HomeMy WebLinkAboutE. BROAD ST., 1035
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BR.EMERTON PERM:IT CENTER
286 4th street, BremBrttm, bJA 98337
r ' Phone: ( 360) 478-5,275 FAX: (360) 478-5278
BUILDING PERMIT
I Job Addr: 1035 E BROAD S1 Permit No: 97-0291
I, Lm::atton: 1,0:3SI::: BROAD sr 9 BR1JADMOOR VIL.LAtiE L1 9 Status: ISSUI::::O
I' Parcel No: 02240U''''028'.'';:~OOO App 1 :1. f:ld : 05/08/1997
Issued:, 06/17/1trn
I Applicant: KEENAN mSSIGN INC. ::160"",:377,,,,8370 Expire.: 12/14/1997
PO BOX' ~IO::~,8 BREMERTON WA <718310
Owner: FPH MANAGEMENT ". 479-4137
I ~13~llKnSAPWAY E~REMFRI'ON WA 9B;EJ.1.2.
I f' t " ".t ',' Kf."'FNAN 1)f."'(;'Tf'N INt"' ' '3(:0 '377 l:B7\ '" fl:' I"I"TNADIlY""'Nf' E'" "8/'''ljtt?
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. PO "OX ~~0::'~8 r.,mEMEJ<TONWA 98:310 '
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r V~lu~tHm *.. .F1~'j"fI'IH ~::~mfiU 6'74..20 'r'Jtf,tlef,l~c:l;lat!edf'fj€H ~,,078.33 j
I 64,SaO,,70 * Plan Check l:~,eef:~: a~~"t:~~1 ."Ackht~()rH:'i~, l"'~els: . ...,,~J~J !
~...", '. ..... .*. Other H:it"ls:. '. b9.bO. . fatal Pfl'f'mlt H~!e: . 1. ,078 ",:ki 'j
i .... *'**********************~'*****')('*'*****~'*****'l+'******.***,*** *****.***.*******,****,~*,**.***.******,*,***~,* I
I MECHANICAL/PLUMBING F,IXTURES-", MECH-Ral'lge.... ......... n.. ..:. 1. MECH-Gas Furnace tol00k btu.:l :1
, MECH~G~$ Piping (outlets ),~ .. = 3 MECH-Exhaust Fans...,,,,,, Hi = 3 MECH-Range Hood (res)..<<<<!...: 1 I
~ I1ECH-ClotheSDryer...~..~....:. 1. 'PLBG-~ater Closet...~"......: 2 PLBG-Bathtub..;..........l...: 1
PLBG-LevatofY .. .. .. ... . .. ... . . 2 PLBG-shower ... .. H H,. . .. " ... . 1 PLBG-Kit chen S mk .. . .. .. .. " . . 1.
PLBG-Dishwasher ......... ." . ..= 1. PLBG-Clothes Washer.,.,..,...: 1 PLBG-Water Heater."...,..,..: 1 I
PLBG-Hose' Bibbs.. ,'..., ., . . . ..: 2
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*.)t,)i)****.**,~*******.**,lf**,******'.*,*******,*.*.****'******'*****'*'**'**'*'*'**'*'*******1('****'****'****.*.***,**:x.*** I
This permit shall become nul land void i fthe buHdingorwotk authorized by this permit isnotcommemcedwithin ,I
.. 180 days from the date ofauoh permit ,orif. this building or work authorized by such permit is suspended or I
fabandoned at any time after the work is commenced for a period of 180dars. i
.. ;
[ NOTICE -. It is the responsibiJityof the permit holder, not the City of Bremerton or Building Official to see .,
to it that. required inspections are made. The permit holder must notify the Building Official when ready for
inspections. Failure of the permit holder to notHy the Building Official of required inspections may result
in the stoppage of the work .until such time that the permit holder can substantiate to the building official
.that the concealed work meets or f,'!xceede code requirements, Any demolition, testing, or financial burden shall
be borne directly by the permit holder. Failure to substantiate code requirements win indemnify the City
against any and all responsibility or liability connectedwit.h the construction.
I , _ _ .0 -, , .--_:' '" _' '
I Iherebycert i fy that I have read and examined this permIt and know the same to be true and correct. All
I , provisions of laws and Ordina.tl~~ thIs type of work will be complied with whetherspecif~ed herein.
or not.. The grantin~.!t~tdoes !'J. presume to give authority to violate or cancel the provlsions of
any other taMOr1 ".cawegu .J..n9. construction or the performance of construction. .' ,
or _ __~,__":,~,:::::_",_",______",__Date; -------~L2.rL2--_-..___
! LcertiythatI am.ex . om the requirements of the state contractor 'a registration law, under
. Sect 10 3, Chapter Ibwsof 1967. .
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~. Signature: . . . '.. .'. l.fl '., . Date: .... .
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BREMERTON PER~~J(-T' CENTER
286 4th Street v ,Brel1ierton~ bJA 98337
I Phone: ( :360) 478-5275 FAx:: (360) 478-S278
r Building Permit Nc~ 97-0291
::r ob Addn~~~f.H~: lO~3J::; r:::: Bt:=~OAf) s'r Sti:lt;Uf.(~: IS S l.Jl::::D
I t I ' 101r r 8ROAD rT rRnADMnnR VTI I Arf IT 9 Issued: 06/17/1997
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It~:'>>m:: cnaoo INSUI..,;AT'ION Df.~pt:: 1:3l....DG n :l;v:!'f.\~:1. on ~ I
It;e~= 01900 S~EETROO(~AILING C)(*lpt:: 81....lX~ D:l. v :i.~$ fc:m::
Item: 02700 FINA~--m_DG D/::ipt: BI....DEi D i v :1. ~;,~:r. (::In ::
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C1 OF BREl"iERTON REGFJPT
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Jf;n Numbe'!" ~ Amount~ ,,:lO 06/17/9'7 14: 44
PaYflllmt Mf~ttIOd: MASTFR Not;iiit l.cm: Mt~TH~HG Mjl\SH~R '(nlt: VW
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I P~~rmU; N('.\~ l ,~ f3I.j;)(, BeDS Pt:J~NI T W/11ECli/P
Parcel No~ ()~?24011~'Ot:\B'''''~)OOO
I Si.t(~ f'lddv'efl~r;l~ 1O:3S E f:~i~O(c'~n
I OCi'it iOfP lO~:IS F BROAD if BROArmnm< V H1,AtiE L, 'f tr
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Thi H F;1a)!'iIlt':l1'\t Total A! J Pmt€l: 1 ~ ()'7f3 . a::~
B~i li)nm!l: .00
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t':!;(;CC:iU nt Des(;]" i pt i ()11 AMCll.mt
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( 4~iE~{J ) HI.HtmNI~ PLAN CHf~,Gt(; "O()
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1 0""'" ( 15 ) HF.eH~INl:GAL PERMiT .00
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. 1 t)O;~( '~~, ) PL UMf3 J Nf~ Pf::t(M 1 T 7H.OO
..l.a( ) OF' t.\tA SURCrlARGE 4,,~m
81 "H)09 (j~21 1> ) PFRM 1 T !::iUHCHAR€iF 5.,00
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BREMERTaNP~RMIT C~NTER
286 4th Street" Bremerton" WA 98337.
Phone: (360 )478-5275 . FAX: (360) 478-5278
BUIL.DING PERMIT
Job Addr: 1035 E BROAD ST.Parmit No: 97~0291
1 .. '. ~....' 10'''IC'' I""' B' 1':l(")AI') '(....1.. 1':lf:l(J^[)MI)(")I':l' V'[ II AI'"I"" 1 '1" (;) c~t. ~.. II . 1')I''''ND T Nf'
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Pa r ce 1 No: 0224011.:...020.....2000 App I I ad: d5/00/1997
, Issued:
Appl Icant: KEENAN DESIGN INC" 360'-3'77'-0::r70 Expi res:
. PdBOX 3020 BREMERTON WA 98~10
Owner: FPH MANAGEMENT. 479-4137'
'3331 KITSAP WAY BREMERTON WA 90312
Contractor: KEENAN DESIGN INC. 360-377~837L.ic ~: KEENADI055NC Exp: 8/2/97
PO BOX 3028 BREMERTON WA 98310
Subcont Y' :
Dase: NEW SIN~iL...E F'AMIL..Y F~ESIDENcE,MODEL: "A"
***********~*******M**M*********************U***~**********~******M**************************
Valuation * permit Fees: 674.20 Total Calculated Fee: 1,078.33
64,530,,70* plan Check Fees: 344.63 Additional F~es~ .00
* Other Fees: 59.50 Total Permit F~e: 1,078.33
*****************************************************************~*.**~***************"******
MECHANICAl.IPLUMBING FIXTURES-- MECH.,.Range.. . . . .. ... , .. ... . .;: 1 MECH-Gas Furnace to lOOk btu.: 1
MECH-Gas Piping (outlets') ~ ; .. :3 MECH-Exhaust Fans..........;.: 3 MECH-Range Hood (res).... .... : 1
MECH-C 1 ot hes Dryer..".... ," . : 1, PLBG-Wat er Closet.....:......: 2 PLBG-Bat ht ub .... " ", .. .. .. . .. : 1
PLBG-Lavatory...'.............: 2. PLBG-Shower.......;.'..;....,.: 1 PLBG-Kitchen Sink';...;~....,..: .1
PLBG.,.D i shwasher .. " ; . .. .n . .. : 1 PLBG,...C I ot hes Washer..........: 1 PLBG-.Wat erHeat er .. .. .. . .. .. . : 1
fHOSL!........>...~_ 3- {il. .?-- . .. ... U. ~ ·
.............................l..........*"......~......~.............l..........
This permit shalLbecome null and void if the building or work authorized by this permit is not commenced within
180 days from the date of such permit, or if this building or work authodzed by such permit is suspended ,or
abandoned at any time after the work is commenced for apertod of 180 days.
NOTICE - !tis the responsibil ity of the ,permi t holder, not the City of Bremerton or Bui Iding Official to see
to it that required inspections are made. The permit holder-must not.ify the Building Official when ready for
inspections. Failure'of the permit 'holder to notify the Building Official of required inspections may result
in the stoppage of the work until suc,h time that the permit holder can substantiate to the building official
that the concealed work meets or exceeds code requirements. Any demolition, testing, or financial burden shall
be borne direct lyby the permit holder. Fai lure to substantiate code requirements wi 11 indemnify the City ,
against any and, all responsibility or liability connected with the construction. .
I hereby certify that I have read and examined this permit and know the same tobe true and correct. All
provisions of laws and ordinances governing this type of work will be complied with whether specified herein
elr 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. .
Signature: ~______.___.____________.___:________....________________ Oat e: ______.__._______________'________
I ,certify that I am exempt from the requirements of the state contractor's registration law,ilnder
Section 3 "Chapter 126, laws of 1967.
~i gnat ure: -,.t.:~ ..~_ '_ . .., .", ___....._........_,...,__"._,...,.....,__.".,;. , Oat e :._.."..._.___..,._._____...;____.~...,,'_--,,--.,.:_,._,
*,,**,****,*,* ~,~ ';;;"*l ., .*,,~****** .
Pprm'it. C'f."~er"'''.''A "ovpr! By': '. [l"rl'f"" 5'-q-~'J .
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BREMERTON PERMIT CENTER
~?86 4th street~, Bremer-tong ItJA 9833.7
Phone: (360 )478-5275 FAX: (~':J\~O) 4,78-5278
BUILDING PERMIT I
~, :.1 Db Addr, 10:::l!;;l E BROAD s'l' Permit No: 97-0291
Location: 1085 E BROAD ST. BROADMOOR VILLAGE LT 9 Statw:.~:: PENDING l
~ Parcel No: 0224011-02B-2000 App lied:: O!VOO/l i7lf17
I sf,ued,:: ]
~ Applicant: KEENAN DESIGN INC. 360''''::~77''''B:370 l::::xpirel?!::
~,' ... PO BOX 3028 BREMERTON WA 98310
"
~' Owner: FPH MANAGEMENT 47171,...4137
3331 KITSAP WAYBREMERTON WA 98312 ; i.
t Contractor: KEENAN DESIGN INC" 360-377-837lic #: KEENADI055NC Exp: 8/2/97 11
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PO i:30X 30~::'B BI:~EME:RrON WA rIm) 1. 0 'I
[; Subccmt r: 1
De':lc: NEW SINGL.E FAMILY l:tESI [)E::NCE' ~ MOnEL "A" ]
********************************************************************************************* '1
I~ Valuation * Perm:l.t F't:lr;'l8= 674.20 Total Calculated Fee: 1 ~07B,,:]3
l 64 .5~W " 70 * Pl'an' Cht~lCk F'ele,;~: 344" (;,;3 Additional Fees: " ()() ,]
,x ot t'H~~r F~'les: 59.,!;:;O Total Permit~fBe: 1~07B,,33 ':I
*********************************************************************************************
MEeHAN I CAl..IPLUMB I NG F I XTURES-.. MECH'''''Range II Mil. II II II It II II d II If 1/ ., l.! II II IJ : 1 MECH-Gas Furnace to lOOk btu,: 1 'I
ME:CH'7Gas Pi pi n~1 (out lets) . " , : 3 MECH-Exhaust Fam,,,.,.,...,.. i: 3 MECH.'Range Hood (res),." , , . ., : 1
MEQH~Clothe8Dryer..."."....,,: 1 PL.BG-Water Clol:let"".",,,,,,,.,,: 2 PL8G-8at htub, , , , , , , . , " . .. . . ,: 1. 1
PLBG-tavatory. . , " , , , , , " , , , , ,: 2 PLBG-Shower 11 II tI It II II II II l II 1\ n 1 ,S II 11- II Il.: l PL8G-KitchenSink""",.,.",: 1
PlSii-O i shw..her. .. . .. . .. . .. .. '1 PlSG-C lot hes Washer..........' 1 PLSG-Wst er He.t er .. .. .. .. r . , 1
I: I::::~~~~'~~~~'~~~~~;...;2.:..1:.2..*...3.......2.......9. ...S....
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r: This permit shall become null and void if the building or work authorized by this permit is not commenced within
l80 days from the date of such permit , or if this building or work authorized by such permit is sllspended elr
r abandoned at any time after the work is commenc(~d for a period of 180 days, I
~' NOTICE ~!t is the responsibilJ.ty of the permit holder~ not the City of Bremerton or Building Official to see
[> to it that Hlquired inspections are made. The permit holder must notify the Building Official when ready for
im,pettions, Failure of the permIt holder to notify the 8uildin~1 O'fftcial of required im,pectlons may result
in the. stoppage of the work until sllch time that the permit holder can substantiate to the building official
that the concealed work meets or exceeds code requirements. Any demolition, testing, or financial burden shall
I be borne directly by the permit holder, Failure to substantiate code requirements will indemnify the City
f~gainst any and all responsibility or Hability ccmnected with the ccmstruction.
! hereby certify that I have Y'f.lad and examined this permit and know the same to be true and correct. All
provisions of laws and ordinanca:m governing this type of work will be complied with whether specific1d herein
or not" The ~Iri'mtingof a permit does not presume to give authority to violate or cancel the provisions of
any other state or local. law regulat,ing construction or the performance of construction.
Signature Date
I certify that 1 am exempt from the n~quirements r;)f the state contractor IS registration law~ under
SectIon 3, Chapter 126, laws"of 1967,
S i gnatu r.' ---1~,~-_,\J.,j:!::1;~c:::_.__.._.__._...._~ D.t., _~__._,,_______..__.______.____.,
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'aREMe:FtTON"PEiF:tM' ," ",t::e:f'.ITER
. ", ,21,164th StrMt~Bremitrton~f4A 9s:'-l3.7
Phone: (.'360) 47f:J.-S:;~i?5'., "., FAX: (S6(J) 4,;7fJ~\~:278.
. BUXLOI MG, PE:RMI1" . .
Job Addr:: .1~~JS tlfx{lAD!~T ,,".,.,,', ".., "..' .~fermit Nr.} ~
LQ{;:~'t i (;)fl t 1. 0 :~~5IaR()A() 8r ~{~I<{)ADMnfJH V ru,..At1t2:t:f9 Statua~
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OWrltin'~' F}:lH MANA,GfH"l,~tNr . 4 jUy''''4, t ~rJ
~~3~HKIH;APWAYf~f<itMRirrnNWA 983n~
K~tENAN [~ES1GlN IN\:;" , ' ,;;~'~O"<3n~,,<H:~7Li,C1IH
PtlfJ,nX ',~lO~>;S.f:$R~!:ME'frrnNWf,j 98~U O'IM
su:bcotl:1: r ::
($' ',' NF'Wr.;'lNG1F fAMllY RE~~'WfNCEMOt)Ill!A"
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ValuatJ dn * Ptl~rmHF(~et:'ti 6)'4,..20' Tob~l C:al(:~ulrih'~dFf~sJ) 'l.onS.as'
~4 fO """Pl. rfHK f' '''$44In rd::llH '''lr~ " Cl€'J
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'~f,MECI1ANltAL1PLUMBlNG fIXTIJRES-- . ftE:eH~.Rtinge-'II'_" 11 \It iii" ft" !! t. 11,. 16 '14' 1I-:-ll' ~ ._. 11:': 1 > M~.Cl+-'ia$Furnace to lOOkbt,u.: '1
'j)~L\'~eCH,~Gls Pipitig (ou~ let~ 1....: S MECH-t:j(haust Fans..,... ...., . '~, . 3 MECH"RangeH~od (r~g , .,' ,1
.. .\.'i.ili:CH,...t:lo~hes O'fYtW. ",~"....:' 1 Pl.,se~'Wat'\llr C Inset.. . . ,. . ..'., .# 2. , PLb3Q-Satht ub.. . . " , d ,,'" . .'.
PLt!tlrUN\!itO'fY: 'i. ..,' '. . . ., . , .;, : 2 Pl..SG--$:hower 'II,. II' it ,II ll'~tllf ~ 'fi 1t ...'., fl'. lI:it .t': 1 Pl.,B6"'Kitdh€;tlSin~, .~.. ".' , .. . ".1 .
PlSG-Dlahw..h.'............... 1 PLSG-Clothea Wee~'"""" ~t.. Heater.... "1' 1
F:' a:z............, 2 _ _ Cfl ... uS.
.u.....*..**.........*lI~...t~...............~.....~.............. ".""....".
this permi.tshall \becomenuHafid void if thebtdlding or work (iQthoY'hed by thi$perml..tl$.ootool!lmenced,w~tl'lin
laO days from the date of $u(:h~~rm1t,or Hthi$buHrUl'lfijorWotK,autnorized brooch pe(IIiUi9$US~l'IOOdl:lt "
abandonedataMtimeaf.ter thewotklst1ol'l\!lleneed far,s. pedodof laO days. , . . " .
, . NOnCE,," It h~t~he rel3~onaibiUt:r of thepermH holder.flotthe t,ityofSramertonorauHdir190fficialJOl!lIllj! , '
" to it thitre~uiredil'lspecHori$ afe Illade., The permit holder;lItustnoHfy tilelhlHdingoffH.l'ial I\lhenreadyffff';
intpecti;ons. Failure. of the permit holder tf;\ootf(y the Building Officlalofreq!Ji'tedin$pecUonsl'li~y.result
lnttie stoppage l4lf the wO\,,!(l.ltrtB such Umll\that the permit holdereansubstantlate to the ,bUUdil'!~toffi,61al
tha~ the ,concealed WClt~ m!etsorl!xceeds code ret!uirr.metth.AnYdemolitiot!; test1tlq, or ftna'Ocial burdervahaH .
be porne directly ,by the Ptt18it'holder. Failure tOEi~ttntiateoode requirements !l}Ul J.ndamnHythe eUy"
afllaifl~tal'l}'and aHre$ponsibHity orHabiHty eormected!l}lthtne' C\oTfl!l'truc,tiQn'.. . . ..
I ht\lreby oerUfy that t have, read andEixamlned thi$perm~t ~nd~l'lo~thesameto beHu~and correct. >At1,.
i;1rov1 $ Ions of ' UWland' orai nanoeltl \;Ioverni \'1st his tYPlaof work ldllbe complied withwhetherapecffi ~hereHl ,
or noL" lhegrantlngaf 4lper.mH does;l'lotprel1Ulll! to g!ve..authtlrity to violate1;lt cancel t~provhdansof'.
. anyot~~r elate 9Y'Joc~11aw.r~!..lla'ti'~ oO'l'lStructitmor the ~rforlllanCeQfGonttrucHaJh . . '
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DEli)I~'H NFtl<.! S:lN(~LF FAMHY RFSJDENCF'. MOIIFL llA"
'~1H\'ll':*l\;.lI' #: ****'IIi**II:1<"\I(,* I'HHH(:**,){jl!jHi:*'j.\:'!(:'Jiii**** ~~,~ **~ ,x,*,~)(i:l('*~H<:'J;;19i~'*** **1l: *'lIi*)("~)(' *:)('ll:'!(,**'~*** )!:'i!;**:W,*** ilHH~ *IHHH\'**
V~duat:i(Jn * Pf!,(ll'dt Fr'lflEH tl'74,;'O lot1:11 Cr:dc:uJat;(i:ld FE;E~~ j .07fL;;5~J
<~ 4. # !);;,l() ..It) *Phm ChfiC k ~ :344 Add:l t; l.ona 1 F~'t'm~s~, Of)
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" hy""MECHANICALlPLUI181NG r-IXnJRES-- MECH"Ran~l!~.. , " ... .". "'," ".; 1 MECH-Gas Furnace to lOOk btu ,I 1
io;'i/;'MECH,"ualii Plpin~1 (outlets)". < I;' ~lECI'Hxhaust Fema.......... ..13 MECH.-Range Hood (rem).." ,. "I 1
"",MEcHkCl()thes Dryer........,,,: 1 PLI3IiHllf:lt!~r ClolilsL" 011'....">>:2 pI.J3e'~Bathtub..,... "'. . .." ~; 1
PLOO""Lavatcn'')i' " , . " .. . " . , . . , , , : 2 PLBG."Sh~)wer . " . , . . . . . , . , . , . . . , : 1 Pl.J3G-tH t then ~1 i nk . , , .... . , " , : 1.
PU~f:H.lifilhwash!l!Y' , . .. .. .. .. n " ~ 1 PL.B6~'C; 1 ot has Walilher......"... ~ 1. PLBk'H4at er Heat m" .. , ". . .. "I 1
f.,I,l,.a6-Ho""ie.Y",B,jb",t,,')~I,.,...,.......,,:,'.,' ~.:,~ " "..,", ~". , :',', ," ,"" ,',' '" C-', ',. "
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E....................~...L,~............. .... . ...........2..................""......
This permit !;lhiill become null and void if the l:>uildinf,j or I~()\"k authorized by thle pf)nnit is not cfJmmel'lctdwHhin
180 days from the datf~ of $twhpermit, 0'( if this building or work authcrrhed by such ~ienllit is sLl$pt~nded Or' '
abandoned at llny time after the work ia CiCIl'Illl'l\:mced fo\" a ~)~!riod of 1130 daYl:>.
NOTICE ... It is the r'(~spon$j,bi lih' Qf ttl(~ pl~rfllit hold(~\"; not the CHy {)f Iilremertorl 0'( f~uilding Official t;1:ls:ee
to it that 'rf.jquired in.specthms Elre lI!ad~}. Thf;~ permit hold(~'l IllU~t flatU}1 the Buildin~1 Official w:!1cm ready for
inapec:tiona. FaHlJH~ of the plift'mit hold~i!lr to not H)' the al.lil.dll)~~ Offiicial of n::ql.dr~~r.I inl\lpection$m~:y result
in thest(lPpa~Je of the wo,'k untO SUG'h time that the p~)i'mit n(!ldercan !~ub$tantiats to the buHdit\j;lofflci'al
that tht~ C:Of\CI.~aled 14twkmeete or exceeds cod(~ requirements. f}flY df:.molition. tl,~8tinfh (1'( financial burden shall
be! bOnlf.~ dh'ectly by the ~'}ermit holder. Failure to $ubstatttiat(-! code n~qutremt)nts will indemrMy the Cay
ifl!;m:'ln~t any and all reapoflaibiHty or Hab:llitr connected 1~1th the cormtnJ.ctictn.
r hereby GElrtif'y that 1 have read and ~~xaldnl!ld this permit and know thtli:ltll'lle to be t'f'ue and correc;t. . f\U
Pfovili!1onlJl of la~1s and ordinances gtw~rl'lirt~ thifil tYPI~ of ~lOrk wU 1 be cCllllPHed with whether (~pecifh~d heretl'l
Of not, f~ ~rrantin9 ofa permit doe-SHot ~1,(~!~ILHllt1~ to give authority to violate 0'( cancel the rnovhlllons of
Iilny ()the~' state or l()(;al Jaill ie!;;lulaHn{1 cOMtnJoth~n or thi~ perf'llrmallCe of cOMti"uctinl"l.
Of.! t e : _'"..."*_....."'~,,~~,__.",.,,,..'.,_ _ _,,_ _ 'w. ___ .,. ."" _
I ct~rtify ithl~.t I lillll eXl\'!lllptfrOlll tt\l~req!Jirelllents of the$tat(~contnct!)'f 'sregbiltntion liw, IJl1drt\'
Section 3, Chl~Ptf:!T 126, hu'm of 1.967.
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. .
". ' ,<,,,- . ...BIJIUJIN-...PERlUIT.tlPPUCA.TION
City of Brenienon, Washi.llgron98310 Phone: (206) 478-5275 FAX: (206) 478-5278
APPLICANT: [2tOWNER [}eONTRACTOR D OTHER:
'/6'kJ EU-tif11t:J S/TAXACCOUNTNO. Ut't
SITE ADDRESS:
OWNER:----EQd (" Oh')~\ . ADDRESS,:33~31 ILl 11 ~ Li,(4t,'l -<l.~
CONTRACTOR:-K6~f>r}J "O~ ;1J~ 1-lJC ADDRESS: ;-/17 B/lA.'td-l1t1J-r,"-- ~ ILtJ .
CONTRACTOR LICENSE #-'(~~^}40 I O\-~1UC. EXPIRATION DATE: g/q)
CONTACT PERSON:-.E f\~JV( CONTACT PHONE # 3bO-]71~8T7b
EJSFR o DUPLEX 0 MULTI-FAMILY D BUSINESS D OTHER:
o SIGN 0 DEMO o MOVE BLDG. D MOBILE '" D GRADING(yds):
[2t'Niw 0 REPAIR o REMODEL D ADDITION D OTHER:
NATURE OF WORK PROPOSED: tvQJ,J ~~ [rD &r @ [tr I} \'1 n !!11
r~ .','," ( ~') -r"'i'" L':~j
.. ..1. ~ J \} I) t ,,-, ''"'' I
!e'.7"-.'J
1/07 -z2--(j BU ItD J~~~f {~~1~j;ji~:;';'1'!r.~,~ '1
SQUARE FOOTAGE: Dwelling:~ Garage: ~ Decks: ____ ~ ,,"' j ",:..h
9<<" 1)~ ~ fJ"",
..' '.'....... ..'VALUA110N..'\\,,' .,...,.rtAN,RE'llEWF.E.E:...:PElU.{ll\FEE::.::':f i\:'.;SPR.:CftARGES:.", ......'::.:1'QTAtfo'l!E.S:...:<
S~3'-!O ~44(o~ $ 30~ ENERGY: $50.00 $ I 018. "53
STATE: $4.50
5,
Applications for which no permit is issued within 180 days following the date of application shall expire by
limitation. and plans and other data submitted for review may therea&er be returned to the applicant or
destroyed by the building official. The building official may extend the time for action by the applicant for a
period not exceeding 180 days on request by the applicant showing that circumstances beyond the control of the
applicant have prevented action from being taken.~pplication shall be extended more than once. In order to
renew action on an application after ex:piratioJ,l,th pplicantshall resubmit plans and pay a new plan review fee.
/' /'
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APPLICANT'S SIGNA TtJRE:,,/ --"~'" DATE:
,e::.., . din7
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,~ .. ......~,~...... #....:~ \"..., ,.....: . i,-/_,"" - ..::--- -- ""~' :-_".<'~........~ ""., _',"~', ~..~" ..: -,' J''''''.-.,;~'' W. \:~ ",,'; :0-._-:,:__ .1!"!/~~:ifl1>:i--/.?;~~!;'
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,.,..,.... .." ','" ..........PL " .lNG'..... ""'...,''0'>"''',,.'
=r ~.~.~~-:~:;:i:~:~::';;.:;~.~:::.~~:~::'=:;:::;:~.:; '::".~:' . . . . :.i ~: ..:. ';. ~. <~:: ;',?~~;t~<< > ---':~
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C::) M)"S'i7S:
SiTE AD D RSS: I{)~J '~~HIJU ~< Lot1
OW'NE.~-6f H- {_'VIVST' ~ .-\DDRESS: 3331 IG(!~-s~ L~ 5'~ \Q
CONT!t\CTOR;-W"JJf.W {)€-J;.~N j:'vC-. ADDRSS: 3'7 11 ~/U)wlJftJe.L~ Y
CONTIt\CTOR LICENSe;# IL (:f,NItO J as~)\J~ EC'!R\TION DAp- <6/q 7
CW)iE PEON.I:,;; Lf71rLf /57 COl'iTI..\CTOR PHONE ;; ?77-JJ70 '.
-
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I hNOd~!r.1M{1.Wj~i!MfEtE~~:EEQD'1P.~~i;:li~j.fm&i*iiM~ti?E~ijf~~:N0tMi~j}m~{~~11l@~i.RtP.:E0EE~"IHRE~W~%1Mm~t~m*lP~~tl
i
/ t BA7::Th"3
z- t L-\ VAlORY
I SEOWE.-=t
i KITC:-=EN SDi1(
I "'OIE.~'d I DrS2"'W.-\S~3
'-: .. ~~:"
! GAS P!.P TI'-i G i V..U~jDRY TRAY
, :C:V.-\.?ORATION COOLE=tS ! Cr.OTFE W..;Sl-r;;R
i .\ C UNiT DT::l ~",: i W:\.l..=.R .E..:..-\T=R
I HE.\T PUMP br:l ~.: ::ms: ! t"R I:'-i r 1.
I RE:---::~T BOX fr.-:li: I DRINKING FOl"'NT.J.,L'i
I AIR ,H.A.i'iDLING l.i~1T rr.:1 S: I FI.OOR SINK OR DRA,f);,
I EC~-\U5T E-\.i'iS I SLOP SINK >. I
; I
~ RA,;,"iGE HOOD (resic:::::ci:!i ! i ! w:\:r=R PIErI)! G ,:v .~ T ~ .=.R.\ l.lON i
I R.J..:.'iGE HOOD (commc::-c::,n I '! I GRE.ASE D.AP/IN .l. .:.RC2 l OR I I
I
I CLOTF.;s DRYER I I I HOSE BIBBS !
I I
I INCINERATOR I I I L\. W"N SP:liNKLEi\ :, is 1 ~\1 I I
I !
I DUCT .-\l.TER..-\TION I ! ! S'w1z"iMING POOL ~, (
,
I TA.'iKS :-rtu: I I I BLDG. S..t W .::...'t (mociic: / moved ~owe) I
I RS..-KlGE.-=t-\.TION L1-iIT I I I ROOF DR.-\.1'-iS i
J
I OT?..E..-=t: I I I OTP~R: I
! MECHANICAL PS-q,.\i17 ~..':; , 515.00 I I PLUM3I~G PEi\.\11 ~ :.=.; 05.00 or 4.50) I
.APPUO.NT'S SIG~A.TU""AE:
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t ~!f~'* ~~*~t~~~~~ ~~~*t!: ** '*, * l4;'~* * ** % 'lIi * * ,X-* ~ '1li * * 1\"it'ltr,X- 'l~'~*-ri** ~'j('** x )\~*~~~ti!1~1~~f*
, ** lHHI! *,~*** 'lO(' * }Hi~H!HHI~* :lH(, ,)lil{(*** ~IHHH('* * * * 11:1( * **,*** )(,* * 'YI.1~ *~ jHN~ \'HH~ *~>l' 1HH\~ **
1 HE'CFIP'f Number ~ 9/000.464, Amount t ]4,4 ,,6~~;i O~VOBlfr7 j t~ t ;?~:l
! l:lt;lYfl1fmt Mf~tht)d~ MASTF:H Ned;;,}'\; !,iH't\i MfHH1.4ICl l'lAStEr< 1: 1'1 t t;: \}f,.J
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