HomeMy WebLinkAboutBRENTWOOD DR., 1121
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BREMER TON PERMIT C::Et..JTER
286 4th Street g Bn::merton'l t..JA 983'37
Phone: (360) 478~'5275 FAX:: (360) 478-5278
BUILDING PERMIT ~
J()b Addr: 11 ;::~ 1 Elf<ENTWOOD m~ PermH No::
t Location: 1121 ~~ENTWOOD DR Status: ISSUED
Parcel No: Applied: 09/09/1996
I r~f:lu(1d ~ 09/1 1996
~llppl :lcant: Spr~AGUE GDI~D()N & SYLVIA ::rn--1. Expires: 03/11/1997
1121 BRENTWODD DR BREMERTON WA 98312
Owner: SPRAGUE GORDON & SYLVIA 2177"'" 1. :3'7S
1121 BRENTWrnJD DR BREMERTON WA 98312
~ontractor= SELF L,ic :ll:: SELF Exp=
I Subcontr:
Deac: GAS FURNACE. GAS PIPING. PRC~ANE TANK (320 GAL.)
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l)aluat Jon * Perm:l,t; r'f,:)es: ~~9 .70 Total Calc:ulat . ~i4 " 70
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"OCl * Plan Check Faes: .00 f)dd :1, t I ona], F r:;e~l: ,,00
" * Other Fees~ S,OO Total PF.~'!"m:!t Fee: a4,,'/O
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~,r"'MeCHANICALipLUMBING FIXiURES'~- MECH-Gas Furnace to lOOk btu": 1 MECH-Gas Piping (outlets).",: 1
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This permit shall become null and void if the building or work authorized by this permit is not commenced within
180 day's from the date of such penlli.t ~ or if this building or work authorIzed by such permit is suspended or
abandoned at ilny Hille after the work commenced for a period of 180 days,
NOTICE .. It i8 the reaponsibil ity or the permi t hold€ff j not t he City of Bremerton or 8uildi I1g Officis 1 to see
to it that required inspections are made. The permit holder must noti fy the Building Official \~hen ready for
inspections, Failure of the permit holder' to not i fy the Building Official of required inspect ions may result
in the stoppage of the work until such time that the permit holder can substantiate to th(~ building officIal
tha~ the concealed work meets or exceeds code requirements, Any demolition, testing, (.rr financial burden shall
be IJoyne direct 11' by the permit holder', Failurs to subatantia,te code iequi ramenh wi 11 indemni fy t City .
a9~il1st any and all responsibility or liab:llih' connected with the COfil1ltruction,
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r ihereby certify the,t I ha.ve read and examined this permit and know the same to be true and con-tIeL All
PjolJlslons of laws,and ordinanc7s governing this type of work :~il~ be cClffiplied with whf;ther specif~ed here~n
Of not. The grantIng of a perrlllt does not presume to glVe autnonty to violate or cEmcf:.l the provadons f.lf
l1?Y ot.per st~...Q,~~t6e(r ;. ,w 'regu1)tin~l construction or the performance of construction, ,
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s' "l'1atur, ... . .."", . '" A (4,,' Date: ..~. j-., .,
!9. . ,_~ -___ ___'-~__~~________.._ -----'1-.1..,--- _ . ___________
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Itcerti'fy' that I am ~mPt from f~ requirements of the state contractlH"S registration law, under
S~ct ion 3, ct, t&f~H~~liiiwB Q,f=~47, ~
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BREMERTON PERMIT CENTER
PERMIT CONDITIONS
i m:l.t No:: ~r6"'''05'72 Paqe:: 1
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I Acct No: Approved: 09109/1996
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BREMERTDN PERMI,:T CENTER
286 4th Street 0', Bremeirton..bJA 98337'
Phone: (360) 478-5275 FAX: (360) 478-5278
BUILDING PERMIT
"J' ~ ^ j,j. 1)''''). rll"II""N"I"W " ("ll"), 1")1':1 ' . I")' t' N ' 0/ '()'''''7''''''
,.00 nCer:: ',I.",~,., t:',:::. U.,,, ,,', "erm:l."; 0':, 10""',J ,::,
L.OCi:~t :i. on:: 1.1 2 1. I3I:ZEN'I"WCJOD DR St at us ::PEND I NG
Parcel No: Applied: 09/09/1996
. , Issuec~
^ 'I' I C'I")I~I^("'1 )r" ("'(")I':II")(")N & c'Y"j'" V 'I' ^ '''''7'' '7" ) '''1'7'' T" I"" , "
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1121 BRENTWOOD DR I3REMERTONWA 9831Z
, Ol;,lnc::~r: ~::;PI:~AGU[: CiOI~DCJN & SYl..JJ:~ A :377"" 1375
1121ln~E::N'T'Wonl) DR EmEMEJrl"ON WA '9B:::112 .
Contractor: SELF tic #: SELF Exp:
Subcont r ::
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"t'~*:)c.~.1l :Am..) :'"'\'_''',,I:::~'' :11'''1.) "",I"J." ,'jj,. "\'n")'" ::. ,;, ','. d.C. ,'J'''nu,II
X**********XX**X*X***********~"~***~*~XXX*X****X**X**~*******X******~*XXX****.**X**X****XXX**
V" 'I 1" 't' .' "r' \l, I") ",.',.t' I""', ">r" "r'\ 0 '7- () "I" " 't' ,,'I (",.: '1' " '1;' 'I" ", ,j I""'~ '" . "'14 '7" ()
d"td 1(:),1,:'''' ,,' "t;.rml, ::,E:~t::...:,,,,::.I",: (J,d" ",d ': Cl.,Ld,bC.l_",'" (,,,t':'/' ,:: '''.:
,,00 ,'xPJ.anCtleck I"ees: ,,00 Adehtlona.l I..ees:: ,,00
"* OthEH' F'€:lE~S:;:: ~j"OO 'T'otal Permit Fee::, , :34,,70
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*,~ ,j(, * *,~ *,~ 1(' ~ * .j(.~, *,,~,~,j(,,~ *,~ ,W*,~ *.j(, K~X'~ 1(' x* ,j(,,~,~ ,~* * * ,~* xx *,)(..M ,j(, ,j(.1('~1("j(. * * ,x 'j('* * *,~ X 1(' X ,X,X ,X.M 1(' ,)(, X ,x ,x ,x'~x,x .~*,x x ,x ,x *.x x'~ ,x'~ x x X ,x, ,x,
:~(ALG~FIXTURES-- ~CH-Gas Furnace to lOOk bt~7~ ~ MECH-Gas Piping (out lets ~ J fl
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Thi8p(~rmit8hallbecome nulL arid voidjJ th(~bunding or work authorJzedby this permit is not commenced within
l.f30days from the date of such permit, oriY this' buildin9 or work aut.horized by such permit lssuspended or
abandoned at any time after the work is commenced Jor a pedodof 180 days.
NOTICE 7" It: is the responsibility of the permit holder, not the City of Br!?merton or Builclirl90ffici.al to see
to it that required inspections are made. The permit holder must notify the BuildIng Official when 'fetidy for "
inspect ions; Fai lure of. the permit holder tonot ify the; Sui Iding Official of required inspect ionsma}' n~sult
in the stoppage of the work until such time that thel permifholdercan substanti,He to theibuilding of',ricial
that t hecOnCt3i:.d,(~dwork meets or exceeds cod~;requi rementa, Anydemoli t ion, tet~ti. ng, or financial burdensha 11
bl~borne directly by the permit ,holder. Failure to substantIafe' cOclerequirementswill iridemnHy the City
against any and allrespons,ibiHtyor liability connecteclwith 'the construction.
I herebycEfrti,fy thi'lt I havEfread and examIned this permit and know thesamEl to be true and cm:nkt.All .
provisions ofe laws and ordinances governingthi~Jtype of work will beu::omplied with whether !3peci fiEKI herein
or not. -- The ;granting ofa permit does not presume to give authority tiJ violate or cancel thepf'.[)v1.s1on$. of
any otherstate.or local law regul.at:ln~~ construction or the performanc:e of construction.
~ . ~. { '"'.' "'jtil 'I'" j~'~ '" I1r"t " '
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I 1''''.'tiJ:y'th'''t-'I' "m ";x"'mpt i;~"m th'., "'."''''\'''';m'~'''i"c.' ":f" "'h"; "';'~lt'~~ "'i'\f't""";;i""\'fl'~' ~L"'l""+"'''''';.'r- '",,:' '''''~'''J'
ul\:O;! -",.I .,Y., tAL~:' r;i I il~J,I. ,Ie. If;';~lt~,.LI,!f~'iHf,,sliyl:,,1~.J l.i;\., ?;7$!.iIJ,~, 1,tl~F,,!:;'I-f.iL\!~, ~"._ j~;;;;_~'lh'I(:ilt,~LLJ ll;iW~ ~J.!H~(~i!
Section 3, Chapterl~!:(;~laws of 1967"'
SJ.Ql'H'iture: ." ." . ....<~ '. . '. .....;' . . ',., Date:
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PermJ t....Cf.:lnt f.:lr"'"""'At)t::,y'bvecl 13y:: . '.;,. DiH; f!:l:: .. . ....
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BREMER-rON PERMIT Cl=:NTER
286 4th Street~ Bremerton~ ~A 98,337
Phone: (360) 47e~-52.75 FAX:, (360) 478'-5;:~7B
BUILDING PERMIT
1 Job Addr: 1121 BRENT WOOD DR Permit No: 96-0572
L"oca t i. em ~ 11 ~~~ 1. Bf~EN"n~ODD DR S'tatuH= PENDING
Parcf.d No: Applied: 09/09/1996
I sBl.J,ed ~
1 i. C;i'mt:: ~:;';PH(-)GUE GORDON & SYL V I A ~377~ 13:75 E:xpin;;:'i.l:
11 ~~~ 1. Bf<ENTWOOD Dr~ m~EMERrON WA 98312
Ol.>Jm:lr:: SPRAGUE GORDON & SYLVIA ::577"-1 ~;175
11 ~:~ j Bf~FNTWOOD rm BHEMEFHON WA (:t8~-l1 ~:~
I Ccrnt Y' act or: SEL,F Lie ,= SELF Exp:
I !;ubcontr:
:"' P,o" FAo FnNArF" G"o 'P1NP PP'JPANF TANI" (8"0 "AI )
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,;,tWf.lJw:~tf6h * Permit F€Jf.%1~ 29.70 Total Calcula.tec!; ~:14"7()
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. :}:~':i:> ,00 * l"an L be 1"'8e,,), . ,,0(, Ace, J,ona f'l~,e,~" ., ,
'----+".'\"'>"'0",* . Other Fees: S"OO Tot;:il permIt. Fee:: :]4,.70
,*~'#***:li~~,*')(' ** ** *1('*****')1;*** *** * * * 'II:'~ * * * x. ,** * * * * ** * *j('J~ *.~ * ,)t'If*'ji;)(, ** *, '*')1; ** ,* ,*,**,** -)( ,I{ 1('* )(,*,*.~* **-li;** 'II' ,)(* * :It'** ,*
MECHANICAk/PUJ,MBING FI~WRES'"'" MECi-Hias Furnace to lOOk btu,: 1 MECH-Gas Pipi ng (out lets). '" : 1\".
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lhis permit shall become null and vol.d if the building or work authorized by this permit is not' commenced \>Jithl.n
r,so days from the date of such permit, or if this building err work authorized by such permit is suspended or
.... ?bandoned at any time after the work iscommenced for a period of IHO days.
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~onCE .. It is the responsibi lity of the permit holder, flat the City of I3remertor\ or Building Official to see
t,o it that required inspections are made, The permit holder must notify the Building Official when ready rOl"
~mlpections, Failure of the permit holder to notify the Building Official of requin~d inspections ffil:l)! result
lin the stoppage of the work unt:l1 such time that the psmit holder can substantiate to the building official "
lthat the concealed vlOrk meets or-exceeds code requirements. Any dE!molition, testing, or financial burden shall
:be borne directly by the permit holder, Failure to substantiate code requirements will indemnify the City
'against any and all responsibil ity or liahil. Ity connected with the construction.
(1 hereby certify that 1 have read and l~xai1lined this permit and know the same to be true a.nd correct, All
!pl'ovisions of laws and ordinances governing this type of work will be complied with whether specified hem::!n
~r not, The granting of a permit does not presume to give authority to violate or cancel the provisions of
:~f1Y other state or local law regulatIng construction or the performance of construction.
SJ 91'1~t U'I' e : __.,_='___=_'~__=,~____=_..="',.,.______"',~,.,~__.,____.~__'_,'___ Dat e: _=,~__=____.,______________."____,~
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r certif}' that I am exempt from the requirements or the etatecontractor's regi€ltratic.m l.aw, under
Section 3, Chapter 126, laws of 1967.
S i gn21 t ur e : ___,.:.,..,,__,~______."'__.._______..,,_,____,_,____..__,."__________ Oat e: _______.._'__'~___.,__,__'____,..,,_'_'_____'
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Pe~rm:l 1: Cent ~~r'-'-"Appn)\;It'~d By: ,,,,,,,,,,...,,,,,,,,,,,.,,,,,.._,,.,,,,,,,,,,,,:..,,,,,,.,,,. Date:~_______~_~______
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~i \~ 03:4f.l PM 8REMEfdOt,. D. c, D, 360 4785262 PClge 1
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BREMERTON PER,-tI T C::ENTER
;?86 4th Street, Hremc:rton, WA wrK~?'
Phone: ( 360 .> 4 78....... 5~.~ ;7:) F.A,X,': (:7 ~V) ) 470-5278
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:',~~r;:, ~ ~ S~~D 1. 1 ;:i~:~(::,:.~::~r~ 'I...' ,! i;)io if th~: bUll:Jl:";'J (-rt ;iJ(_~'I"'~ t1utr',c:,~:.~<.! ~I this perrni~ is n()~ C;jl'ilr:I.~:i"ICC(: !LI
~' : r~ '::~ .;- "': -;.\.'. L '71i~ ~ (";: if til..!!-::; t'uil:j:n;J ,.:r '\icrr, ,Jl.tt:~';c'(::ec; t.,. s!jch p.srm.i-t i::~ (.:t1:;:,;if:':,"1i,~(;\,
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~,-:' r';, ;3 ~ .,.... ;" ;.. t .1 ;'n-e ,3 ..,' :f(~; t';'j C,~IITW!(~'r"~.,:~:;' f;,:r 2 f-,O~~G:~ ',:if ~8() CdY~.
, " :ry of the pe'mlt holc~r, 1nt t~! (it ;~:<j~")f to~\ :~ f ell I; Ij H!i) Cff i:: 1 11; ~ 0 ': ~':~
('; :~ ~ ,,' ,.,..~ '.1 . ~~ ~~e .i"IjaOD~ rhf; p(;~rnit held!;! mc:\j~ lict i: ~r~f; BUl.tdJr19 Offl~ial ~Jr;(?fl rCL1d,~" f:):~
., ,,.-,,-',--. : ,":~ .:.,,\~\;;rlit hclc~( ti:l r\~";tif',: t~.'i,b 3ljj li,117~\J C,ffic!~l uf 1'8..1uired in~pl:.'~:~t Ion:; ~J/ (~;;"";\ji,'r,.
'_.1 :,~ , 'e ,
. L ',or-, ~.'Jl~~;'f( Li7",tl~ such tinE; th;~t t~;c: pCr'ii'1: l(k-;f ljar~ S!..ib~~:3nt ia~e tCl 't;"{r CUi, :cLng o{"~i':;i):
.,"'" .". :.'. ';':' ~
, : ;:'5 c;~; r :",' :i j r mrets or eAceeds coc!e 'requirem~llt~;. ;\~:?' df:::7lCi) ~ 1 CJ;i , "l~7tj:1g, or fiil~1r;('~d! bl,~';d2n ~~\lll
t:;::: ~.:c) r ne :j;, r ;~;I", ' nermit rloliJer, Fcdl',Are 1.' sut;,,:;a:!~:JI>: cod,::; ._',;0t5 i'lill i:ldem,,:fy {he [ir.,'
~J;;'2lt.!:,t ~jt:>' :; ~s~~n9!bl]lty or llabll:t! lonrccted with th~ ~Dnstr~(tion_
-- , t ":c:a r [ ha\i~ nJad oi'Jd 6;l:21mincd this f)'~(."llt ,;r,r,; :':~'lCI,J U';,~ sarr"~ to be true and t;t;t'rcct, Al.!
! ," f,':; ,i."" J~!J ordinance_9 9ovr:rning thls t)'pe of w:d .~lil tie compli~d with v;hether BP~~c;fl:1(1 h('r~~,r
9r2~ti1g of a permit does not cresume to ~i~C ~U~ -:~1 to viol3t~ ~r cancel thr provi8lon~ of
~~i t ,.L ':.dU, :)( local law regulating GonstructlJ!1 or t,",r ,':', ,'_ ...~rii>' ,.If ':C:'l!3tr'lctl0'J,
c
r~ 1 ~'j!':d t I,,: 1':',;' ~ ~..........,.. ...-...... __........ II' ."".... .............. ................., ....,........_ ...~....... ..__ ..... _ __..., "". ...._ ... ,.. !~: (.'! ~: :.3 .: ..,....,..... -' ,.............. "" ..--............ '--,- -'- .....~...-.... ........
r Cflt'; i f / th",' I al11 e:tempt from th€.' ',NNir/;li11entl;l MUle r,t:lte <~':<~ : ,,:,J1 '-(i rt.:qll.lt(~tjor, ldw, iJl1C!cr
Sect Lm 3, cnJ,::ter 126, la\ijs of 1967.
SlgrratLir~; [)'3>': r Fe...
..li.'li."; li~.lI, ~ K,~~.;;;;~)i~:, ,,;;**.*.;n~"UU__h__ .,,- - .....____,_u,._ C)-h-h------'-~~------"70-I7t~ U e:lJ
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B~EMERTaN PERMZT CENTER
:286 4th street l' 8remer-ton" '''''A 9833;1
Phone: ,( 360) 4,78~.5;:?',~) FAX:: (::'~60) 47t1--5278
BUILD!Nfi PERMIT
Job ;'ldd'('~ litH 8HENTWOOD DH PermIt No~ 96""057~::
L('Jm:l't;it')n~ 11:21 ~3RENTWCIOf) DR St~tus: PENDING
:Pa'(';I:~l ,N()~APpn6d~ 09/Q911996
I t~sued :
Appli.C:I~nt: SPRAGUr:: (::iOR(lON & SYL,VIA a77""1~~7S,Exf,:d.res:
1 121 BRENTWOOn ON BREMFRTON WA 98~~1~? I
Owner: SPRAGUE GORDON & SYLVIA ~Ji7"'"13'75 '
, UiH Bt~r::NTWoOn DR HHEMEHTON WA 9m31,i,t
CQnt;nH~tQr: Sf:.:LF LJc ~,':St::L,F Exp:
~' Subc:ont r ~
" I
I') .lI!' ,. i':'A~:' 1;:'llr':)N,l\f"t,":~ ",,'A(,':' j:i'!'I-:ilNC" Qt:;,,(')~)ANt::" 1'{!.Ni," ,( ty)() r;'AI )
, e<~c" <3 v ," 1"\ h!..t..~, t1.,l . ,. f,",pl" f), f' n. I:" n, [,\ ~h"" t'il . ""
. r .
*****;(**,~,)(:******,~****~*,)li**'l*,***~,*,*,~,l(*************1i,,'1t**********,><-**** *****************~******':j(,***
V "[' . 'I,,' '" r,' , t 'L' .'. "Ie) '7"(\ "r' t. 'I ("' 1 . 'I' + 'd... f'''' ' ")4 '7()
j,'1,UI:HIOT.1 .,.: f f.:H"ml f'6ee, ,~',f" 1 Cli:h _.aCU"lih;e. "et;1.' ':'. "
, .00 *Pli.'mCheek fe(:;:~~~.Oo Addtti.!maL f:'E:lt':ls: ,,00
, * Other F(:)E:1~1: ~LOO. TClt2l1 P<~rmH Fee: a4.70
iJ(,*,,)(.*****************,l(***~'*************'lf,)f*,**,~HHH~***)(,**~.,)l\*,J(.***,)(,,)(-***,)(-********,lt:***'~~HH('**'*****')1;**'* ,
MECHA~.I CAL/PLl~lNG. FI )(1URES-'.. . . MECH-G. as Furnace .t p lOOk btu. '1 /'I€CH-llas Pi pi 119 (OU'. . .' " '0..', . ,,'
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lhiH permit shaH become null and void if the buildin9 o'fwo'fk authorized by this permit is not commenced within
fao days from thel. date of sllch permit, or if thle buildtng or warkJ,1tlthcirixecl oy sl.lchpermit iasuspel1ded Qr .
~.bandoned at any time after the work is cCllrlmsnc8.drqr a pe):,iiJd ~f 180 days. .
i .". ..' . '. : : '.;' .... .... . ....
. NonCE - Itiathe .resrxmsibil ity of the permit hold1Jlr,' not,. the! City of8remerton or Building Official tasse
tcdt t~at required inspections. ',8. remade. . The per~ithofde:mu$tnqt~f~ ~he Build~ng, OffiCialW. hen ready for
~.nspectl:ons, -Failure of the permit holder to notify tht'f Bmlding O~f1cl~l ofreqlllred inspections may result
lin the stoppage of the work until such time that t~" perlnit holoo(~an substantiate to the building official
that the concealed workmeete t,,'exceeds code requlrements.i:\nydemolitiofl. testimhor financial burden shall
p~ borne directly by the permit holder. Failure. to sub~ttUltiat't! .code require~nts will indemnify the City . i
~9ainst any and aU responsibility or liability cot)nect~d,~ith the '-construct ion, .. .
.' " " .'~ E
I hereby certify that! have read and examined-thispermi't and-know the same to be trueandcorrect.AH I
pfovisionafjf laws and ordinances governing this type qf work wUl be complied with whether specified herein I
or flot ,The granting of a permit does not presume togLve autt~dty to violate or cancel the, provisions of
:nrother at ate or local I.. regulating coflStruct \"" or 'the p'J~or~""" of COOS: ruct lorj.. .' . .1
.;;1gilatuua. . ... ... ... .. .. .... .(late. I
' _ta;'llll,~l:I;;!_~"fIII""''''''''IIil''.'','IlI''t...'~_>!l;>''l'l<'I''''$O...'''''lI\l<''lII;J1I'II'.lI!I~I\4l~O\QI._./l....i=;II'''w-~....'''''~_:r..It\l1......'ll:f_#'~0IIri_,,....1'l..'''ll' ! ,..._~...'IP....._____...~-<lll4~"""'1f~$.....__""".~~_""""I:II_......'...IiII'...'
, i ce~tH)' that! am exempt from the requiremel'lt$',of the state COjltractor 'sregbt'ratlon law, und~l". I
Sectlon 3" Chapter 126, laws'of 1967:, \ I
SignatUre:",,' ,',', , , ' " 'Oate: ",. I
, ' ''''..''''''__~_'''"'...~_l'!'''''',.....wIl'''''i_'''''....._"..._,..",__."....:lIli__,liolI_...,._......_'''!''''''.'lW___....,.__,_".,,,"',,-.._"", ~,~ !lfI<-_~..."""____.........__bII>_-'4-.......__"'I<iI.>>II<("'___,....><I>o,....___
~*IJ('****~*****')(.iHI),)(.***1(:****** " , ' " ;' ; , ,
Pt;"('mjt l'll.~rlte-'r"""'AP")Y'nve'd Bv' ' O~fte;\'
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I 8UILDINf:!i PERMIT
::lnl':I j::lddr: j j ? 'j H.~ENTWnOn nr< Permit No: 96-0572 :1
I !JJCI:lt ton; 1. I:? l. 1~RI;::NT1AonD Df( St;;:ltUB~ PENDING I
l PErf' C€': J No ~ A~'lied: 09/09/j996 I
I Issued::
I Appl. lCilnt: SPHAGUEGOHDON & SYLVIA :rJ'7""' 1. a? s F:xp I rf~$:
f 1 J 21 BRFNTWOOI) DR Br<E~lFRr(JN I.IA 9B~31 ;,~
I
I ,
I Oli\Jner:: SPHAGUE GORDON & SYL,V r A :;~'?7." 1. :375 I
r j I? j BRFNrWOOD Dr:? BFHMEHlON l~rj 9H:J 1 ~? I
! Cont'ri.'lcton SELF' L. i.c 'Ii:: SF:U::' F:)(p: I
I I
[, ;/ Subcont r 1: I
I n,~",'d fAc' FHRNA-"'F -- F:~\<.~; PIPINF Pf?OPANF TANK (T'JO ('AI.) I
, CO'"L . ) ,,,).. . L __., .Ii ,,~, , . ,1, . '" I . ,>,.,. ,:.\ i. __ I
~,* ** * l(' **-)HII'X: ;JiHHHf,*');! ~HHHO(:')t'-if j('1('~' *1<, ** * 'l!:'* X * *X,*~ ;j\,l>t'X-*lHHf jI' ~Ht *1(' *~.* 1(-*. ** * 1{..)(. t!:'fi: * * )(.~, *" ** )>< * *** ** 1H~''l(')( KK*')( *: 'iV 'It* !If * 1
VaJuat.j,{;)f! .)i; permi t FE)e~:~: ?9,,'?O Total Calculated Fee: :~:l4" '70 I
I ,00 * Ptan Check F'eeta: ,,(JO AddU; lof'II.'ilF'ei'.m: .00
[
* Ot h~")r . FeHDf.'1,~ 5,,00 Total Permit Fee: :iJ4.70 I
. .* * *** ~ '~**')!;')HH+-~ *'K'*(~ *'l* *** * *'l( * lHB<-)( 'It* '11: -l(. ,ill ,!{ If X"lH{' ,)(, M'l(' * **'1(. ** .~:* * *)( j('lHI' * M")H~ 'X:**'I! *l<,,)()()()( * *.)iI'* *, *** **11' *~:)\ *,\(. *l{: J(,;.( I
\ MECH-Gas Piping (outlets)",,:
MECH(~NICAuPLUt1aING FIXTURES""~ I1EC'fI-Ga <' FU: ~e to lOOk bt u. : 1 1,
~ }
\
I
i *************M**M*************MMMMM**********K********************************************M**
thIa permit shall bf~COI'!)(~ null and void if the building or woh authorized by this pe,rll'lIt ia not COfrllllf.H'ICt:.d with.tn
~HOdays from the date of lStlch permit! or if this building 0'( work authoriz.ed by such pElrmlt is suspended or
~bandoned at IiIfW tim€! after the work hi comml;mced for a period of 180 df-lYfil.
l
j
~.jOTIC€ ,~ It is tli(~ n)apomdb1Hty ()f the permit holdl~r, not thf~ City of Bu~mert.:Ofl or 8uildIng Offl.dal to ~lee)
to it that \'f~quirt'ld inspectiofl€l aye made. Tn!:. ~l{mllit holder !IlI.lst notify the Building Official ~lhen ready fo\"
lnspectiol'\.s, Failure of the permit holdfJ'f to notify tn€: Bld Idiil~1 Of'ficial of H}(juin:lc! inspections Illay result
dn the stoppage of the Wl,rk until such time that the ~~_~rmit holder can substantiate t(.l the building official
that the concealed work l!l6f~tS or exceed~J code requirement13. "'Any d(~-IIlol it ion; testing; or financial burden shall
be borne dh'f.:~cf;ly by thl:~ permit holder.. Fa:l.lure to substant tate code rectl!i n~ments will i ndemnU'y the City
against any and all n1sponsibil it)! or liability conn~:ctf.~d with thtl construction.
:1 I'\(-!n~by celt i fy that I have read 'and ~n((uTii ned thi.s perm! t "arm know tht'i: same t(l be t rue and correct. AU
prlJvisl{1n,~ (if li':iwa and ordl.nanc!;s governin9 this tYPt:: of' work wi 11 be comp1i€)(! wIth lllheUlf~r spat;! fisd herein
pr not. The \,/ranting of a permit does not pn~SlJme to give authodtl' to violatf: or cancel the proviaionrj of
any otneretahl or local law regulating constructIon (If theperformanC(l of com1truction.
DEi t e : """"""'","""~,,,\IIi"'~:J'v;,,*,!l r~_;;;Ol"" .a"-IOJ'Ir~ IW' ,"",,u.l....,,,,,,, 1lW_1"'.:/'4 ,,"_4 ,lilt RIll "",.",,11o\O
I c~~rtif)i thrlt 1 alii t'lX811lPt from th!';! '(e~lJi'(elYl!:~f1ts of the etlllt,e ccmtnctor'fil re~jht'fE1tion Im\l, und~w
SecthiTl S, Chapter 126, laws of 19t~?
S i gnat u f' (I: _".,.."""",..^_~.."_...".,,..._~,.__.,,.,.,__.._........,,_,,_.....,.._..'''_.."......" ,,".,,__,~ _".,__..,,~,..,
M****MM**M*************MK**
l:.ierm:lt Cmrt(:'~'f"'ArlpT'Oved FlY::", , ,'''.., . , " , , OHtf.~:. ,. .,., ..
1J\'I.II~~.~.lIf~~VMj~'~llg!l;
q-,-,,- . Ity 0 ... remerton.. as ngron .... . 'q... one.,-. . .. I _ . ,_).q, . _ . / _ ... q
,'. -":;,,;,:.;:,:;- '- ,.:::"q:,::;q ,-, " ':';:::., ,:" ,.' q -';":',', q. qq":-:.;':',';'qq ",":', " ' ", ";;':" "" -, . ,'-:--'.-'-'.. .',' " ',::':" .-- ':, ,"'--:".'
:J,i,'I>>K_~Ct\l:%\i;j;;l.gZ@s.O?i\.illl!'f?illllPLIJMBIN(i;;t*'M; ......;#:'>1
APPUCAi~T: [3l OWNER 0 CONTRACfOR 0 OTHER:
COMMENTS:
SITE ADDRESS: / I ~ I 'B,t"' ut~d ~, i;,e.k. lfJ~. 98:1 (~
OWNER: bo~o\..J 4-- Sy( V l'c::;.. ~u.<L ADDRESS: J I ~/. 13c-e~~d ~. ~. o..k,
. . 9~3/~
CONTRACfOR: -, ADDRESS:
CONTRACfOR LICENSE # EXPIRATION DATE:
OWNER PHONE # 3"/)-j37S CONTRACfOR PHONE #
,
'iN€lf{ :@f:!!::it!;fJfi!:;!f:~~#lD{flj$(j~J;nRJi&E..~:W;fi::j&;Jii::tm:rif::lt1!i1E1$;!f!i!:i!iM:~~::HtM!;!i:;!i@ff;if:J:~;EffJFtF1Xlm1REiiIi!ttJ::;i;ii!iffjff ''---EER
..... ...
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.. . ' . .
RANGE I WATER CLOSET
WOODlPELLET STOVE I BATHTUB
I GAS FURNACE btu's: dO'h.,v1-1"4~ LAVATORY
CONVERSION BURNER bt1I's: SHOWER
UNIT HEATER btu's: .. IGTCHEN SINK
BOILER btus: DISHWASHER "fe IN fi;? n tin .r; f
I GAS PIPING LAUNDRY TRAY l!:;'Jil..!7tS U rJ tc
EVAPORATION COOLERS btu's: CLOTHES W.A.SHER ,;:,.,
AC UNIT btu's: . WATER HEATER ~r:P ~H 100C
HEAT PUMP btzl's: URINAL --'
tQ11S:
REHEAT BOX btu's: DRINKJNG FOUNTAIN ,,,,IV
AIR HANDLING UN1T bt1I's: FLOOR SINK OR DRAiN nllll II R11'I Of ~ARfMENl
_'11 E<HAUST FANS SLOP SINK II
RANGE HOOD (residential) WATER PIPIING & ALTERATION
RANGE HOOD (commercial) GREASE TRAP/INTERCEPTOR
CLOTHES DRYER HOSE BIBBS :'c.
INCINERATOR LAWN SPRINKLER SYSTEiYf ':c'
,
DUCf ALTERATION SWIMMING POOL
TANKS type: BLDG. SEWER (mobile / moved house)
REFRIGERATION UNIT. ROOF DRAINS
OTHER; OTHER:
MECHANICAL PERMIT FEE . $15.00 , PLUMBING PERMIT 'fEE 05.00 or 4.50) I ,
MECHANICAL FEES: ,~
PLUMBING FEES:
, TOTALFEES:~J 0
APPUCANTS SIGNATURE, ~J If'r;;-'''''( ~- DATE:
--,......., .'.,.-"-...-.....,,-.,..........--... .,~...,,-...,....-.."'-~'''~'''----- ~....-----"'. ..,-;'-'---:':~":'-,":-- . , 1
. .
*~****M****M*K***~*****M************.********K************H*H***
CJ TY OF f3h11::111::'RHlN f<FCF J PT
*******M*****************K**************************************
'f<FCFIVT Numbt':r ~ 960000 J ::l f"irM)\.! nt: :: ~Jt1. .:70 09/09/96 10:: ;?9
I. Payment Method= CK Notfit i:on:: Spr~AljUFtMl(ln I I'll t: = \)1,1
,',,, '"'' ,,,,,, .-., .,. ,..~ '''' ".,- .... II " ,,~, .,.,. """"~ "",. ,,," "'" ..." ,',....~. "". ''',' .... .~..
[' Pe!"'mt t No:: rYPf~: NIP MI:::t:lllPtJlCl !'!:Rl'1 I T
Site Address: ]121 8RFNTWffi3D DR
L,oc:at ton: 1. I? 1. BI{FN'lt.JOOD Dr.:
"lota1 Fflt)l;l: 34./0
'fllfs P;;~yment :l4..70 TOti:'1. l~IJ Pmtf:': : :J4 ,,7()
Fie, 1 ancel: .00
'***********MMM***MM*****M**********************M*****H*KM_I_NNW
Ancount Cnde! Df%'lCl" i pt :1 on Amount
1. " I. 005 ( 11:\ ) MECHltN I C(\!.. PF:ltM I r ;~~(;f " 70
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FROM : section 8204
Article 82
Section 8204 - LOCATION OF CONTAINERS
8204.1 General. The storage and transportation of Lp-gas and the
installation and maintenance of pertinent equipment shall be in
accordance with U.F.C. standard 82-1 and sUbject to the approval of
the chief, except as provided in Article 82.
8204.2 Maximum Capacity within Established Limits. within the limits
established by law restricting the storage of Lp-gas for the
protection of heavily populated or congested commercial areas, the
aggregate capacity of anyone installation shall not exceed a 2,000-
gallon (7571 L) water capacity (see sample adoption ordinance,
Section 5).
8204.3 Container Location. containers shall be located with respect
to buildings, public ways, and lines of adjoining property which can
be built on in accordance with Table 8204-A.
Containers shall also be located with respect to special hazards
such as aboveground flammable or combustible liquid tanks, oxygen or
gaseous hydrogen containers, flooding or electric power lines as
specified in U.F.C. Standard 82-1, Section 3-2.2.6.
,
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1994 UNIFORM FIRE CODE 8204-~
,
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, , ' ,- TABLE 8204-A-LOCATION OF CONTAINERS
. ,
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MINIMUM SEPARATION BETWEEN CONTAINERS AND
:..,: . BUILDINGS, PUBLIC WAYS, OR LINES OF ADJOINING
PROPERTY THAT CAN BE BUILT UPON MINIMUM SEPARATION
CONTAINER CAPACITY Mounded or Underground Aboveground BETWEEN CONTAINERS2, 3
(water gallons) Containers 1 (feet) Containers2 (feet) (feet)
, x 3.785 for L x 304.8 for mm
- -- Less than 1253,4 10 55 None
f
, { 125 to 2"0 10 10 None
" 051 to 500 10 10 ~ 3
'" 0,
501 to 2,000 10 255.6 3
2.001 to 30,000 50 50 5
30,001 to 70,000 50 75 (1/4 of sum of
70,001 to 90.000 50 100 diameters of
90.001 to 120,000 50 125 adjacent containers)
. -, I Minimum distance for underground containers shall be measured from the pressure-relief device and the filling or
( liquid-level gauge vent connection at the container. except that all parts of an underground container shall be 10 feet
I (3048 mm) or more from a building or line of adjoining property which can be built upon.
\
2In applying the distance between buildings and ASME containers of a 1 25-gallon (473.2 L) or more water capacity, a
minimum of 50 percent of this horizontal distance shall also apply to all portions of the building which project more
than 5 feet (1524 mm) from the building wall and which are higher than the relief valve discharge outlet. This hori-
zontal distance shall be measured from a point detennined by projecting the outside edge of such overhanging struc-
ture vertically downward to grade or other level upon which the container is installed. Distances to the building wall
shall not be less than those prescribed in Table 8204-A.
EXCEPTION: Installations in which the overhanging structure is 50 feet (15240 mm) or more above the
relief-valve discharge outlet.
3When underground multicontainer installations are comprised of individual containers having a water capacity of
125 gallons (473.2 L) or more, such containers shall be installed so as to provide access at their ends or sides to
facilitate working with cranes or hoists.
i\ 4 At a consumer site. if the aggregate water capacity of a multicontainer installation. comprised of individual con-
tainers having a water capacity ofless than 125 gallons (473.2 L),is 500 gallons (1892.7 L) or more, the minimum
distance shall comply with the appropriate portion of Table 8204-A. applying the aggregate capacity rather than the
capacity per container. If more than one such installation is made, each installation shall be separated from other
installations by at least 25 feet (7620 nun). Minimum distances between containers need not be applied.
5The following shall apply to aboveground containers installed alongside buildings:
1. Containers of less than a l25-gallon (473.2 L) water capacity are allowed next to the building they serve when
in compliance with Items 2, 3 and 4.
2. Department of Transportation specification containers shall be located and installed so that the discharge from
the container pressure-relief device is at least 3 feet (914 mm) horizontally from building openings below the
level of such discharge and shall not be beneath buildings unless the space is well ventilated to the outside and
, is not enclosed for more than 50 percent of its perimeter. The discharge from container pressure-relief devices
, shall be located not less than 5 feet (1524 mm) from exterior sources of ignition. openings into direct-vent (sealed
combustion system) appliances or mechanical ventilation air intakes.
3. ASME containers of less than a 1 25-gallon (473.2 L) watercapacity shall be located and installed such thatthe
discharge from pressure-relief devices shall not tenninate in or beneath buildings and shall be located at least
5 feet (1524 mm) horizontally from building openings below the level of such discharge and not less than 5 feet
(1524 mm) from exterior sources of ignition, openings into direct-vent (sealed combustion system) appliances,
or mechanical ventilation air intakes.
4. The filling connection and the vent from liquid level gauges on either DOT or ASME containers filled at the point
of installation shall not be less than 10 feet (3048 mm) from exterior sources of ignition, openings into direct-vent
~. (sealed combustion system) appliances, or mechanical ventilation air intakes.
1 6This distance is allowed to be reduced to not less than 10 feet (3048 mm) for a single container of 1 ,200-gallon (4542
L) water capacity or less, provided such container is at least 25 feet (7620 mm) from other LP-gas containers of more
than 125-gallon (473.2 L) water capacity.
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1-367
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FROM : section 8210
Article 82
Section 8210 - PROTECTING CONTAINERS FROM VEHICLES
When exposed to probable vehicular damage due to proximity to
alleys,driveways or parking areas, Lp-gas containers, regulators
and piping sh~ll be suitably protected.
. .
FROM : section 8209
Article 82
section 8209 - CLEARANCE TO COMBUSTIBLES
Weeds, grass, brush, trash and other combustible materials shall be
kept not less than 10 feet (3048 rom) from Lp-gas tanks or
containers.
. .
FROM : section 8208
.
Article 82
Section 8208 - SMOKING AND OTHER SOURCES OF IGNITION
NO SMOKING signs shall be posted when required by the chief. Smoking
within 15 feet (4572 mm) of a point of transfer, while filling
operations are in progress at containers or vehicles, shall be
prohibited.
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,.BBEMERT'ON BUILDING. DEPARTMENT
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i PIum:binglMeCbanieallnspe,c;tion Report
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i Scope of work: GA$ FURNA.CE". PIPING PRO?ANE'l'~ Pennlt Number: 96-0572
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I A..dres,s:. 'B~'~OOD pRIVl\:. 1121 Owuer:p.I\?R1\.GVF.. (',OROON
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I CO,ltractor: ' Phone: 377~1375 .
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GAS PIPIN.G
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Under.tal (lli1.si for;.15mi.1U~) Yroptuiz.ing& sUPi>OI't .... ... . . ...' ..' ". ..'
12" Iflinirnum '~)Qwgi"adcwbcn unJc:rii'ound . " .. C();tted1w1:ap~1 when undcrgi"ouJldollwidUh6" of earth
Gr\ilu.ld~Jojilt unions ..rol,li,bhed inccrtaiJlIOCllitiom . "u$hi.. , shot :dlo\'lltd in conc.e.-..Jed areas
COMMErm,_..~~ ~...~ ~.~?f~ -
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GA$ptPING APPROVEn:~--,- .....-----
FURNACE
MaIlufa~'s~f~t;ions on site . Loodon, acoess. sU.l!~rt
C~ancclo~mh"'!tihk!l _Vendlldearana: .lo cornhusliblc::s'
Vent siulrg3csupportJ~nne<:f;ions , . V~nttermiQ;ldon
Colobustionair _Qhi.!!'~ liner, andJorsepatatefluesasttfJuited.
G~ $htlt~lifwi~~fliI)3' uircd .. ,'.. PiJQtekvaled.offfloor.in~rag(!
. OUdlJ:S:iZ(: &:: s.1( . QrtJif1lluiatedwhen RetUrn air
COMMENTS:
FtJl\NAiCE APPROVE}): ~~
MISC. APPLIANCES
Mf;H '.. ..., . .... "'l!i" .'
.., .!~'.~ur~S$~ !lca.tJons on sUe
C~cew~m()~tib,1es
~eJ\tsi~in~&: ~uPl'Qrtlco.mections
Combustion air
. .C:QIllut.-&ffwjdtin3' '.
.\Veod.$'t~~ ~lMal' 'roved ' .
'Woodstcwc$&fli"e Qca:uht fitnn dooJ1J
COMMENTS:
MISe.APPLIANCES APPRoVED:
WATER BEATO
L()eadon~a<<css.suPP()tt
Verldng:~a:tocombustib1es
V~ttmnil1ldOh
Chi . liner a:ndJ or ;trate nUelI all aired
Pil~televatedQff Hoorin gange .
'. Relief valve dtairac:dto outside
Unlona'On .\\'ateri
COMMENTS:
WATER HEATER. APPROVED:
AI.I.WORKIJMJER THIS P.BtMlT APPROVED: rf/fi /D/cffft,
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