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Home My WebLink AboutBLUE HERON PL., 6037 r--u -~ . -. . INSFECTIONRECORDCARD CITY OFBREMERTON BUILDING DEPARTMENT 11237 PERMIT NUMBER ADDRESS 6037 BLUE HERON PLACE OWNER MICHAEL ST .JALVIES PHONE 377-7772 CONTRACTOR- ORCA BUILDERS PHONE ~ FOUNDATION ~ 1. PERMIT ON SITE 7. CHECK FOR FILL 2. CHECK PLANS TO PERMIT 8. REQUIRED -STEEL IN PLACE 3. CHECK SETBACKS 9. CHECK FIREPLACE FOOTING 4. PROPERTY STAKES 10. ANCOR BOLTS 5. FOOTING WIDTH & DEPTiH 11. FOUNDATION VENTS 6. SOIL BEARING O.K. 12. CRAWL ACCESS . COMMENTS: FOUNDATION INSPECTION APPROVED BY: - 2A FRAMING 20. AREBLOCK!NG STAIRS 1. WIRING APPROVED DROP CEILINGS 2.FOUNDATION.VENTS ruBS OR SHOWERS 3. SHIELD UNDER POSTS ROOF & CEILING LINES 4. POSITIVE CONNECTIONS FURRED OUT AREAS 5. SOIL TO WOOD CLEARANCE FIREPLACE AT CEILINGS 6. BEAM SUPPORT HOLES PLUGGED TOP & BOTTOM 7. TR. MAT. NEXT TO CONC. LID IN VOIDS 8. WASHERS ON ANCHOR BOLTS 21. WINDOWS 9. BEAMS PROPER SIZE MEETS ENERGY CODE CLASS 10. FLOOR JOIST SPAN SAFETY GLAZING 11. NOTCHING & DRILLING REQUIRED ARE EXITS 12. STAIRS WINDOW SILL HEIGHT WIDTH 22.-CEILlNG- HEIGHTS RISE & RUN 23. SWAY BRACING WINDERS 24. TRUSSES LANDINGS PROPERLY INSTALLED __ HEADROOM STAMPED 13. ATTIC VENTILATION {upper & lower} PROPERLY BRACED 14. CHIMNEVSTRAPS SECURED 25. A TIIC ACCESS 15. FIREPLACE COMBUSTION AIR 26. RAFTER & JOIST SPAN 16. FANS VENTEOTO OUTSIDE 27. ROOFING. FLASHING. SHEATHING 17. WATER CLOSET CLEARANCE 28. SIDING 18. SMOKE DETECTOR 19. SHEETROCK BACKING COMMENTS: UNDER STAIRS ABOVE GARAGE DOOR HANGERS FRAMING INSPECTION APPROVED BY: IJIIII 23 INSULA liON COMMENTS: 1. PROPER R"VALUE 2. VAPOR BARRIER 3. PROPER-FASTENING INSULATION INSPECTION APPROVED BY: , .' . M MECHANICAL :t,_ HVAC APPROVED BY: . 1. PERMIT ISSUED GAS PIPING APPROVED BY: 2. FURNACE LOCATION 3. FURNACE CLEARANCE WDST 4. 'B' VENT SIZING 5. 'B' VENT CLEARANCE 1. WOOD STOVE CLEARANCE 6. 'B' VENT SUPPORT 2. CHIMNEY CLEARANCE 7. COMBUSTION AIR 3. HEARTH EXTENSION 8. DUCT SIZING 4. CHIMNEY HEIGHT 9. DUCT SUPPORT & JOINTS 10.GAS PIPING TEST WDST APPROVED BY: 11. GAS PIPE SIZING 12. GAS PIPE SUPPORT COMMENTS: 'J PLUMBING .. 1. PERMIT ISSUED 6. PROPER ATTINGS 2. UNDER TEST 7. REQUIRED CLEANOUTS 3. WATER PIPE SIZING 8. PROPER GRADE 4. DYN SIZING 9. HWT PRES. RELIEF VALVE & UNE 5. PROPER SUPPORT 10. SEISMIC STRAP COMMENTS: UNDERGROUND APPROVED ROUGH-IN APPROVED BY: BY: 3 WALLBOARD 6. FIRE SEPARATION IN GARAGE 1. LID OVER SIDES 7. ATTIC ACCESS 2. NAILING 8. DRAFT STOP IN ATTIC 3. W/R AT ruB OR SHOWER 9. PROPER CaNST. OF FIRE WALLS 4.5/8 UNDER STAIRS 10. DROP CEIUNG & LIGHTING 5. FURNACE ENCLOSURE COMMENTS: WALLBOARD APPROVED BY: 4 FINAL 1. HANDRAILS 9. HOT WATER TANK PAL 2. GUARDRAILS . 10. OUTSIDE GRADE HEIGHT 11. SOIL TO SIDING CLEARANCE INTERMEDIATE 12. SMOKE DETECTORS 3. EXHAUST FANS 13. FIREPLACE HEARTH 4. WATERPROOFING IN SHOWERS 14. SAFETY GLAZING 5. DISHWASHER AIRGAP 15. INSULATION 6. FIRE DOORS ' WINDOWS MEET ENERGY CODE LABLED AS REQUIRED UNDERFLOOR & ATIICE INSUL. SELF CLOSING WATER PIPE & HEAT DUCTS 7. FIRE DAMPERS INSTALLED 16. WOODSTOVE APPROVED 8. PENETRATIONS IN FIRE WALLS 17. WINDOWS & DOORS CAULKED FINAL PLMB. APPR. (comm.) COMMENTS: FINAL MEeH. APPR. (comm.) FINAL BUILDING APPR. Cons'!: yuct i ()F! F<e~3 i den{:.:f':~ :Zc)n inn FoundattoF! Hu.e i. ne:i.,:s 'ryp\::'~ i:::--r arn i nu rv:] L/'\,. Other r..1 (:/LII:::~!\ii~~:i (1) (I n [: :] ... ,.f N f'~ t.'.1 I" "I fl L ..1 !., ..\ F\ep<:30 :i, Y' ,.. '" Stat:u,e f"1e;chan:' ca 1 r ] L J HE~~mO(!e :I fl c~C) c!(,~ . ilIa:! lboa.rd L ::I ticid il;:i..o1'1 r:;('i :::i F' i n i':l. 1 ,.,., ,,' ',.! t l\ . . ".u. ..... ,.... ",.. ,,,........ ..._ ..n' :'"''' ".., "'" ''':,'' .".. .":' '"',' .W. ,"'. "", ..... ."" ':;" "... ..... ...,. ..." ..... "... ...., ,.... .".. ",.. ..... .".. ,,__. .,,<~ ..,.. ..." ..... <.." "... ..,., ..... "". ".," "._, ..." ..." ''c'" ..... ".... ,,,,. ..... '~" .-.",~.,,, ~".. ..... .":'.'''^" ..,,, ..... "'" ..... '"'' ..:.. ,.... ..... ..." ...., I'n--,-'i \,',ej "'''W' "rn-,,'----j p"':( I L ..,...., ... ,.,.. . .""'.,. .. ., ~".I')' /1m', ',y" .. 1'-...,. ." ....b.... ,,'.. ...../ . . . c;\: . . . '. ' ... ,.......... .. ~ lC4,'! /') ;:::: ::::: :~::: ;:::: :0;:: ::::: ~::': ::::; :::~: c::: ;::: ~:::: "" :..:: ::::: ....: .",. ::..: :;::..::'::;::; :::. .::::~::: ::::; ~~ ::::: ~:;: :;::: ::::: ::::: :::.:: ::::: ::::: ::.:::::::.:::::, ;:::: ::':: ::::: ::" ::::; I:::: ;;::: ::::: :::: :::;; ,I::: c::: ::;;:1 :::::;: ::::: I::: ::::' Ie;:::::: l ::::: :~~S':'j;~,\, ~:~ ::::: :::;:~ ,.~"-A """(),,.< I D E PAR T MEN T ! B REM E R TON L, T) 1: r"l C:C)HDI () F' PEF<fvlI l I 1 j cat :i,onl'.Jumber I .5 Pcorm :i, t Numb!'::.,.. '.... ..... ..... >n>> ..,....... .m. ..", .'w"" ".., '.m ."... ..... ..... ..... ..,,, .,... ..... .,." .,. ,,". .'w ..... ...., ..... ...... "~"...... ..... "..' .... ._, ..... ..... .".. ,.... ;.......... .,... .,m... .,,,., _.. .".. .... .... ....~ ..... ..... ..,_. ".... ,_u ....... ...., ..,., .".. ..... .,. ..". ...., ..... ..... ..... ~h.. ...., ...,. . . it c'; f?l i:~ Y"i to show setbacks. than :;-::0 :... '. . l -,- - ~ ---"--- '---------'--._,,-~_. -. -_..."--_._._-~-~'.__:,_---y-------:"-"-,,,,,,,,:,,,,,,,.:....-......::~--,--,,, \. , ' - , INSPECTION RECORD CARD CITY OF BREMERTON BUILDING DEPARTMENT 9477 PERMIT NUMBER ADDRESS 6037 BLlJE HERON PLACE OWNER r.HAFFF.Y r.ORPORATTON PHONE 876-5770 CONTRACTOR CHAFFEY CUSTOM HOMES PHONE 876-5770 I 1 FOUNDATION 1. PERMIT ON SITE 7. CHECK FOR FILL 2. CHECK PLANS TO PERMIT 8. REQUIRED STEEL IN PLACE 3. CHECK SETBACKS 9. CHECK FIREPLACE FOOTING 4. PROPERTY STAKES 10. ANCOR BOLTS 5. FOOTING WIDTH 8.. DEPTH 11. FOUNDATION VENTS 6. SOIL BEARING O.K. 12. CRAWL ACCESS COMMENTS: n1z~~ FOUNDATION INSPEC~N .{-o /) f.. '" t ~ 'I-I f - P '1 ~ APPROVED BY: M ~ ~-27-~? H:- 2A FRAMING 20. FIREBLOCK G STAIRS 1. WIRING APPROVED DROP CEILINGS 2.FOUNDATION VENTS ruBS OR SHOWERS 3. SHIELD UNDER POSTS ROOF &. CEILING LINES 4. POSITIVE CONNECTIONS FURRED OUT AREAS 5. SOIL TO WOOD CLEARANCE FIREPLACE AT CEILINGS 6. BEAM SUPPORT HOLES PLUGGED TOP & BOTTOM 7. TR. MAT. NEXT TO CONC. LID IN VOIDS 8. WASHERS ON ANCHOR BOLTS 21. WINDOWS 9. BEAMS PROPER SIZE MEETS ENERGY CODE CLASS 10. FLOOR JOIST SPAN SAFETY GLAZING 11. NOTCHING & DRILLING REQUIRED ARE EXITS 12. STAIRS WINDOW SILL HEIGHT WIDTH 22. CEILING HEIGHTS RISE & RUN 23. SWAY BRACING WINDERS 24. TRUSSES LANDINGS PROPERLY INSTALLED HEADROOM STAMPED 13. ATTIC VENTILATION (upper &. lower) PROPERLY BRACED 14. CHIMNEY STRAPS SECURED 25. ATIIC ACCESS 15. FIREPLACE COMBUSTION AIR 26. RAFTER &. JOIST SPAN 16. FANS VENTED TO OUTSIDE 27. ROOFING. FLASHING, SHEATHING 17. WATER CLOSET CLEARANCE 28. SIDING 18. SMOKE DETECTOR 19. SHEETROCK BACKING COMMENTS: C I ".n./I'. "'lJ UNDER STAIRS {JAIl' ~ Se~ ABOVE GARAGE DOOR HANGERS ..... ~/l/1I9 J V- FRAMING INSPECTIO DNA- ~ //S'/8'~ .~ ~ APPROVED BY: ~ 2:3 INSULATION COMMENTS: 1. PROPER R-VALUE 2. VAPOR BARRIER 3. PROPER FASTENING INSULATION INSPEC~/ ~ I./z~ri APPROVED BY: . . , , ~ 1 ~~ MECHANICAL HVAC APPROVED BY: ~%- 7...M--1f' 1. PERMIT ISSUED . . 2. FURNACE LOCATION GAS PIPING APPROVED BY: 3. FURNACE CLEARANCE iDST 4. 'BI VENT SIZING 5. 'B' VENT CLEARANCE 1. WOOD STOVE CLEARANCE 6. 'BI VENT SUPPORT 7. COMBUSTION AIR 2. CHIMNEY CLEARANCE 8. DUCT SIZING 3. HEARTH EXTENSION .9. .DUCT SUPPORT & JOINTS 4. CHIMNEY HEIGHT 10.GAS PIPING TEST WDST APPROVED BY: . 0 t dJ 6c:J~%()f 11. GAS PIPE SIZING 12. GAS PIPE SUPPORT COMMENTS: J PLUMBING ~ 1. PERMIT ISSUED 6. PROPER FITTINGS 2. UNDER TEST 7. REQUIRED CLEANOUTS 3. WATER PIPE SIZING 8. PROPER GRADE 4. DWV SIZING 9. HWT PRES. RELIEF VALVE & LINE 5. PROPER SUPPORT 10. SEISMIC STRAP COMMENTS: UNDERGROUN~PPROVED ROU~~VED BY: d tJ~..::v- K/ ~//'r"7 BY: c.. - "3G>'" g""f 3 WALLBOARD 6. FIRE SEPARATION IN GARAGE 1. LID OVER SIDES 7. ATTIC ACCESS 2. NAILING 8. DRAFr STOP IN ATTIC 3. W/R AT ruB OR SHOWER 9. PROPER CONST. OF FIRE WALLS 4. 5/8 UNDER STAIRS 10. DROP CEILING & LIGHTING 5. FURNACE ENCLOSURE COMMENTS: WALLBOARD APPROVED BY: tPi-/~ ~31- 81 L. FINAL ..&. 1. HANDRAILS 9. HOT WATER TANK PRL 2. GUARDRAILS """ ~."",--""".,"-,,,- . . 1 O. OUTSIDE GRADE HEIGHT 11. SOIL TO SIDING CLEARANCE INTERMEDIATE 12. SMOKE DETECTORS 3. EXHAUST FANS 13. FIREPLACE HEARTH 4. WATERPROOFING IN SHOWERS 14. SAFETY GLAZING 5. DISHWASHER AIRGAP 15. INSULATION 6. FIRE DOORS WINDOWS MEET ENERGY CODE LABLED AS REQUIRED UNDERFLOOR & ATTICE INSUL. SELF CLOSING WATER PIPE & HEAT DUCTS 7. FIRE DAMPERS INSTALLED 16. WOODSTOVE APPROVED 8. PENETRATIONS IN FIRE WALLS 17. WINDOWS & DOORS CAULKED FINAL PLMB, APPR, (COmm,)~ .~ COMMENTS: FINAL MECH. APPR. (comm, / r' FINAL BUILDING APPR. I 0 7-n- r . - r 0; :~~'il:',r',1.,).1:{;-'lf-".-' ':!:' -;--1,-,-,,:'; :-:-:;-~ I . CITY OF BREMERTON - BUILDING DEPARTMENT 478.5281 - 817 PACIFIC AVENUE, BREMERTON, WA 98310 INSPECTION REPO,RT ' . PERMIT NO. . C~~.{(:y /P6e;tf~J~ I have this day inspected this structure and these premises and have 10und the fOIlO~ihg violations of City, County and/or State laws governing same: K. 01/1 It - :c ~ P!I..I-. bl~' C> .K- ~ J::;>ti-O- {+ Yl() + / , rd5kd. / / / You arE! hereby notified that no m~re work shan be: 'cove red upon these p~mises until the above viola- / / lions are corrected. When corrections have been malle, call for te-in~ ~ I Do ~otRemove Tlis Tag DATE.. ~-3Cf'Y7 .. ..... . ! . INSPECTOR FOR BUILDING DEPT~ r- cc' ,..,-""..>....~" ,...."."..,'. .q""',...,"".'i.e,'.i.....':.f'....... ..., .i...;.~fi"."'. ..eF .''l!''''' .:".. ""f.. .~"'-.ni7f' . I . . .. CITY OF BREMERTON --. BUILDING. DEPARTMENT I 478-5281 - 8.17 PACIFIC AVENUE, BREMERTON, WA 98310 I .. IINS.PECT.IONREPOR" PERMIT NO. 9~77 . , . I have this day inspected tbis structure and these premises and have found the following violations of City, County and/orState laws governing same: ~~P.7;;""~'r' .ret[i/,~~J 0"';. ~1o'1"'e..ld"~~,,,,, ~r . WA,krA~ky-,.. ~P..re~iF./~...,~ ~/e~f" ~ etllA..~S'7 Fvr~c,...~/'S dr41"'1 I--"t-. +VkAe./.4ll{ljo. . " You are herebyn6tified that no more work s~an be covered upon these premises until the above viola- lions are cor.recte~. When correcti?"S have been.. mad: ca~. for re. -In~. ~ Do~ot Remove T liS Tag DATE .5 ((. ' fl7 ,.' .. ' " ' . ,.INSPECTOR FOR BUILDING DEPT. or' . ';-\i":;r:<'-~--:",~-,-'- . '~, -- ,'. .~~ \ . CITY OF BREMERTON - BUILDING DEPARTMENT 478-5281 - 817 PACIFIC AVENUE,BREMERTON, WA 98310 INSPECTION REPORT PERMIT NO. '?~77 / I have this day inspected this structure and these premises and have 10und the following.violations of City, County and/or State laws governing same: Ho f- rY S&({el-y ~?'/I ~dr re5'~ I ve../ ~ ~re^ (AD-!- 6rbc.l<-eJ -1-0. 1'-e>J-f4.v+- .rofe..,-I7~ ~ ~ ;f~flers AvJ r 6e t;~J ..OfFi!J)) Ie e<--Lh . c> ~ ~~ You are hereby notified that no more work shall be covered upon these premises until the above viola- . D;a~oinel;rri~~~OT;li;S T;gbee;m~L::;ns~~L . . r .. . INSPE FOR BUILDING DEPT. ______. I I - ---- ------------------------ .'- -'J :,""'<', ' ;'f ' .:_';~11~' ,;<;; " ,...~ ._:; {~ ~. . CITY OFE,iREMERTON -BUILDINGi:)EPARTMENT 1f77 478-5281 ...,.. 817 PACIFIC AVENl:JE;BREMERTON, WA 98310 INSPECTION.RE'PORT PERMIT NO. . , ", , 4,,', . . I have,tbisday insp~cted.this s.tructure and these premises and havec10und the foUc)wing violations of City, COl.lnty and/or State law~governingsame: . or .f You a herellY notified tha~no more work.shaUbecovered'up .th,se premises.until the above viola- D;,a~~n2R~mw;.~rihi;S T;gbee~7i 7;yrre'inspecll~n. ~ . " .. .'. . SPECTOR FOR BUILDIN~ DEPT. "', ~ r/~ ,. - -'" ,:.-~-" ._-'---<'--':~~~ ,,,^/ . . "'---",/ CITY O,F BRt;MERTON --: .BUlLDING DEPARTMENT 478-5281 - 817 PACIFIC AVENUE, I;JREMERTON, WA983.10 INSPECtiON REPORT PERMIT NO. . . You are hereby notified that no more wor~ ~hallbe~overed upon ttlese premises until the above viola- . lions areco:"'Cted. When correcti~ns h_ beenmaj;'CBUfor re.,nSpecll".. .. .... Do~o," Remove T 1,15 Tag DATE~l!fr . J. ~~ . . . . . , . . ; ., .. .'. INSPECTOR FOR BUILDING DEPT. ~~~~~~~~ft'~~~~~t/!.~~~~~"""'~'J<"V,\""l'I , ' "~_,,.' '. ,l . \~_~ .. ,\ . . " . ~ :.. . r- BUILDING ~PERMIT k - . City of Brem(3rton, Washington 98310 Phone: (206) 478-5281 Assessor's Tax Account No.: 5092-000-114;';'0001. Site Address': .6037 Blue Heron Place 876-5770 Owner's Name: Chaffey Corporation .. . Address: Port Orchard Appli<;:atit: . D Architect [iJcontractor D; Teh~nt - - Architect Firm: Address: Phone: Contractor: Chaffey Custom Homes Representative: Address: S02HighAvenue /1201, P(-,rt Phone: 876-5770" '." .-.." CHAFFC#150NG 7/15/89 Contractor's. License No.:" Exp. Date: [J .8eside;ce D Business D Other: gNew D. Repair D Hernodel/Addll - D Demolish D QGplex D MUlti-Fa~iIY (No. units ) .. DSign D.. ParkjngLot CIGrading'(cu. yds " D Bldg. Move Nature of Work Proposed: . " New 2.331 S.F. SirtglEltfami1y residence. Plumbing fixtures to inclu.de: .5 lavs,3 toilets, 2 tubs/ sholfers., .1 soakingtub,l shower.....;Plumbing to be by S11verealePlumbing D.. Waste o Sewer D Septic. [J New D Existing []Storm . ValuatiOll.ofMaterial$/Labor: Plan Review Fee: Permit Fee: Surcharges: [UBC$ae;. 304(b)] $ 307.00 $473.00, 3.50 State .~ [i] . ... 79748 Receipt No.: . 79748 . EnergyXJOf$1S[J Receipt No.: . Date: . ... 3/30/89 Date: .- -,',-. . " " Zone .. Designation:. Occupancy Classification (UBe): MinimurnF\eq, Setbacks: Front: Side: Rear: . Height: Com;"entS/COhditions of Approval: Need application for water service, sewer inspection permit. All new hose bibs to be bullt-iii vacuum breaker . style. . ... ..... .. ...... .. . . . . ' ..... Sllloke.d:etectorsshall be 110v A.C., installed in accor4ance w/ requirements of'{JF.C ,Co#tractor shall submit sanitary sewer lateral dJ;awirtgprlorto approval of sani.tary sewerpertdt. Driveway permit required from Engineerip.g prior . to cutting sidewalk. C~mtr:ttctormust call before 9:00 am for same--day inspection.. Calls received after 9:QOwill be inspected the following day. Richard R. MU1l1tt1a.1I Building Official" INSP/=CTIONSREQUIRED: poundation [! . Fr~ming[Jj Plumbing [!] . Me<;:hanical [!] . Wallboard [!l FINAL ..(J OWNER OR ~UILDER SHALL CALL 478-5281 FOR ALL F\I;:QUIREDINSPECTIQNSANDRECEIVE APPROVAL PRIOR TO CONTINUING WORK,SEPARATEPERMIIS ARE REQUIRED (WHERE APPLICABLE) FOR PLUMBING AND MECHANICAL. All provisionso(laws andordiMnoesgoverning this type ofw . be complied with whether specified herein.or not Thegraming of a permit does not presume to give authority to violate or canpelthe ~:~:::~'"'~y~'"' ..':....... ~.ct;oo,,,..o mo ,..,~..'T" Dam #~,J "c. .... , .. ... . . ... .... .. .. ...... .. ,. >. . . ...... .."... . : COPi~$tO: White-owner; Yellow-file; PinkcAssessor: Goldenrod-Building Stat.Cod~ J . I r . BUILDING PERMIT APPLICATION ... , City of Bremerton, Washington 98310 Phone: (206) 478-5281 - Assessor's Tax Account No.: .SOCJ Z -000- / /<-/ -000 I Site Address: c(; 037 DlutY .1IB?i!?tTYJ . ;O/A-Ct.Y - l3~cnv/oYJ Phone No.: ~7&' -0770 Owner's Name: (],#J1-FI=ECj CtlSTdMI/<JIVIUS Address: S"O~ #t'g/t Aver' :;tt.20/ fi~j Applicant: ~ Owner D Architect ~ Contractor D Tenant Architect Firm: (!/lffFFE L/ C!iJ ,efRJ~fJ- Ti tJ fl) Representative: , Address: Phone: 87h-S770 Contractor: f2/f/l-FF6Y {!ttSTt1fr1 fIoffl 155 Representative: Address: 6Z'2- H{jh At/o>~ ZLJ/ 'l6d tf)LeJ~ uJIJ-. , Contractor's License No.: ~lIffF;C(> __* JSO NG Exp. Date: - 5a. Residence D Business D Other: l2Sl New D Repair D Remodel/Addn I D Demolish D Duplex D Multi-Family (No. units ) D Sign D Parking Lot D Grading (cu. yds D Bldg. Move ,'*,- Nature of Work Proposed: C/w ~ s;- cr. 7d/L 3 -%t='eV~.- I ~-~ S.;s-i"Q)'tJ - 8; () ~lsho~cPl- z::... aMAje>- sd-! Sq. Ft.: il!,4FY/ - /,$:;-/ Utilities: D Water D Waste D Sewer D Septic D New D Existing D Storm Valuation of Materials/labor:.. r Plan Review Fee: Permit Fee: Surcharges: IUse sec(["lbH 51 $ 367~ $ </73.ce9 State $3.50 M to C), 61J/ Receipt No.: 1q 7lf? Receipt No.: '7Cf 7 LIP Energy $10@ /KI Date:. 31 =) D) !1 Date: t.3J3() )fCj ~m.L 11 79t.S"Q I I ~ Zone Designation: Occupancy Classification (UBC): No. Stories: Setbacks: Front: Side: Rear: Height: Heat Source: _ Comments/Conditions of Approval: ;:;/ Cl,. m /; ex..- - ..s,' / tI CYi'z.d#/ c;> fl u..w/b 'YJ @ E@~::gp -tfflv ~ l L\2- 6 ,_ 8 ,.- - I understand that applications for which no permit is issued within 180 days following date of application shall expire by limitation, plans and/or other data submitted may be returned to applicant or destroyed by the Building Official. (Sec. 304(d)UBC). I certify that the information on this application furnished by me is true and correct and that the applicable requirements of the City of Bremerton will be met. ,,--Signature Date ~ Copies to: White-owner: Yellow-file: Pink.Assessor: Goldenrod-Building I Stat. Code 1.--_ /7/-lS) _ _J..4