:1 B . wner sIgnature __ _____k::-fn _'_ 00'''_ _ ___ ___00 00 00 00_ ------.-00-00-'00-7"'- Y n_ n_____n____nnn_ _00_ 00_ n__ ____ __ n_ nnn __ 0000__..__ ___ _ _ _ 00 _ _ ___ __ ,I' His Authorized Agent Building Inspector ---___________._____.___::z~____gif::;rt~___.____n______n___________.__n___ ... DF By _____.un.u.u_u_.____.____________._n_1!..D.n__h____________ __ ______ __ n______. RETAINING "TALL OR FjNCB fj,PPLICATION \ , ~ r ..' All fences must be on private property and shall be subject to removal if on public right-of-w'ay. ./ This fence to be located on street front ( ) alley ( ) at .. ,J- /.s>O.~ ad S8 ~tJ~ t............ . . . , ... ,'.m";j O.K.'d by .~ ;2;ngr. Dept. Date a- I J ~ / t:;;, ~~ / ' j~ " ,1.-.- \ ..:.......J%...../J.... . \~:\'~:~,i" " ':, ,.:-.'~ ..i' ,;,... 'J 1 ", " r.., . .\~ \. PERMIT '.' CITY OF BREMERTON BUILDING DEPARTMENT PHONE: 478.5281 JOB ADDRESS l,ance Wheeler OWNER Self CONTRACTOR 1510 Bloomington, Bremertoup WA. MAIL ADDRESS ZIP MAIL ADDRESS 479-8120 PHONE PHONE LICENSE NO. Class of work: D NEW D ALTERATION D REPAIR D ADDITION [] MECHANICAL D PLUMBING INSPECTION: Groundwork Wasted Vents Htg. Ruffin Stove or Insert CHIMNEY(No fee information only) Masonary Lines Unlined Factory Mfg Type B Type L Location: Internal Outside Wall No. Type of Equipment STOVES Gas_ Oil_ Wood X FIR~PLACE INSERT FURNACE Gas (Nat._ LPG. _) Oil_ Wood add on _ Other_ Electric_ BTU Type: Up flow_ Down flow_ Horizontal_ Wall_ Fee -- ~ .illL CONVERSION BURNER: Gas_(Nat._ LP_) Under 100,000_ Over 100,000_ Oil_ UNIT HEATERS BTU_ Gas_ Elec._ BOILER Gas_ Oil_ Electric_ Other_ HP_ GAS SYSTEM Max. 5 outlet Total_ EVAPORATION COOLERS Roof_ Wall_ BTU <.,,,,,) AC UNIT Electric_ JtA'q~($~.m.. BTU_ , /<,. /ii, I,., ..~. HEAT PUMP Single Paclkag18e"v~,S:I?"~La",'.~~'-;r Add ori~ BTU TOf1:L--, MIXINGOR REHEi+I'BQi"'G,!,,~~'~~a:~ AIR HANDLING UI'j,I~>Ef~.l",.JTU- FANS Exhaus ")SuppW"',,{ iB~ " \I -. >,,,, '.,' RANGE H.OOD1i ntl~I_. Comm._ CLOTHES DRYER Res:,'1."""C't~;fn;?L.~t..,." i' ".1/ Incinerator . '11' .$ < ALTERATION TC) DUCT SYSTEI\II' Heating/Coolin~ ExhaUSL- TANKS Oil----" ~as_ Propane wlOK from Fire Dept.~ Gallons_ REFRIGERJ\;TION UNIT '---- - l1-;; lrL,,;.,...) ~ '{~'~>' ;t,;:.;:::'" ~. ~ ~ 1'1:, l(I~ .." > - . __ . ~ '" ';{1 '€-~"~ ~,J;~;:(-<I'" PERMIT $ TOTAL FEE $ f) 50 1000 FINAL APPROVAL (SEE OTHER SIDE) RECEIPT NO. (White-ORIGINAL, Vellow;IJ~ISPECTOR, Pink-APPLICANT) .X11 Gas Test No. Water Chimney Refrig. Type of Fixture or Item Fee WATER CLOSET (TOILET) BATHTUB LAVATORY (WASH BASIN) SHOWER KITCHEN SINK & DISP. DISHWASHER LAUNDRY TRAY CLOTHES WASHER WATER HEATER URINAL DRINKING FOUNTAIN FLOOR - SINK OR DRAIN SLOP SINK WATER PIPING & TREATING EQUIP. WASTE INTERCEPTER (Grease) VACUUM BREAKERS & BACKFLOW DEVICE LAWN SPRINKLER SYSTEM SWIMMING POOL - Private Public GROUNDWORK SUMP ALTERATION POST & BEAM ,~~/gt \ q......-- (} PERMIT $_---.:... TOTAL $ NOTICE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- IZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION ORWORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHE- THER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRE- SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOR- MANCE OF CONSTRUCTION. ;~y (;;;C;~ t;:? l~;'",/~>t , >:'~! (V':X.e",., rt.,.(.,,, SIGNA TUE'f> OF CONTRACTOR OR AUTHORIZED AGENT ) .', 'I ".,<j"'~.~:J~.'~..,,,.,/.'.(..'..~ ',.',' .. ~j:':l');" - (D~T~; , / qj'?E'j/34 (DATE) ?()r)~ kJa~b SIGNATURE OF OWNER (IF OWNER BUILDER) PERMIT NO. t'\JO ,{,>. "t4 1".~ e PERMIT . CITY O~ BREMERTON BUILDING DEPARTMENT PHONE: 478-5281 JOB ADDRESS Lance Wheeler OWNER Self CONTRACTOR 479:-8120 1510 Bloomington, Bremerton, WA. MAIL ADDRESS ZIP MAIL ADDRESS. Class of work: D NEW D ADDITION D ALTERATION U3 MECHANICAL CH I'MNEY (No fee information only) Masonary Lines Unlined Factory Mfg Type B Type L Location: Internal Outside Wall PHONE PHONE LICENSE NO. D REPAIR D PLUMBING Gas Test I NSPECTION:G roundwork Wasted Vents Htg. Ruffin Stove or Insert .Water Chimney Refrig. No. Type of Equipment STOVES Gas_ Oil_. Wood~ FIREPLACE INSERT FURNACE Gas (Nat.~ LPG. _) Oil_ Wood add on _ Other_ Electric_ BTU Type: Up flow_ Down flow_ Horizontal----"-'. Wal~ CONVERSION BURNER: Gas_(Nat._ LP_) Under 100,000_ Over 100,000_ Oi~ UNIT HEATERS BTU_ Gas~ Elec._ BOILER Gas_ Oil_ Electric_ Other_ HP_ GAS SYSTEM Max. 5 outlet Total~ EVAPORATION COOLERS Roof_ Wall_ BTU_ AC UNIT Electric_ Gas Elec. Combo BTU_ HEAT PUMP Single Package~ SpliL- Add on_ BTU Ton-----, MIXING OR REHEAT BOX CFM_ BTU_ AIR HANDLING UNIT CFM_ BTU_ FANS ExhausL-- Supply_ Bath_ RANGE HOOD Residential_ Comm._ CLOTHES DRYER Res._ Comm._ Incinerator. ALTERATION TO DUCT SYSTEM Heating/Cooling_ ExhausL-- TANKS Oil_ Gas_Propane wlOK from Fire Dept._ Gallons_ REFRIGERATION UNIT Fee ~~ PERMIT $ TOTAL FEE $ 5 50 1:0 """()(f"" FINAL APPROVAL (SEE OTHERSIDE) RECEIPT NO. . (White-ORIGINAL, Yellow-INSPECTOR, Pink-APPLICANT) No. Type of Fixture or Item Fee WATER CLOSET (TOILET) -- BATHTUB -- LAVATORY (WASH BASIN) -- SHOWER -- KITCHEN SINK & DISP. -- DISHWASHER -- LAUNDRY TRAY -- CLOTHES WASHER -- WATER HEATER -- URINAL -- DRINKING FOUNTAIN -- FLOOR - SINK OR DRAIN -- SLOP SINK -- WATER PIPING & TREATING EQUIP. -- WASTE INTERCEPTER (Grease) -- VACUUM BREAKERS & BACKFLOW DEVICE -- LAWN SPRINKLER SYSTEM -- SWIMMING POOL - Private Public -- GROUNDWORK -- SUMP -- ALTERATION -- POST & BEAM -- PERMIT $ --'-_ TOTAL $__ NOTICE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- IZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED ORABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED, I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHE- THER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRE- SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOR- MANCE OF CONSTRUCTION. W~ SIGNATURE OF OWNER (IF OWNER BUILDER) ~O PERMIT NO. - 9/25/84 I I (DATE) 2395 '" PER -If--}WFLI .L}-J.( . ... (' .. CITY _REMERTON BUILDING DEP/~RTME. L~.2.. .. PHONE: 478.528'1 .. " JOB ADDRESS .-- ---~-:--~. - - <-,-"._,--~-_._. ______..4.LUif~j;:.____..0it!;:...f(!~~.--.-----.-.---.--...-.--.---.--.---.-.---.--__.________::f2_ '1 ~ ~ / ;;. q 01;::(: .. _ / MAil ADD.RESS . 2/.. ...,... ZIP g1 _ ... _ *- PHONE __.___._.dL(~.~de..efe.IL_._____ / 5L(2-.____YdclLiP!(?fLe.~~f.__.~_._1::.~ /!.!~~_?;Z~_.. ~::;~N~___;;-A~OI:~~DDA~;T~;;~EP~~;:~----____~~CE:~~ A TION _._~CHANICAL o PLUMBING CHIMNEY (No fee information only) INSPECTION: Groundwork ___.___._______ Gas Test ______ Mssonary Lines .._..________ Unlined __..___._______._ Wasted Vents _____.._.__ Watf.lr ___ Facto!)! Mfg Type 8___. Type L __._..___._____ Htg. Ruffin ___----;-_ .. Chimney ____ LOc.atKlt'I: Imerna! ......_____..__.______.Outside Wall._.__.___._.__ Stove or Insert ___.. . Refrig. ______ ...------.------.- ---r---..----..-------. _f\!;?;..______...!lP.." of EqlJ!f.!:!'.!!:lt ____ ----!:!..I!...____._ No. _.. Typo of Fixture or Item STOVES Gas.____ OiL_._.._ WOOd~A-- __..!::.L_ 50 WATER CLOSET (TOILET) fiREPlACE INSERT _____ BATHTUB FURNACE Gas tNat.___._.._ LPG.._.__} Oil__ LAVATORY (WASH BASIN) Wood add on .__._.... Other_____... Electric__ SHOWEll 8TU KITCHEN SINK & DISP. Tvpe: Up flow.._.......,._ Down flow__._.____. DISHWASHER HorizontaL..__.._ WaIL_._._._ ____. LAUNDRY TRAY CONVERSION BURNER: GIH'_____(Nat_.___ LP_._.__) CLOTHES WASHER Under 100,000.___ Over 100,000...__. WATER HEATER OiL.....___. ____ URINAL UNIT liEATE.RS RfU____.._ Ges__..._. Elec____... ___ DRINKING FOUNTAIN BOILER Gas................_.. Oil..__._._._ Elr,ctric_._..... FLOOR - SINK OR DRAIN Oth<Jr.___.__ HP_.._...._. ____ SLOP SINK GAS SYSTEM Max. 5 outlet TotaL_.__ ..__.___ WATER PIPING & TREATING tOUiP. EVAPORATiON COOLERS RooL_. WalL..__ WASTE INTERCEPTER (Grease) BTlL._.__L _ _____ VACUUM BREAKERS & BACKFLQW DEVICE AC UNIT Electric......_...... Gas flee. Combo I.AWN SPRINKLER SYSTEM BTU.._...._____ SWIMMING POOL - Private Public HEAT PUMP Single Package___. SpIIL_ GROUNDWORK Add on._.__ BTU Tan______ _____ SUMP IvilXING OR flEliE.AT BOX CH/t..._ BTlI._ ALTERATION AIR HANDlIlIIG Ulllff' CFM.____ BTU....__ ___ POST & BEAM 1'611 FANS Exhausl.___..._ SiJpply___... 8ath__ HANGE HOOD Residential__ Comm..._...__. CLOTHES DRYER Res_..._.___ Camm.__ I nciollr a~()r ALTERATION TO DUCT SYSTEM Healing/Cooling..._____ ExhausL._._.__ TANKS OiL.__. Ga~L..____. Propane w/OK from Fire O?Pt...____.._ Galions____ REFRIGERATION UNIT PERMIT $.____ TOTAL $.__.._ PERMIT $ TOTAL FEE $ -5 SV :-/O-:OU NOTICE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- IZED IS NOT COMMENCED WITHIN 120 DAYS. OR IF CONSTRUCTION ORWORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ! HEREBY CEFlTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK Will BE COMPLIED WITH WHE- THER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRE. SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCA.L LAW REGULATING CONSTRUCTION OR THE PERFOR- MANCE OF CONSTRUCTION. ..---.---._.____..._~:451<f~__.__.________________ SIGNA HiRE OF CONTRACTOR OR AUTHORIZED AGENT (VA TE) ; "I A lAP P R OVA L ___..___.__...___.__._..___..___.___...._..___............__._.___,,__,,____...___._..._._ SIGNATURE OF OWNER (IF OWNER BUIUP:gl tnATFJ (SEE OTHER SlOE) RECEIPT NO. -.---------___.._ PERMIT Nt tWhiMfl'Ol"lf"'JI!\l'Al", \"1111<, ilSPECTOR,l'ink-APPUCANT) /- . " ~ r' - 'aUI :_0" \JG ft= ~-Vl:T .~ 3691 A j< City of Bremerton, Washington Phone: (206) 478-5281 / ~.../.- / / i OWNER'S VALUE BLDG. DEPT. VALUE PLAN CHECK FEE RECEIPT NO. PERMIT FEE RECEIPT NO. DATE .. <\',J':> 9- G/ "?."), '7-" ....Ju/ ,T u / - _-5 a- ,"- / .........--..~=.=""- I~'--" $ /;;~:;.() L'_.ff ~ ~ ~~ OWNER'S NAME: ::;7 PHONE CONTRACTOR /~~.!/-..._<"'. STATE CONTRACTOR'SLlC, # " RESIDENCE o BUSINESS o OTHER o NEW o REPAIR PHONE o REMODEL ~ ADDITION o DEMOLISH ADDRESS PLANNING I ZONING FIRE ZONE STORIES OCCUPANCY THIS PERMIT ISSUED FOR: ~. '"'"' /i ., .- AVI(ltA ..,r--~-7' ~~ - {}L.-4~""'C r/' ___. (:...,..~ All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. INSPECTIONS REQUIRED: Foundation ~ Framing 0 Plumbing 0 Electrical 0 Wallboard 0 FINAL)if FOR INSPECTORS USE ONLY: REINSPECTION: TYPE OF INSPECTION DATE TIME NOT APPROVED' APPROVED COMMENT DATE TIME APPROVED FINAL INSPECTION APPROVED BY Building Inspector ISSUANCE OF OCCU ~ANCY CERTIFICATE REQUIRED BEFORE OCCUPYING BUILDING 1J!i- I - ~'! () 1 !." '. / ,,~ , OWNER'S SIGNATURE1\~,( "'/1,./lL1/) r' '" I ")(':1, ~f'-" /; ./ I ---, ! BY BUILDING DEPT. /'1... 4-..'. Authorized Agent i!L~_.,; A~~ ' i"L~___Jr}c". ~ CITY OF BRE~'~ L rC1J~2~E~TMENT r--... VALUE~t!J_ ) ~ ~. .) C RECEIPT ) ,.4./.7.':1... .......... . ,m"" m' 1/:.......... "AM ,,"C< ,................. :... ..........., ., ~~ . - .-- AD:>RESS/LOCATlOfJ OF .JOB. .::.. '~:'~~'~_':':'~""" ...:....:. ... ....:........ ..... ..................,... ...... APPLICAT ION I SSUED fOR: ..... '/', ',~~~"""""""""" .. . . ~.... .:.. .. . . . .. .. .. . .... . . . . . . . . . . . . . . . . . . . .. PROPERTY TAX ACCT. NO......................... ,," , . ~ !. . .......... OCCUPANCY..:...: .'... .-.! Typ.E Of CONSTRUCTION. .-:. ~ ,."..... .-... . - OWNER.. . .. . . . .~. ~.. . . . . . .. . . . ~ . '_' . . : . . . . . . . . .. . . CONTRACTOR. ..... . . .... .~ '. .... ,,' " " . . . . . ~ . . . . . . . . . . . . . .' . . . . . . . . . . . ?DRE~S: ~/.S(/!. ~.~ ._.:~,...,..:.,~. .,.... .............. .. ApORESS........ .................. ~',,-... ......... ......,... HOllE.... 3 2'A."S.:ff d?!:~.1...'... ~....".... ....... .oo.. . . . . PHONE..... ~'::.:. .... STATE LIC.I...............~......... SIGNAtURE '~~PL1CANT .~.R B~.......... DATE. ..~;;/~.. "' RECEI~EO-:~" . ~CCEPTANCE OF APPLICATION DOES NOT INSURE ISSUANCE OF BLDG. PERMIT. LANNING COHMENlS/REVIEWEDBy.......... ,~ BY i NGINEERING COMMENTS/REVIEWED By.......... ~ ~ BY ~ SEPARATE PERMIT REQUIRED fOR WORK IN RIGHT-Of-WAY, EXCAVATION, PAVIIlG, SIOEWALKS,SANITARY & STORM SEWER. ~ "----...y API" D"" BY ; = fIRE DEPT. COMMENTS/REVIEWED By.......... :TRAfFIC DEPT. COMI-IE!"lTS/REVIEWEO By.......... ./~ '''API' 'D " BY PLUMBING REVIEWED By.......:.. ~ WATER DEPT. SEPARATE PERMITS REQUIRED fOR PLUMBING AND MECHANICAL W6~~ ----.,;' ,,~ ELECTRICAL REVIEWED By.......... ~UILDING REVIEWED I SEPARATE PERlill REQUIRED fOR ELECTRICAL WORK. I AP!"D :W CL.t.. fPv V B e tJ A (TC<ue G-ct-::J_' ~' ,r ,'" Compliance Officer DATE,...".,........ . J __ --' '-- - .. I~S P E C T ION S ------------- e Inspections Required for Stated Construction BUIlDfNG DEPARTMENT 4 FOUNDATION o ELECTRICAL 0 INSULATION D POST & BEAr~ IKl PLur>1~ I NG r 0 SHEET ROCK OR COVER 0 FRAMING o MECHANICAL 0 FINAL ENGJNEERING DEPARH.1ENT D FORM INSPECTION FOR CURB, GUTTER, SIDEWALK AND/OR DRIVEL-JAYS o FINAL INSPECTION FOR CURB, GUTTER, SIDEWALK, AND/OR DRIVEVJAYS o CONNECTION TO CITY STORM OR SANITARY SEWER r~AIN LINES o INSPECTION OF PIPE INSTALLATION PRIOR TO BACKFILLING (City storm or sanitary sewers and side sewers) D INSPECTION OF STORM DETENTION SYSTEr~ PRIOR TO BACKFILLING D INSPECTION OFR/VI EXCAVATIONS FIRE DEPARTMENT D o D LIFE SAFETY FIRE EXTINGUISHING SYSTEM o FI RE .CODE o SPRINKLING SYSTEM REMOVAL & INSTALLATION OF UNDERGROUND TANK THAT WILL CONTAIN FLAMMABLE MATERIALS Allow 24 hour prior notice for all inspections. Emergencies will be handled as soon as possible. If required inspections are not called for and made by the neces'sary City Departments, a Stop Work Order Vii 11 be posted unti 1 necessary inspection is completed. Any materials hindering the inspection will be removed so an adequate inspection can be performed. All completed structures will have a Certificate of Occupancy BEFORE the structure is occupied. If a structure is occupied without a Certificate---o:r-Occupancy, the City will have the water utilities removed and order the structure vacated until compliance is achieved. I have read and understand all the above that pertain to the construction at (Address) SIGNATURE TITLE DATE 'f ( '"\10 "Y, Je . PERMI'rs ... ~. Indicate belavl what requirements, permits are required for this project. PLANNING DEPARTMENT o SHORELINE 0 REZONE o VARIANCE 0 SHORT' PLAT o ENVIRONMENTAL IMPACT ASSESS?'.1ENT DENVIRONMENTAL IMPACT STATEMENT BUILDING DEPARTMENT o BUILDING o MECHANICAL o HOUSE MOVING o o o ELECTRICAL GRim ING PLUMBING o D SPECIAL USE PE~~IT CHANGE OF SITE PLAN o DEMOLITION o SIGN ENGINEZRING DEPARTMENT -, OS IDEVJALK CONSTRUCTION 0 STORH SEWERS D DRIVEWAY '0 CURB & GUTTER CONST. q SANI:::'ARY SEWER CONSTRUCTION r ".'_ o STORH DETEN'l'ION REQUIRED o INSURANCE AGREElv~ENT FOR RIGHT-OF-WAY- \';ORK HEALTH DEPARTMENT o SEPTIC TANK o FOOD SERVICE