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HomeMy WebLinkAboutE. BROAD ST., 1175 I I ( Certificate of Occupancp 1Dtpartmtnt of ~ommunit!' iDtbtlopmtnt 7iu ~te {4~4~~ de.~~.~.I09~de ~ &~ (!MIe, 44~lt,de~.~ (!MIe, ~ ~.. fiat aZ de tbtte ~. {4d({alta, di4 ~ fII44 UI ~.<<d ~ u~tltNt4 1M- ~ M 1t4e, ISSUED TO: NARROWS DENTAL SITE ADDRESS: 1175 E BROAD ST Type of Occupancy Occupant Construction aassification Load Common Use VN B 3 DENTURE CLINIC Permit Number: BLOZ-()()99 Date: 08/09/2002 Christopher Hugo~ Director Special Conditions: THIs CERTIFICATE MUST BE POSTED AND pERMANENTLy MAINTAINED IN A CONSPIClJ.OUS PLACE Certificate 0 f OctUP antp 1!lepattment of (!Communit!' iDebelopment 7~ ~ ,'44<<e4 ~ ~ tie. ~ ~ S~ 109f1/de ~z~~, a4~" tie ~~.euu, ~ riat aZ tie. ~ ot l4d<<aHa, tiu~. eu44 1M ~~. ea, UtJ<<latlDd ~ ~ M @e. ISSUED TO: WHEATON WAY COINS SITE ADDRESS: 1175 BROAD ST Type of Occupancy Occupant Construction Qassification Load Common Use VN M 6 COINS I ANTIQUES Permit Number: BLOO-0212 Date: 01119/2001 Special Conditions: THIS CERTIFICATE MUST BE POSTED AND pERMANENTLY MAINTAINED IN A CONSPICUOUS PLACE -,-/1'- \ Certificate of Occupancp iDepartmentof ~ommuntt!' jDtbtlopmtnt '7'".~ ~~.~ de~6j.S~ 1096jtJe ~&iUU<<}e.<<e,tU~",~~~e.<<e, ... ~tJd attk _ ",tuIt<uIU,du:~wtU be ~,;,;# {!ib, Wfl'14tM<<4 /M ~.M tt4e. .. .... TELE VAULT(;OMPUTERSERVlCES .>SITEADDRESS: B 11 RETAIL PennitNumber:BL97-008; . ....~ .O~Bun>>mGomCML Special Conditions: ...... .......... ............................. .... . J"'i ... ~~~~~~~~~ . i CERTIFICATE OF. OCCUPANCY ~ ~ fY~ ~ ~ k CARPET CAROUSEL ~ i ~ at 1175 E. Broad ~, 'N'~ i ~dud/k~~be~uUth/k~o//k ~ ~ ~of<'k ~of~""~~ ~ i TYPE TYPE OCCUPANCY ~ ~ CONSTRUCTION OCCUPANCY LOAD COMMON USE ~ ~ VN B2 11 Retail ~ ~ ~.. 9"~. i ~ November 9, 1994 ~ ~ ~.~ David A. Nelson i ~ This certificate must be posted and permanently maintained in a conspicuous place. ~ ~ . Permit No. . Bus. Lic. ~ ~~~~~~~~~~~~~~ ~~~~~~~ ~ .. . CERTIFICATE OF OCCUPANCY . ~ ~ '-.tJ J 1175 East Broad ~, 'H~ ~ ~dudlk~~k~uUlhlk~oIlk ~ ~ ~o/du, ~4~Mhetem~ ~ i TYPE' TYPE OCCUPANCY ~ ~ CONSTRUCTION OCCUPANCY LOAD COMMON USE ~ ~ VN B2 11 Retail ~ ~ 9))ate.. flJ~' ~ December 14, 1990 ~~~.....c ~ ~ ~ 'IfIidaI David A. Nelson --- ~ ~ This certificate must be posted and permanently maintained in a conspicuous place. ~ \I. Permit No. Bus. Lie.. ~ ~~~~~~~~~~~~~~ -....... -p. _ _ h'.......... . " ... . I .., ': >i'~"'.~ "..: ~"~~..,;' <i' '"'-' .,' ... ;:', ~,'~'. ~,<;. ~",t,,;C":>' . ,:: .' 2 t:, BUILDING DEPARTMENT _/ii,,"'-- ." ~ -" -( " >- ~/:.::.:,>~~~< ~' '.."~~~: ~ ' INSPECTION RE~RD CARD e CITY OF BREMERTON BUILDING DEPARTMENT 8147 PERMIT NUMBER ADDRESS & DIRECTIONS 117') R Rro.<ln OWNER Douglas Smith PHONE 503-255-2274 CONTRACTOR 'T'pn.<lnr' Mi rn.<lpl Kpnn.<lll PHONE 47Q-f..?7,) 1 FOUNDATION COMMENTS: CORR O.K. 1. PERMIT ON SITE -- 2. CHECK PLANS TO PERMIT -- 3. CHECK SETBACKS -- 4. PROPERTY STAKES -- 5. FOOTING SIZE CORRECT -- 6. WALL SIZE CORRECT -- 7. CHECK FOR FILL -- 8. REQUIRED STEEL IN PLACE -- 9. CHECK FIREPLACE FOOTING -- 10. ANCHOR BOLTS -- 11. FOUNDATION PLATE -- 12. FOUNDATION VENTS -- 13. CRAWL SPACE ACCESS -- FOUNDATION INSPECTION APPROVED BY: 2 FRAMING COMMENTS: CORR O.K. CORR O.K. 1. WIRING APPROVED -- 20. FIREBLOCKING -- 2. FOUNDATION VENTS -- A-STAIRS -- 3. SHIELD UNDER POSTS -- B-DROP CEILINGS -- 4. POSITIVE CONNECTIONS -- C-TUBS OR SHOWERS -- 5. SOIL TO WOOD CLEARANCE -- D-ROOF & CEILING LINES -- 6. POST CLEARANCE - 2" -- E-FURRED OUT AREAS -- 7. BEAM SUPPORT -- F-FIREPLACE AT CEILING -- 8. TR. MAT. NEXT TO CONC. -- G-ELECTRICAL HOLES PLUGGED_ _ 9. WASHERS ON ANCHOR BOLTS -- H-PLUMBING HOLES PLUGGED__ 10. BEAMS PROPER SIZE -- I-LID IN VOIDS -- 11. FLOOR JOISTS $PAN -- 21. WINDOWS -- 12. NOTCHING & DRILLING -- A-SAFETY GLAZING -- A-FLOOR JOISTS -- B-VENTILATION -- B-STUDS -- C-REQUIRED FIRE EXITS -- 13. STAIRS -- D-WINDOW SILL HEIGHT -- A-WIDTH -- 22. CEILING HEIGHTS -- B-RISE & RUN -- A-BASEMENT -- C-WINDERS -- B-MAIN FLOOR -- D-LANDINGS -- C-UPPER FLOOR -- E-HEADROOM -- 23. SWAY BRACING -- 14. ATTIC VENTILATION -- 24. TRUSSES -- 15. CHIMNEY STRAPS SECURED -- A-PROPERLY INSTALLED -- 16. FIREPLACE COMBUSTION AIR -- B-STAMPED -- 17. FANS VENTED OUTSIDE --- 25. ATTIC ACCESS -- 18. A-BATHROOMS -- 26. CEILING JOIST SPANS -- B-LAUNDRY ROOMS -- 27. RAFTER SPANS -- C-KITCHEN -- 28. ROOF SHEATHING -- 18. WATER CLOSET CLEARANCE -- 29. ROOFING APPLICATION -- 19. SMOKE DETECTOR -- 3D. SIDING -- 31. CLOTHES CHUTE -- 32. SHEETROCK BACKING -- A-UNDER STAIRS -- B-ABOVE GARAGE DOOR HANGERS -- FRAMING INSPECTION APPROVED BY: S-~ 0/<- I 5/Z1$) M MECHANICAL e e CORR O.K. CORR O.K. 1. FURNACE SIZING -- 1. WOOD STOVE CLEARANCE -- 2. FURNACE LOCATION -- 2. CHIMNEY CLEARANCE -- 3. FURNACE CLEARANCE -- 3. HEARTH EXTENSION -- 4. 'B' VENT SIZING -- 4. CHIMNEY HEIGHT -- 5. 'B' VENT CLEARANCE -- 6. 'B' VENT SUPPORT -- 7. COMBUSTION AIR -- ~ 8. DUCT SIZING -- FURNACE APPROVED BY: 9. DUCT CLEARANCE -- HEAT PUMP APPROVED BY: 10. DUCT SUPPORT -- 11. DUCT JOINTS -- GAS PIPING APPROVED BY: 12. GAS PIPING TEST -- WOOD STOVE APPROVED BY: 13. GAS PIPING SIZING -- 14. GAS PIPING SUPPORT -- OTHER: 15. OTHER -- P PLUMBING CORR O.K. 1. UNDER TEST -- 2. GATE VALVE -- 3. WATER PIPE SIZING -- 4. DRAIN PIPE SIZING -- 5. VENT PIPE SIZING -- 6. PROPER SUPPORT -- 7. PROPER FITTINGS -- UNDERGROUND APPROVED BY: 8. VENTING -- 9. CLEANOUTS -- ROUGH-IN APPROVED BY: 10. PROPER GRADE -- 11. HOT WATER TANK P. R. VALVE -- 12. OTHER -- 3 WALLBOARD CORR O.K. COMMENTS: 1. LID OVER SIDES -- 2. NAILING -- 3. W/R AT TUB OR SHOWER -- 4. 5/8 UNDER STAIRS -- 5. FURNACE ENCLOSURE -- 6. FIRE SEPARATION GARAGE -- 7. ATTIC ACCESS -- 8. DROP CEILING & LIGHTING -- 9. BACKING AS NOTED ON FRAMING_ _ WALLBOARD INSPECTION APPROVED BY: 4 FINAL CORR O.K. CORR O.K. 1. HANDRAILS -- 9. OUTSIDE GARAGE -- 2. GUARDRAILS -- 10. CLOTHES CHUTE -- A-HEIGHT -- 11. SEWER/HEALTH DEPT. -- B-INTERMEDIATE -- 12. COMMERCIAL BUILDING -- 3. EXHAUST FANS -- A-MECHANICAL APPROVED -- A-KITCHEN VENTING -- B-PLUMBING APPROVED -- B-BATHROOMS -- 13. SMOKE DETECTORS -- C-LAUNDRYROOMS -- 14. FIREPLACE HEARTH -- D-DRYER -- 15. SAFETY GLAZING/ 4. TILE AT TUB OR SHOWER -- DOUBLE GLAZED -- 5. DISHWASHER 16. INSULATION CERTIFICATE -- PROPERLY INSTALLED -- 17. FREE-STANDING 6. FIRE DOORS -- FIREPLACE APPROVED -- A-SELF-CLOSING -- 18. WINDOWS & DOORS CAULKED __ B-SWEEP OR THRESHOLD -- WEATHER-STRIPPED -- 7. ATTIC ACCESS -- 8. HOT WATER TANK -- FINAL INSPECTION APPROVED NOTES: BY: ~~ (p (1I(~ 7 f)~ PLANNING: e '" ' . "" '~."""''''' " " . ':~\'~;:.: ' '-- ~\.-- ',> :,.\,~', .,,' JllJ1.e2Z, 1987 Permit No. . N/A .::; '., ~ I ... ............. ..<tt .. ... ... -\ r--'.. BUILDING P'ER.MIT .Ng .8147 h CityofBremerton,Washingtorr98310 P~one: ;(2061478"5281;< . 4574-000';;'015:"'0001 / . A~sessor's Tax Account. N... 0.: . ... . . . .. . . . .. . 1175 E. Broa.d 503 255-2274.. . " . O~rchitect Mj ('ha~J'Te~ . PI16rie:.-(79-6275 ,Mdress: . . o Residence r~]R~n:JodeI!Addn o Demolish []parking Lot o Graqing'(cu. yds Nature of Work Proposed: wal.ls . And. .hang.app~. .... 45'.Qfla.millat~ edcountertops. . Utilities: 0 Water Va;hJati6n of Materials/labbr: [UBCSec.304(b)] Zone. Designation:' Side: INSPECfIQNSHEClUiRED:'oundafionD Framing.GJ Plumbing [J Mechanical 0 .Wallboard~ F[NAC~ OWNE.ROHBUllbER.SHAlL CAll 478-5281 .FOHAI..LREQUIREDINSPECTIONS ANDRECEIVEAPPROVALPFUOHTO CQNTINUING WORK. SEPARATE PERMITS ARE REQUIREP(WHERE APPLlCABL.E) FOR . PLUMBING AND. MECHANICAL; . All provisionsot'la':'s .andordinanges governing this type of work will be cOl]1plied with whether specified herein or not.. The granting of.a permit does not presume togiva aUihorityio violate or'cancelthe p~ovlsions.of any.othe~~t~~. .r local law reg at~onstruction orthe.perforl]1anc~ of construction. SEE AND READ NOTICE ON REVERSE. . . .......... ... .... . \ ... .... ... . ,,--Signature /~: V"/ '.~ f ,. f., .,.......... Date5--~<-'~7 1 Copies to: White-owner:Yellow-file;Pink~As$ess()r: Goldenrod-Building I , ' ", ~ .. .. "i j 1". . pq~.~ : 01&.K. Q..fs# ...:.o.~.6'j..oE~.s i' _ i ' ; 3 /'() s; . ~. II . 1'; ~ 'q~~v-e ..-. '.. r:' r . i: . 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I J . . . ~RMIT APPLlCtTION r-BUILDING "'\ City of Bremerton, Washington 98310 Phone: (206) 478-5281 Assesso"s Ta, Account No <k~-Ci ~'till'f?"'~ Q ) Site Address: 1/7.> E. D A-.h. Phone N :~ I ~.s= ~ "l-..:7'f j) 711 '/' ~.., Owner's Name: Otlt1(J'ff SI"YJ I Address: f, 7/ c. fftJ. Applicant: DOwner o Architect o Contractor ~ Tenant ArcFlitcc~ Firm: /'1I'~A<2} ~nJ~11 Representative: Address: Phone: 479 - Q~<::- Contractor: .s:-$t..r Representative: Address: Phone: Contractor's License No.: Exp. Date: o Residence ~ Business o Other: o New o Repair RemodellAddn o Demolish o Duplex o Multi-Family (No. units ) o Sign o Parking Lot o Grading (cu. yds ) o Bldg. Move Nature of Work Proposed: lJt;,/J.J2. -A-P~~;( .3 '" ... ~ f /~ 1e...4JI' t:de~~ Qt4~~ bP!l.DX is-I ()f i~~/..,~ <7' ('?J4~~*,r ""A..s I 44p 01.-3 S~I// ~HJ ~ / '41'~ . Sq. Ft.: '3~t5 Utilities: ~ Water o Waste o Septic o New Existing D Storm Valuation of Materials/Labor: Plan Review Fee: Permit Fee: Surcharges: [UBC Sec. 304(b)] $ :z. 9:. 2- S $ 0/ s--: "d # 2/ ()I)P.~~ State $1.50 ~ Receipt No.:7' '1(,,>" Receipt No.: 7'f4~" Energy $10/$15 0 Date: ~/l~ t'7 Date: ~- , .7 - e 7 Zone Designation: ~3 Occupancy Classification (UBC): ~d No. Stories: - Setbacks: Front: Side: Rear: Height: Heat Source: , Comments/Conditions of Approval: C~ ~ 9 V 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 J:~Brem~rton will be met, Date rJ./~ J Copies to: White-owner; Yellow-file; Pink-Assessor: Goldenrod-Building Slat. Code I I .'.~ '~~ , ,. ~?-BUILDING 'ERMIT APPLI&TION '\ City of Bremerton, Washington 98310 Phone: (206) 478-5281 ' Assessor', Tax Account No" ~N~:-!ttl't?"~ r. ) Site Address: 1/7 S-E. A-..D Phone N(l.:~! ~F 1,.. 1.-7'-1> Owner's Name: j)Olltj'-'1-f ..S'm /771 Address: 117/ E. ~/f't). Applicant: 0 Owner 0 Architect 0 Contractor ~ Tenant Architect Firm: Representative: Address: Phone: Contractor: .S&'t..r Representative: Address: Phone: Contractor's Licen;:;e No.: Exp. Date: o Residence ~ Business 0 Other: 0 New 0 Repair ~ Remodel/Addn o Demolish 0 Duplex 0 Multi-Family (No. units ) 0 Sign 0 Parking Lot o Grading (cu. yds ) 0 Bldg. Move 11 Nature of Work Proposed: ~~1.J) ,4.-pAp/C 3~'" ~ f /R le;./4y ~~/4 Qt. 4~7 iJ,p.P2.DjL 'IS-I (J.f 'd~/~,~ /' ~4&1'#'-kV- ~A...s ~ 4/sb ~ --5 // ~ / $4;: !lA~ 'If};S _ Sq. Ft.: 3,& t:5 Utilities: 19j Water 0 Waste Sewer 0 Septic 0 New Existing 0 Storm . Valuation of Materials/Labor: Plan Review Fee: Permit Fee: Surcharges: [UBC Sec. 304(b)] $ Z~ Z- 5 $ 0/'5": DO ""2 () /) eJ. "'~ Sta1a $1.50 ~ '/ Receipt No.:7'- '7~r Receipt No.: 7'1j1.)~ Energy $10/$15 0 · Date: 5=- 11- e 7 Date: ";--1.7 - t! 7 Zone Designation: ~ '"3 Occupancy Classification (UBe): ~.d- No. Stories: Setbacks: Front: Side: Rear: Height: Heat Source: Commen1slCond";onsotAPProval'.--rc; hI'"" 117l~o: ~ ~/~~, ; I understand that applications for which no permit is issued within 180 days following date of application shall expire by limitation, plans and/or other data submitted may be returned: to applicant or destroyed by the Building Official. (Sec. 304(d)UBC). I certify that the information on this application furnished by me is true and correct and that the applicable re~ Bremerton will be met. ~~ ). . '-..Slgnat~ Oate JI ~ ~ , Copies to: White-owner: Yellow-file: Pink.Assessor: Goldenrod-Building Stat. Code I ; " ....;: e e .. 'H -,- ..,,,, ^ #c r CITY OF BREMERrCN BUnDIm DEPA.~gr PEPMITAPPLlCATICN DATE 5-19- 198 7 TO BE CG1PLEI'ED BY 5-22- 198 7 Douglas Smith self GJNER mNTRACIOR 1175 E. Broad @ Wheaton ~.TION OF JOB m l'@ ~.. )'~~J For remodel MAY21.19SY>,. . ENGINEERIN; <n1MENTS/REVIEWED BY c:ES .'ia'~~il.,.. No C(jN~~/Il77 ',:;;' -,' ~,~; ", ^""-",,- c:::" ::" _;-:; r ~', -,:'f;' ^ . _ ~" ~. <1>"'- - .,' :;~'~i-,',;.">:" .::", :i;/: ,;~" ,:. ," -', ,,_.,': _J~~'>::,,_. _;\;':"'-;}" ir,;,. r '." ",::>.-';'" ,-, '>--" -'-' ,_':":0.1);( ~UILDING 'ERMIT APPUc!tTION J ~ City of Bremerton, Washington 98310 Phone: (206) 478-5281 ~' Assesso"s Tax Account No.' <k74-~N ~,:cizt'l!7.J,~ r. ) i Site Address: 1/7.> E. ~D A-.D . "phone N!:~! ~.s-= l,..1--7+ .~ Owner's Name: .l;>Ott9'-'1-f ...)'m / -nI Address: 117/ c. ~~J). .~. !",pp!icant: DOwner 0 Architect 0 Contractor ~ Tenant i 1 Architect Firm: Representative: ~ i Address: Phone: \ Contractor: S-$t..r Representative: Address: Phone: Contractor's license No.: Exp. Date: ~ 0 Residence ~ Business 0 Other: 0 New 0 Repair ~ RemodellAddn o Demolish 0 Duplex 0 Multi-Family (No. units ) 0 Sign 0 Parking Lot ; 0 Grading (cu. yds ) 0 Bldg. Move Nature of Work Proposed: 13?/4.P ~,RPX 3"'''' ~ f /~ /.e.;./dy a.?fJI/~ q.. 4p7 iJ.pP2.D,K- 'is-I pf- 1~-../~,t, / ~4&1'~,?V h,A..s . 4/sL!J e1. -_? Sd/// ~H ~dJ;S . / Sq. Ft.: 36" t5 . . Utilities: ~ Water 0 Waste Sewer 0 Septic 0 New Existing 0 Storm Valuation of Materials/Labor: Plan Review Fee: Permit Fee: Surcharges: lUBe Sec. 304(b)] $ Z. ~ Z- 5 $ ~~ ~~ '" '2 otJ~.41I~ State $1.50 @- '/ Receipt No.:7" 91.r ReceiptNo.: 7'4j.t.)~ Energy $10/$15 0 Date: S:ll- eJ7 Date: ~-,~- S7 Zone Designation: ~ '3 Occupancy Classification (UBC): ~ d- No. Stories: Setbacks: Front: Side: Rear: Height: Heat Source: I CommentsICond'ions of Appmvaf' , I I understand that applications for which no permit is issued within 180 days following date of application shall expire by limitation, plans and/or other data submitted may be returned to applicant or destroyed by the Building Official. (Sec. 304(d)UBC). I certify that the information on this application furnished by me is true and correct and that the applicable ~e~ Bremerton will be met_ ~'* ) ",---Slgnat~. Date / ~ "!7 Copies to: White-owner: Yellow-file; Pink-Assessor: Goldenrod-BUilding Stat. C;ode I ; ~ ;-- BUILDING 'ERMIT APPUc!l liON "\ City of Bremerton, Washington 98310 Phone: (206) 478-5281 Assesso"s Tex Account No.; 'k74-<::r:s::rN~,-!t:ti!f?.J,~ r. ) Site Address: 1/7 S- E. cOi€D A- Jj Phone N(t~;, ~..J= ~ 1.--7+ Owner's Name: j)Otl'1'-"1-f ...J'm/7ii'/ Address: //7/ E. ~#/). Applicant: DOwner D Architect D Contractor i;( Tenant Architect Firm: Representative: Address: Phone: Contractor: ..s:-$Lr Representative: Address: Phone: Contractor's License No.: Exp. Date: D Residence ~ Business D Other: D New D Repair i\l Remodel/Addn D Demolish D Duplex D Multi-Family (No. units ) D Sign 0 Parking Lot D Grading (cu. yds ) D Bldg. Move Nature of Work Proposed: l3t?/~J) ~~PJ( .3~'" ~ f /~ ~4IY ~?/~ ~ 4p~ bpel))C is-I ()-f ld~/.A,,;4 /' ~4~#,,~V ,f,A..s " 4/sb 01.-:r , / SLJ(// ~HJ ~~;s _ Sq. Ft.: 3 t& 6 - Utilities: ~ Water D Waste D Septic D New Existing D Storm Valuation of Materials/Labor: Plan Review Fee: Permit Fee: Surcharges: , lUBC Sec. 304(b)) Zoo. z.. 5 ,_ 4,.1"- &# (,) , . .Ii $,...J) T ~ . r:l _ , '-If 2. ()Pt?tl1,g _ State $1.50 ~ . / Rece;pt No.;7' 9",r Rece;pt No.; 7(,94' Ene'gy $10/$15 0 I Date: .s:./1- ~7 Date: ~-'3" $7 , Zone Designation: ~ ""3 Occupancy Classification (UBC): ~ d.. No. Stories: Setbacks: Front: . Comments/Conditions of Approval: j I . I . I understand that applications for which no permit is issued within 180 days following date of application shall expire by limitation, plans and/or other data submitted may be returned ~ to applicant or destroyed by the Building Official. (Sec. 304(d)UBC). I certify that the ~ information on this application furnished by me is true and correct and that the applicable , relG-r~ Bremerton will be met. 0~ ) ~ Sjgn~~ /~ Date S;~ '17 ~ ' / Copies to: Whit~-owner: Yellow-file: Pink-Assessor: GoldenrOd-BUilding Stat. Code I I . , .. - BUILDINIG ~RMIT APPLIc.t TION r "'\. City of Bremerton, Washington 98310 Phone: (206) 478-5281 Assesso"s Tax Account No., <k?/-O;;;s;:rN~'till'l7..j,~ .Q ) Site Address: 1/7.s- E. ~() A-1:J . Phone N :.50; ~-F 2..- '1.-74> Owner's Name: j;)Otl9'-"9-f. S'm /71'/ Address: 117/ E. ~fff). Applicant: DOwner o Architect o Contractor ~ Tenant . Architect Firm: Representative: Address: Phone: Contractor: .s:-$t.r Representative: Address: Phone: Contractor's License No.: Exp. Date: o Residence ~ Business o Other: o New o Repair ~ Remodel/Addn o Demolish o Duplex o Multi-Family (No. units ) o Sign o Parking Lot o Grading (cu. yds ) o Bldg. Move Nature of Work Proposed: 13?~ 4 J) ~p ~ t:1 ,J( 3~ / 81 /~ ~41Y ~~/~ ~4p~ ,{j.pPe.DJL is-I ()-f- ld~/~,4 / &~~kv- ,f,A..s . 44b e1-_:r , ~ / s~/// ~H1 . 'ttJps _ Sq. Ft.: 36'6 . 19J Water o Waste o Septic o New o Storm Utilities: Existing ~" , Valuation of Materials/Labor: Plan Review Fee: Permit Fee: Surcharges: (UBC Sec. 304(b)] $ Z~ z..f $ 'f/S7 ao '" 2/ (){)~.4#..e State $1.50 ~ Receipt No.:7' 9~r Receipt No.: 7'f~~'" Energy $10/$15 0 Date: s: 11- t!J7 Date: ~-'3" 87 - - Zone Designation: ~3 Occupancy Classification (UBC): _~ d- No. Stories: . Setbacks: Front: Side: Rear: Height: Heat Source: I , Comments/Conditions of APproval:~ \?\ .~ . Y\ 1"j,C? ~ ~. ,4~g7 . . '~~~\~ I 1 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). 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