HomeMy WebLinkAboutBURWELL ST., 1221
B REM E R TON B U I L DIN G D E PAR T MEN T t
PER M I T 1
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Application Date 10/02/1995 Application Number 95AP08964 1
Issue Date 1.0/02/1995 Permit Number 16588
Assessor Acct # Project Group I
Site Location 1221 BURWELL' 1
I Owner -Last Name KITSAP MENTAL First HEALTH HI
r - Street 5455 A.I.MIRA 1
., -City BREMER TON State ViA Zip 98310 I
- Phone (360) 373-5032 1
~ Tenant's Name Phone(206) -
I Agent's Name Phone(206) -
Architect's Name
f [ ] Building [ ] Grading [ ] Sign [ ] Paving
(X] M.e~hanical [ ] Move Building [ J Burning [ ] Underground
[X] plumbing [ ] Mobile aome [ ] Land Clear [ ] Demolition
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Building Contractor:
Work. will be completed by owner. I
Natl1reof Work: piping,l.water heater~
Gas furnace,
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Cquneil District Census Tract
Construction SqFeet Inspections
Type Required
Residence [X] Zoning Foundation [ ]
Business [ '" Type Framing [ ]
j
Of.her [ ] Insulation [ ]
New [ ] Plumbing [X]
Repair [ ] status Mechanical [X)
Remodel [ ] code Wallboard [ ]
. Addi tion [ J Final [X]
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ReceiVedBYb r ~ . Approved BY:, .
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I B REM E R. TON BUII..DING D E PAR T MEN T
'P;E R M I;T'
I M E CH A N I C.A L A P P L I CAT ION
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I on Number 95AP08964
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I Contractor NELSON'S HE1\TING
Street 5873 W.WERNER ROAD I
I City BREMER TON
Phorie (206) 479-9976 State WA Zip 98312 I
Repre:;;entative JERRY J
State License # NEr..SOI*228LZ Expiration Date 06/09/1996 I
City License # Expiration Date I
l
Stoves J
Fire Place Inserts
1 Furnaces
I Conversion Burners
Unit Heater
r Boilers I
~ 3 Gas System: Max 5 Outlets i
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t Evaporation Cool.rs j
Air Conditioning units 1
~ Heat Pumps
I Mixing or Re-Heat Box I
Air Handling Units ,
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Fans I
Range Hoods 1
Clothes Dryers 1
Incinerators 1
Duct Alterations
Tanks 1
Refrigeration Units I
Other Items
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B REM E R T ON B.UILDING D E PAR T MEN T
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PLUM BIN G PER M I T A P P L I CAT ION
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I Appli.cationNumber 95AP08964
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I Contractor NELSON'S HEATING
I street 5873 W. WERNER ROAD
! City BREMl':RTON .
I Phone (206)479-9976 StateWA Zip 98312
, Representative JERRY
I state License # NELSOI*228LZ Expiration Date 06/09/1996
Ci ty License # Expiration Date
Toi lets,
Sathtubs
Basins
Showers
Kitchen Sinks
Dishwashers
Laundry Trays ..
Clothes Washers
2 Water Heaters
Urinals
Drinking Fountains.
Drains
SlopSiuks
Water Pipi~gand Alterations
Interceptors
Hose Bibb
LawnSprinklet
Private Pools
Public Pools
Building Sewer
Gas Pipe
Roof Drain
Private Hot Tubs
Public Hot Tubs
Other Options
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fj{ril_"~&Iffr~~i".[~~i~~27J^ml
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APPliCANT: 0 o~n rll CONTRAcrOR ] OTHER:
COMMENTS:
SITE ADDRESS: /;) ~ I 13 iJ R!Iv C l,- L
OWNER:J\ts~ 'f en, f'I} iNt~\.. )..h~Lt}J, ADDRESS: 5" '1 ~S /lLY>) I f?A
CONTRACTOR: !J b LSllu$ I~t(., 1A C\ ADDRESS: 58 )3 11th IN f./l/^J,\(t 1<'0\
CONTR:\CTORUCENSE# htLS6} ~ l..'L~L2. EXPIRATIONDATE: ~ ...1 ~Cfb
OWNERPHONE: 3')3> ... S63~ CONlRAcrORPHONE# 471 ~ 11710
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OT "l!'. .0. 'h'U~""..v......"...._ .. -. h . -.. . . . .-.::.v.......<~~'<.... -~_ - .~~ IS: . . --iiC __~_~~ <.:--:.;.., ". _'" -. ...._.. _...~.""_~....~..u_.._ ..... .
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R..\NGE WATER C-OSET
I WOODIPEI.I.ET STOVE BATHTUB I
, GASFURNACE _~. lS>OfJb LAVATORY
CONVERSION BURNER lna~ SHOWER .
UNIT HEATER /nt,~ mCHEN SINK I
BOnER _~ DISHWASHER
I GAS PIPING .. L-\UNDRYTRAY
EVAPORATION COOlERS _~ I aOTHES WASHER
AC UNIT lna~ :J... I WATER HEATER
HEAT PUMP 1mI's: ttmr: I I I URINAL I
R.EHEAT BOX 1mI's: I I DRINKING FOUNTAIN I
AIR HANDLING UNIT .. ku r: . I I FLOOR SINK OR DRAIN !
I EXHAUST F:\NS I I stOP SINK .. I
J RAL'IGEHOOD(R:Sidcntiai) I I WATER PIPIING ac ALTERATION
I RANGE HOOD (CDmmc:tcial) I I GREASE TRAPIINTERCEPTOR
I CLOTHES DRYER ... H... fHIHOSEBIBBS
I INCINERATOR . ....1 .......... ......... IUWNSllRINKl.ER.SY5TEi\( I
I Duer AlTERATION I "SWIMM1NGPOOt
I T.\.'IK.S t'lPl: I I BlDG. SEWER (mobile: / moved bowel
I REFRIGLTt\TION l~1T !: ROOF DRAINS !
I OTHER: I i OTHER: !
I MECHANICAL PERi\fIT FEE I 515.00 r PLUMBING PER.'dIT FEE (15.00 or 4.;0) i
MECHANIC.\!. FEES;
PLtJMBING FEES:
TOT~.u. FEES:
.-lPPUCANTSSIGNATURE: 1.f1ltJ r: ~ DATE: ItJ -,1-1 r;
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NOTICE OF PERMIT REGUlATIONS
This permit shall become 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 authorized by. such permit is
suspended or abandoned at any time after the work is commenced for a period of 180 days.
NOTICE - It is the responsibility of the permit holder, not the City of Bremerton or Building Official to see
to it that the required inspections are made. The permit holder must notify the Building Official when ready
for the inspections. Failure of the permit holder to notify 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
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official that the concealed work meets or exceeds code requirements. Any demolition, 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 responsibility or liability connected with the construction.
I hereby certify that I have read and examined this permit and know the same to be true and correct. 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.
~;:p ( ~ /0-2-15.
~atur Date
I certify that I am exempt from the requirements of the state contractor's registration law, under Sec. 3,
Chap. 126, laws of 1967.
Signature Date Permit Number
pcnajt.doc
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f.!Rli:Mi!~RTON J3UI[,DINO D E PAR T MEN T I
I RECEU?1' # 088971 * Tl:d, f'~ :r s Not A Permi t * O(':t 02, 1995 I
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Permit Amount Paid pI an Che(:k Am,ount Pa.id
Mechan:i,oal $ 21.00 I) '" . 00 I
I 6;~.<322 .1005
, PI ulnh:lng ,; ,00 $: . I
<ill'- .1003 I
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I .$ .00 $ .O() I
, t;2-<~4!). a
f:i'ees
I Sto:ez Ada.ptel' $: .GO I
34-3BS,lOOO
Zoning Fees I
r Geu Payment: $ 5,00
Oth(~r Fea~~ $ ,00
t y Sur-Ch.arge!'$' 5.00
81',322,1009
State SIG
643,<231.13 ~';;t~~~-;:t~,~;~
I Total F€lEtS $ :~2 . 00
~ Amcm,n tpa:id $ .32.
Prim~ P~~yment $ ,00 t
I ~.~~~;;::: t~,:;;:~0_~'
~ Ba:l.an('1e flue $; .00
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$ .00 $ .00
I' Recet V't1'ld. From: On lOi021199!", I
I NelBon lUg },5121 Fori95APOa 2 I
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~..... - _.____________n_ _ __~___.______ _________________~._~___
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BREMERTONB,UlIDING DEPARTMENT
PlwnbillglMechaaieallnspection Rep.ort
Seope .fwork: GAS F'LJRMACEI PI1?INGW/H Pennit Number: 16588
.A44ress:, ,12.21", BijRWELL Owaer: I(tTSAP MENTAL1tIU\LXFJ1
Contraetor:. NELSON' SHEATING Phone: l :'"
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GAS PIPIN'G
Und<"""t (Hl sifor lSminur.es) , Pro~ sizingksupport , ". ,. "
12"minimumh<:low g~dc: whentu1~oamd Coatr.dJwrappe4 when un~wtu1dorwit!hin6lit;;f.carth
Ground:'jointwUons 'prohibited in ~nl()Ql'iom 81l$Mngs not a1I~in <iGl'l~ a~i ,
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COMMENTS: ~
GAS PIPING APPROVED; ~ --z;;:;1 /oly4{"
FURNACI
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MB.ufaaurer's sredfiQl'i~on'site ~tion.aecess, support
Cleanneeto (;Ombustibles Vc:nting:dtaran<<: to combustibles
VentsJz.in~ &;supportlCOIlftCCtiOIlS Vent termination
G:.mbustion air qumney:.liner . andJor'sepuatc lil~~s~Uitt4
GassAut-oW wiclUn 3' Pilot elevated off n~r ,in,.gar.tge' ,
I Du~:si;r.e&Sll~portlinsulatdwhen requited Return air
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COMMENTS:
FOBNACE APPROVED:
MISC. APPLUiNCBS
i. Manufa~er'gs~fiQtions on site :L.>c:ation, a(;(;e$s, support I
C1eaJ..",etocofubustibles Venting:: dcarancc to (;OmbUstib1es
V~t siu~.ksl1p~ortl(;Onne<;tions Veottcrminauon
COmbusdonair CMmney:liner andIOl' sepata,teflues astequired
Gas.hut..otT widUn 3' Wood stoVe & flreplaC1bi: prope:r hearth. "
Wood stoves: EPA apl'~ '; Gas IIJ2.t: safctv sbut-off '
W~.st(JYes&: 6replaccs:dl5ht fitti~doort Gassbut..off witbin 3'
COMMENTS: i
MISC.APPUAN'CES APPROVED:
W.ADR BBATIIl
ManU:ra~'ss~fications oosirc
C~Ge tb<1Ombtdubles ,
Vdltsizi~& su~portl~o~
Combustion air ,!>>ired
. 'Ga$sh.t~<<Witbin 3'
Ga1:e\'alve00 <101d ,w:atcrSI1PP7 '
.,",COJl~top1vani~conneaio...
..' ;., Sei '.;',.., ".
, . "stJUc:.stra '\ , II
COMMJJttS:
,WA'RRHEATER APPROVED: :
d~ ;(15:/
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ALL 'IfHJi. ~ TBlS M APPItOVEDa
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