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HomeMy WebLinkAboutBURWELL ST., 1908 . . ft' ~ ,.I .... . ::<..t. . ' ...: "I :...>':. - l.. : \. " '.' . '.' ." . . - ., . ..... . . ., ..... .BREMERTON_. 'P'E:RM.:[T ::CENTER-- ." :.;. .- :'; .....:.. : . _ . L.. 286 ':4th StT$et'_ BrBmert'on'__ -.IJA 9f3337' . - '. .:. ..' ..' '" ..... '. .Phon(!t: (360) 478:"';5:27,5 '. " FAX:. (360).:.478-5278 .: '.: ...... ~ ' '. "'; _:. '. .,.. . - : '. - . au I LD I NG. PERM IT" . . -: -. _ . . . . ". . :' '. _ }ob' 'A~dt: 1908 'Sl!RWE_L.L. 'Sl',- " ' ..' . . Perm! t. No:. - 97-05.59 '. . . Locat ion: '.-1'~08. <eURWF.LL.. 51' : , , . .. St at us: .1 SSUEL'i . .-. : :'-P1ilrt:el' No:' -. . '. . . , Applied: 08/26/1997 . . . . -. .... " '. . . Issued:. 08/26/',997' .' .'. }~p'pi'i'darit,:"BROWN~:.-R'I6HARD.W"'"'' -' ~ 4'79-'1014"- ',' Expires.: 02/22/1~98.-' '. ....-. "19.98 BURliJE~L. -ST'.'BREMF,:RrON WA 9~337" '. -. .: . '. . . - . ~ . . . ".~ -..'.OWf1eri "BROWN.p RlbHARd w':. '., _._ .,479-:10t(.-.... - '. .:' -'.' .' . :: '1908 'B'URWELL cST' 'BREMERTON- WA 98337. . :: C~~t;act~;~';'-NORtHw~~;r F'~~EPL~CE '&'.GA~, !:iYS" "313~4631 .' .'U.c.t; . NORn-iFG044KG Ex'P:' 0~/07/98. .;'. '. ..: '. .' '2700.YINCENT WAY 'BREMERT-ON WA 9831-2 .... '" -,... ~ '. ". so~cp~t~.:.: .: ',-:' c. . ..' . ,'. .... . . . ,''-D.l:}~c.=.:':G~i'n~'Epl~,A'ce., 'GAS' prPIN~' ." . . , I,. '.:: ~ ..", ..". . '." _ .-.,' . '. . . , ' .'" . . '." . . . _. :' . : . _ . . ',****j~******~*****************************M**************************************************. " :''-.': .' Valuation ..M.:.... Perm.it"fees: '. .- .... 26.95.... rotal 'Calcuiated Feer. '. 31..'95' . ~ ~:>,' .....> '.;" ;' . ;.... ..00 - .:. .....* ..'Plan Check Fe.~EI: . . . '. .00 .' . ...,. -: .Add! tion~l FaetH . '. .00 .: ',' .- ...;;. ,...., '''. :.... .'. *' '. .' Other' Fees: " 5.00' ,- . Tota.l."Permit Fee.: ". ~:H .95' ., ~: :.. ~**************.*******,**,lf****.***********~*******************,******-*'If*********************.**** . . :.. '.':}l~CH~~ICA~/P~UMeING:ffI'~TURE'S:'';'. .'. ,~~~o~/~i1et stove:.....~..:. ~., 'MECH:-Gas Pip~ng (ou.tlets)......:.. '1.- -,., . .. I . I . .. ~ .' :. ! 'I . . . ' "f" .' '.'1 t....':.. .. . ., . .:. "";., F ~ : .'I'~'., .. .; ., . ~ " . . , . '. .' \.' . ,,~ . . . . . . .' , . . ~ .: '. :' ~ . ~ - .., . , . . .: : - ". ' : . . . . . ..' . . . " . . . . ". : ", ***~****************~****************************************~****************************~** ~ .th'1s .permit 'shall' become null and void .i f the' buflding or .wor'k autho.rfzed . by' t'his perm'it 1s not commenced w1tMn '. 1.80' days f.rom' the' date of 'such per'mit " or 1 f 't-his' building or .work. authorized by such permit is susPended or . :' 'abandoned at"4ny.-t(m, af~:er:'the'work hr.ccimmenc.ed 'for a'"p~riod..of 180 days. ". '. ".' . ,-' .... ~..;. ~ - . \ ~.'. '.~' :. '. . ,.'. - -. . : . ",'. . " . '. . . .' ". \ . ,".NOTICE'.. 'It is.'the. resp~ne.ibil it'y-.-of"the 'permB: 'boleler.J not the City"of Br einert on. ot :auUding .'Official. to see " . '. t.o:it :-that required inspections"aie~.mada."'. The. permit -holder must not.ify the .BuUding 'Official when ready "for " inspect 'ions..' Failure of the permit' .holder to no.tHy the SUl1din; Official o-f .reqiJi.red inspections 'may 'result . . -.' . . . . in the stoppage of the .wo.r~ until -Such ti~. that' the permit- holde" 'can substantiate to the building 'official. . . that. .t~' :c6ncealed'wotk meets or :exci!eds' code requirements'- .Any demoliticin, testing, or financial burden aha) I. . . .b~' born~ r.Iir.ec~1Y by the' permit holder'.. 'FailuY"e' to"substantlate'- code ':requir~ments_ 'will indenin~fY thE! cIty' .' ". aga~nst. a~y' and. all r-espon~ibfl1ty'o.r. Habili.ty co~nected with t~ const'ruc1rlon~ -. _~." .' ~. _ '. . . . ,. .' . ...." , .; . , ~ . . '.. " '. '.I' ~ .- (heteby:-certHy that .I.have'.r.ead:'and'.exam1'ned t'his permit.and know the. same to be true'and borrect. 'All'.' . '.' provis,fons of-Jaws and o.Tl;linances governing .this. type of work wiU 'be ,complied with whether speci.fied herein: '. ". :or not. . The grS~1ng of a. ~1II1t ~. not 'presu.e tci give authority. to violate 9T <:intel' the pfovlalane, of': .-. :.' .-.any .~t.ne~ ,8.t~t~..~. local .law. regulat.1ng co.nstruction .ar t~ per~ormanc~. ~f 'construction. ....., . . " ~i~~I),~ ::" .... .~/).~ ..:..... .' "'DB't'el'" ,h ~ 'J'J' . '.:' ..' . , . ..". ,--. - ----- . ~-.---~------..... -f..~:-..~~.&a-:~~_..c.I;IIl-=*.-'---"'- : . .' . ..:..:.. ' ~ -' , . '." '. ..' . .. '" . .. .' . .' . ~ ter.t! fy hat. lAm exempt f~oin..-thtf~equi r~ments. of 'the state confractoy':t. regl'strat ion 'law, '. uimer .' . .' ,;~::i::::~-~ ~le'c-_~~.__~ :'. :.perlllit'_'c~nter~...APprov.ed';Br~~;~.~__.,~~_. .oa~e:~~S.,~:.'~...G~_~..'., 9" '/ ~ ' _ . . " . I, . ',' " " . . ,.. ' .. :. 'Is. . - .... . . : I . :.. '. . '.. . . ' . J'(JtJ', Adtiy'ess ~ . 1901:3 - t3liRWE~L,L.~. 'S:r:.." ,~ '. l..Kc)c::at Ie)n:' f90f.;: 8U'RWL~L..:L, 51' .< Assr: A(~qt "No .~. ::, . . ~ . .... . _~.. . ..... ,I' .. r. to. .' ~ ~'J~....~~~'. . . . ::: _'. .:-: _' _ ; . .. ... .-' -.: , ~,i'~~;;~;;1';~;." .:. ~ <. -..:....i /.c" ' . ~. BR'E;:ME.RTQN. .'PE;:RM X'T'- 'CE,NTER '. - ,,' ," .' " '286 4.th s.treet,;' Etrsmerton_. ~tiJA' ....98337, '- __ .'j>; . '. ' . : 'Phci~ ~ (3.60). 478-:5~jS'. FAX: -(.360). 478....52:78 " 's., . "1;:" '. ':"",... ,,'.w. . : .ai,dldin!;;J' F:>ermi t:. Nc)':' 97"'O~;~:1'9' :'-.' 1 ' .',' ,- '. Status:' ISSUErr .: . Issued: 08/26/19" Exp i n~s: '02/2~?/ 1. 99€~ .......:.".....,\"i~_... ': ' '? . .' . '. ..<.... '.'.. '!-:<..' ....:'..;....:,R.E:;.Q-.~..I..l~.,..E 'D" '...-.f.N-S p'.e::.'p 1>1--0 N'S' ~ . > :.. : . ~'. I:t.'f.~m~:. .eH '400. r~II::;CHAN rqA.i.,.. '..< '.' ~:' ....:. t:HiJ;:It;: 'BLm;; D:l v i~ a itm = ..... " , .,., .',,'. - ... - - .:' .',.:'. '. ,-. '.' ." '.,'. . .'. *,**~~******")+"~*************:*'~*~*******'**********,)+,***~*************,)+******~:***.**~.)t'* . t:E:S'r.iN.l~f'-,: .MIJ.$t'-bt~ 'T',f.~c~.,gnlnlljd by.th~ W.aahington"ASSQb:Lati'on qf Eiuildihg ()ff':\..ci.ata .-'; $'PEC.:O~SP~'. MWi$'t b~. re!~h$t;eT'.ed 'w:l.th t:hf3 State 'c:"f 14A. ~.. ..': ..,..' ,. .'. '... ".~;''f' O~=- WAr ,St;'11t:t.,,"C)f- WA C)ept;.. of Labcrr' arid J.-ndustri,.f!'S '4'lB"'''492,3.-- '. HE;:AI..TI.n',. '. . EJrsmerton/Kttst.itr' Heal th, tHstr h::t: ' - 4'78M"5~Z;;~5.',._ ..... :'. ':~ . " ' . . ~.:.' . .... ...., . .' .,' '. . : '. ; , ' . , .'Al,;,:'L. . I:~'SP~:C'.l :1: CI'NS~' 'p~::~rciR.MEi:): ~y .-r~'E . c: I ri .t1F SR'F.::;~l:::~n~N M'~.l~il'.. "';F.~ S(::H~~bl:JI:_'iE:.D '~"I~ROUGH l'HI::" '.. .'r:)r.::'r;~M.:rl" Ce'~'N.I" "'R' " .(.'3i..O') 4.78.~:C::?'7t:. , ....'.. " '. ' I. r r.;;.r, ,~t, .. r,;;;,. ,lI .. g - ...).... 0 p. . . , .... - *****~**~,)t** *,)f******'*.**'~~*.)t***,*,***,***.)+,***'*******~~*.*~*******~:~'******')+.*.*******~'*'~ . \ '. " '. . ,. '.._ ,~ - .1 ' ':.', . - '. f' . .' _ . - -. ' . ' . :.' 1:;)'~3rm j,1; 'H(:i 1 der:' . . . . ,. .::..../,~f~~ !;i~l~~:~ur r.:t n..,..' '.:.. ~ "':". ,. '_::~.'.-."'~."'::::- . ,... r:)at e: ....;;p..-';:...,~..(,....~.,~,->..~,...~,:..~."".~..._..,: . .~,' "10, . , , . . , . . ;...... ,'. "- -, ", , '. .' " ~ . .. .' -.. l , " . .',. " ~. .. . . . . ".' " .f . . ~ ~ 'l: . , .. ~ ~ . .'.' " -. . ., ,1:, " ..', , . . '. . : \ :. -; ( . . . ,. " '~"E'''111 '.:_ . . .....i,-:. " .':- ~, : :~ ~.... .;'l- . , '. F.~ t'-.\, \ I . . .' '.. . .' '. . , . .' '.. . . " :' , . . . t ." , , . , . - f ~, " ". ". '. .. . '~~>~~:/ ': ''-: ~ . ',.::.' ~ <.j',.. ' . . . " I, '.:". ",,' . , '. , . I - . .; . . . ." - --- ':.S-~j:::>:;;i:,<:'::-::H::.\!;i:;:'~;-::;:::::::i-~i->':i~~:!~;~nnn:'i::am':-:~!iA::nDT:~!:Tn'::;A::~I:'~r\XT!-::-:!:::::~:;;::;;::.:[;:::::;:j;::::::::::!!::-:~!:;:::::;i:::~;~::-:': :::~~~~~~:;~.;;:;~;;;;::~:;~::~:;:::-:::~-:~~:::~~:'"::::;:~:~~;;~:~:::~~r~'E~Yn:~I~~~~n:.ITIr:.L:I~~M~' I:: . Vl~:::~:-~'~~:;;-'_:.: :;:.~;;.:. ;~;;;;:: :~::;~~;:.,:~: :.:~~::::::~;;::~-::::': ~'::i_:!::lj!~i~:~,f~~~~~~~.~~~-j;:~~~7!:i;i:ii;~~~~:{'6or~7.~$.ii~fi1-~:~~;-{a~ij)!!41~-~~i$::::';;:;:i [lI . - '... .. -- - - .. -- . - . D' ... - - .... n '" ' . .... '.- .. n.. _.. .... ___ _. _ 'h_ . _ ..... ....... _ _ ...... '__'_' _" _ h_' _ '" ...... _h.... ___... ., ........... . '" ............ ..., . ... - '.... .... .._......-..,........ ... .... . .__. . . '_u._ . _ ..__. . ......_.. .,.,. ............. ,... .. .,.... . -'- .. . -... .... ......... . ... ... - ...- - - . . - -. -.. ... .. .....-. ... .-........ - -'.. .. , .. . ..- ... -.--.' .... ....---.--. ...... .. .. .- - .... . ........ . ....... ::":::'.:: . .:::_ -::::::. ::I~C....~:~-l\i.T:T~:~;,~->:_-..:::::::-,::::., :-,:'::::::: .:_::: :::::::: ,:::'..::':-:"':-._'. ..pf':'--'iJ;1l~IN.: G: '.. _: ,":',:-... :,-..:',::::,::-. " .... ........ ...... 1'-:.U.!il II1:U.~.I:'-'~Li......., ....... ....... .,_.... . . .. ...... . ~IJ:II.:D .. .... .. ... . ....... ., ,.......-- ... -- .. . -.. '-' -' ....-. - ...... . .. .. - -- .. '" - .. . .. .. APPLICANT: ~ OWNER rRI CONTRACI'OR. 0 OTHER: COMMENTS: . - SITE ADDRESS: /90? . B uf(we (I .5/ ~WNER:_?' c:,: t} AP-D tJ..J, f,SdZ 0 v.J tV ADDREss: CONTRACI'OR: UfJ ~;-'{~~T Fit 1i. t' I fl-c.. 'P ADDRESS: cONMJ6/ScW# /P + K& EXPIRATION DATE: OWNER PHONE # L{? 'f ~ fOJ '( CONTRACI'OR PHONE # -. '~~t~:::~~:~~::~~::~-:~'~:()f,~:altnPM~::~'jH:~}~{jjH::~:f~ ::::E.e:': ::NO(:: - - - - - - :t<etsw .-".......... ...-1YPlt.Op~...... ....-..... . NO'" ,-.... .- ..- ... ...... H~~:HH~~~~n~~~nm: :~ ~-:: :L:: /. :::: =: ';. -.: .: :~~~~~~~m~~tm~:~~~~' :. ..:.:':.:i!:'; :::.::.: ....:::.: ... ...... ........ ... :_:.... .:lII::: - - , RANGE WATER CLOSET I . .-wOOD/pELLET STOVE/GAS FIREPlACE BATHTUB GAS FURNACE btu s: lAVATORY CONVERSION BURNER btu's: , SHOWER UNIT HEATER b,. $: KITCHEN SINK ......... ""'" ~, r~ Ft raN rr ~ ~\.l BOILER btu. 's: p~SHWASaER .~ np H:- 1~,'~" ~,) E': q~ : " .' . ~ ~ ~ . t.,.:; P"'l ;"'. GAS PIPING :Jr\ ' LAUNDRY TRAY 1\\ '. .. , ., '" ',t." EVAPORATION CooLEts b,. $: CLOTHES WASHi '.:=. J\!I~ 2,,, 1,~ t ;,,- f AC UNIT btu's: WATER HEATER HEAT PUMP In.'s: tons: uRINAL N'~~."'\~~i\,.~~:,f' ~',,"')~"J ;!...., .... .. ~ REHEAT BOX In.'s: DRINKING FOUNTAlNHr.;.~,:;~ o~t::~~. :"( , , . 1.1' AIR HANDLING UNIT btu. 's: FLOOR SINK OR DKJU.N ... EXHAUST FANS SLOP SINK RANGE HOOD (residential) WATER PIPIING & ~TERATION RANGE HOOD (commercial) GREASE TRAP/INTERCEPTOR CLOTHES DRYER HOSE BIBBS INCINERATOR lAWN SPRINKLER S)'STEM DUCI' ALTERATION SWIMMING POOL TANKS t:yfJe: BLDG. SEWER (mobile / moved house) REFRIGERATION UNJT ROOF DRAINS OTHER: OTHER: MECHANICAL PERMIT fEE $15.00 PLUMBING PERMIT FEE (15.00 or 4.50) 5l :~f~ DATE: g"Z b - r") MECHANICAL FEES: PLUMBING FEES: CITY SURCHARGE: . eTALFFES: APPLICANT'S SIGNATURE ' ~f2~ pmapp.dot ~msed 4123/cn .. *****************~******~******************************~******** o lY OF BHt'MFJHON Rt'CF.l PT ***********~**~**********~*******************~**********~****~** Hf:'CE1Pl Numbt't'O 970008-4r Amount: ~lj .95 00/26/97 ](.l:26 Payment Mrethod: Ct< Nt.')tation1 Ot(tlWN C-KtA13B fnH ~ Vt.J- ,../'toJ"'*W.'_I.....!l.....""'.....- .......'......'-10...... . 1'I_~.(I.....'~L'..-l~" .f.._......._.~,.......,.t/........,;Il....... ",.....,_, ..'IIon.._lo,oC......__........._..........'....""'_.. ,............_._.,...__....., Perm! t N(j: 9)',~0559 r)lp~H M/P , Mr:~GH/PU1ri PERMt r 5 it: e Acldresn,~ i 900 Bor~W~t.l., ST t..oca-t ion ~ l i.'Of~ BU~~WEU. !i'f Tt.lt a I Fees ~ 31 .95 fhts P('lymf.'.IOt 31.95 'fotal ALL Pmta: :~l.'/J a~lance: ~oo ************~*********~***********~**~*******~**********~******* f1cc(,lllnt t:Qde n~ecr i pt i on ,",mount 16.<mZ.1005 (221.::I) MFi:CHANICAI.. PERMIT F~F.$ '-6.95 EO w. 322 .1009 (N!' 19 ) Pr:HH n SURCHAf<GF ~l .00 "",....._"." ,tHI""""""..... ........._...,. ............. ........"...'...10.......... "....""'...... .....~,. ,1"-"1~.It""'I...'.. ,.1, __. ~_._..fI..... _...tl......"._ ....,_ ~III .... ..uo......._ ,""IP'..I_..............___....~.... .......:1.... -. \.. N";... BREMERTON BUILDING DEPAR1'MEN1' PlwnbinglMecltanlcallnspection Report . Scope of work: Gas fireplace, piping Address: 1908 Bu:rwell St Contractor: NW Fireplace and Gas Pennlt Number:. 97-0559 Owner: Richard Brown Pl1olle: 479-1014 -; GAS PIPING Under leSt (lOpsi ~r 15 min~tcs) Proper .i:ung &: sup~~ 12" aninimlun below graclc wlle'.a und~ouncl Coatccl/wrappCl.1 wilen lande:rgrowad or widuh 6" of eartL Grouucl-joillt ullionsllrolaiblccd in a:rtaln locarions nllslain~s not allo~d in conc.calccl areas COMMENTS:__ GAS PIPING APPROVED:_ c4(~__ fl:.'"'t. 7"" '\ 1 FURNACE ManuCacturu's~cltions on she Location, aca:ss, sU.fl!.~rt Ckarana: to combusdbb ' Ve:~.ting: dcarana: to colObull.iblcs Vent siung & sUJ,poruconncaions Vent termination Combustion air Claim~: liner andlor separate fluq as lCCIuired Gas sbut-offwidain 3' Pilot elevated off floor in garage: --,-- Ducts: sb.c & sUPl,ortlinsulaled wlaen required Return air COMMENTS: FURNACE APPROVED: MISC. APPlJANCE8 M~_uufaClurer's slJCdfiariolls on.lee Locauon, acc.ess, SUppOI'[ Clca.ranClC to combustibles Venting: dear:u.ClC to combu.ribles Vent sizi,!'g & supportlcouneaions Vent termination Combustion air CI.iannc:y: liner andJoc separale fluc:s u rcqllircd Gu .hut-off widun 3' WCKMlstove &: fircplaa:s: propc:&' bearth Wood stOVClt: EPA a'p'p~ Gas log..: safety shut-off Wood .tOVClt &: firepla(lCS: u.d.t fiuinl-': doon Gas .Iaut-off wilhill3' COMMENTS: ~ APPROVED: ~/~ f'''':l-?....-,7 WATER BEATER ManuCacturer', ,pedfiatlons on ,ite Location, aca:ss. .upporl ClcaranClC to combusdblcs Venti3: dearanClC to combustibles Vent .iunll: &: .upport/connections Venlternunation Combu.tion air Cldnancy: lina' and/or lICparate fluCII .. requi~ed . Gu .Iaut-off widain 3' Pilot clr:vated off floor in Kanat.e Gate valve on col(( wara- ,uJ!f.1y RelieC valve drained to outside to ltamllizecl connections Unions on walea' piPes Sci'lOic: Inap COMMENTS: WATER "RATER APPROVED: ALL WORK IJNDEIl TIllS PEItIDT APPI10VED: ~/~ ~, 1-1" i 1 -' ,-_'_-., ~ _.. '~-,,;.W _. ...- ~ ~.... ._ - --------~ ~ ' " " '_: CIt:V .OF :BREMIiRTON - BUILDING 'DEPARTMEN:T " "478.5~8~"':" 817 PACIFiC AVENUE, BRI;MERroN, WA 98310' .' l, . -.i'...., , ',I:N'SPE,CT:I:O:N REPO'RT PE~MITNO.~dC)\ ~ " I have this day ins~ected ,tbis struct~re and these premises and have 'found the following ',violatlo~s ,of City, County and/or State 'laws governing $ame: ' ' ")) 't::' 1_A.! ',,v 3 I 'Vi ,,:,,': r (2or~~:r_,b,:~,_, ,(V'QV\I GCv.-,~ vS,,-leL-@ ..-r h. {o~ ", , . :~ .' , ~J r"', . .... ~ I , ", ~, ,'. '/' . ' ,-, , , ~ , . - "" . . " " " , ,l', ,,' , " " , " ". ',You are hereby notified'that no more work shall be covere,d upon these preRllses untn the above vlola- , tlon~ a~ corrected. When corrections ,have been rn,ade, call for re-inspection.. , . Do N~~~emoveThis Tag ~/,6'~~', ~~~Pt , 01 ' r'''":''':''''~-'-''--''!-~ ~o- "';'.-,!,....;- ::,'7',"'"<~;~?~~<;:""-~;'T',~~" ~.-, ,...,.' ':"....,.,..::'~~~-----~~ .;;;r.~' - :..~:,)/:, '.-, CITY OF BREMERTON - BUILDING DEPARTMENT 478-5is1 - 817 PACIFIC AVENUE, BREMERTON, WA 98310 ,'... 1,,', , - ~"...t f ,- INSP~IOrEPORT ' PE~MIT.N<<):',)p\ . I have thl~rd,ay inspecte~.-!this structure and-these premises and have 'found the following violations of City, COUl\ty and/or State'laws governing same: , , ~ ,i;.." , ' I'" , ! . ,.. ',' '" ' " A..! f \ I \...J 7<:' (..'!T ~' ::, 1 I c> 1-'......' {'J I) VJ ,c.. 0 v'- ~ v':,,! I 15 L ["S"' T" .,,"'- ',Ii;; .".. I. > , .... .. .. f 0 /,.,1 "( .....' h '~i vI ':1..", ~ ~l_ ./'!:....,....;.." , -., /- - , '.. " ....~ ".' ~ -..; ..".. , ,r<J:>' 4 .; / ..f ~..- ,~ It:I.~'7: ,~ ""'" '- (I f..(..; .~ i _!... " , " l r i . -, "" ,... ..-<!!,.>Io ...,~,} " ':1 ~ 1" ~ , , .." " i , 1 -_.._,..................-'-~,..'"-,.'--:"..,1i ! l tr--~,..~ ( ,..~..~.,..~~,_...~ .:...\ I !i ~...~...... i ....7 / .. 1 }'.' ~.." ~. -~ ....""..-..-..., '~n _ -........,..""...... \! I /-......--........... ' , ,I \\' "i I ~-, --.,.-_, .. . . \ t-,.;-~...; , .,...... i, t ;;.-." ........./ f. ! I '! \ I , I f ,........_~~ .. - . , '- "'-w,_......_~...... ... . ...'.--_...'w. .,( , ' . .- You are he;by'fI'otift;cirLiirn~ more work shan b~'covered up~ri these premises until the above viola- -lion$ are corrected. When corrections have been made, call for re-inspection. -' " O N t R' 'Th-' '1': ,,'- , r "'I/" 7 'l,;" ,0 0 elJlnVefJ! IS'/ 'lag ",rI~:rEq.. ,1..:). ~::.~ ,~., f.f t,~, ,:-,tr.c_ , -~~ f J I" r \'./ : . ~ - , '. ,,: ',).~SPEC1O~ OR ,~,U DIN~ DEPT. ' "'.) ,:.L. .1 ( :J "~':;,,~ " ~,,(~~{ .... ~ :_,~,:,('-:::', \'~\,- c' ~-,/, ,", !:' i\ ,I"" . & .; . . ~. r, f '" I:"~ - .!;~~ . " " . '.' , .~ ,!.' J : '~~_'d[" : ,:;.:;,- ~ .,'.' ..... ~ ii' J INSPECTION RE~RD CARD CITY OF BREMERTON BUILDING DEPARTMENT ADDRESS & DIRECTIONS 1908 Burwell e 3&:>>- PERMIT NU OWNER Barbara E. Brown CONTRACTOR se If PHONE PHONE 377-4005 COMMENTS: 1 FOUNDATION CORR D.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 ",ENTS -- 13. CRAWL SPACE ACCESS -- FOUNDATION INSPECTION APPROVED BY: 2 FRAMING COMMENTS: CORR 0.11. 1. WIRING APPROVED -- 2. FOUNDATION VENTS -- 3. SHIELD UNDER POSTS -- 4. POSITIVE CONNECTIONS -- 5. SOIL TO WOOD CLEARANCE -- 6. POST CLEARANCE - 2" -- 7. BEAM SUPPORT -- 8. TR. MAT. NEXT TO CONC. -- 9. WASHERS ON ANCHOR BOLTS -- 10. BEAMS PROPER SIZE -- 11. FLOOR JOISTS ~PAN -- 12. NOTCHING & DRILLING -- A-FLOOR JOISTS -- B-STUDS -- 13. STAIRS -- A-WIDTH -- B-RISE & RUN -- C-WINDERS -- . D-LANDINGS -- E-HEADROOM -- 14. ATTIC VENTILATION -- 15. CHIMNEY STRAPS SECURED -- 16. FIREPLACE COMBUSTION AIR -- 17. FANS VENTED OUTSIDE --- 18. A-BATHROOMS -- B-LAUNDRY ROOMS -- C-KITCHEN -- 18. WATER CLOSET CLEARANCE -- 19. SMOKE DETECTOR -- FRAMING INSPECTION APPROVED BY: CORR O.K. 20. FIREBLOCKING _ _ A-STAIRS _ _ B-DROP CEILINGS _ _ C-TUBS OR SHOWERS _ _ D-ROOF & CEILING LINES _ _ E-FURRED OUT AREAS _ _ F-FIREPLACE AT CEILING _ _ G-ELECTRICAL HOLES PLUGGED_ _ H-PLUMBING HOLES PLUGGED_ ---.:... I-LID IN VOIDS _ _ 21, WINDOWS A-SAFETY GLAZING B-VENTILATION C-REQUIRED FIRE EXITS D-WINDOW SILL HEIGHT 22. CEILING HEIGHTS A-BASEMENT B-MAIN FLOOR C-UPPER FLOOR 23. SWAY BRACING 24. TRUSSES A-PROPERLY INSTALLED B-STAMPED 25. ATTIC ACCESS 26. CEILING JOIST SPANS 27. RAFTER SPANS 28. ROOF SHEATHING 29, ROOFING APPLICATION 30, SIDING 31. CLOTHES CHUTE 32. SHEETROCK BACKING A-UNDER STAIRS B-ABOVE GARAGE DOOR HANGERS M MECHAN'icAL ,. e e CORR O.K. CORR 0.1t 1, FURNACE SIZING -- 1. WOOD STOVE CLEARANCE -- 2, FURNACE LOCATION -- 2. CHIMNEY CLEARANCE -- l' 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, 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_ _ COMMENTS: WALLBOARD INSPECTION APPROVED BY: 4 FINAL CORR O,K, CORR 0.1, 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 DETEClORS -- 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 BY: NOTES: PLANNING: ,- ,_ . P:ERMIT' '. ''': crrv OF" BREMERTON' BUILDI.N,G DEPART'ME'NT ,.PHONE: 478-5261 1908 Burwer1 S~. SITE ADDRESS Barb ara: ;E. Brown, same ;. - ASSESSOR'S ACCT, /I ',377-4005 OWNER 'MAIL ADDRESS PHONE self CONTRAClOR : .1"" '_ MAIL ADDRESS [i] AbDITI~N '. D. ALTERATION Class of work: D NEW .. EJ ,M'E'CHANlCA'L COMMENTS ~o. llpe of Equipment - Fee STOVE!p G~s~ Oil~ WootLx.,' 1 FIREPlACE INSERT FURNACE Gas (Nat._ L,PG.---.:.....) Oil---':" ' Wood ,add on~ Other~ Electric_ BTU " Type,: ~p flow_ Down flow_ Hor,izonta,-:- Wal'~ CPNVI:RSION BURNER: Gas....,.......: (Nat._ LP -> .. Under 100,OOO~ Over 100,000_ Oil-,- UNI1' HEATER BTU~ GalL.- Elec.~ , .- ,- BOILER Gas_ Oil~ Electric_ Other_ HP .,....-----, GAS SYS"fEM M~. 5 outlet Total-=---,- , ,EV~PORATION COOLERS' Roof~Wall_ ' BTU_ , ) AC UNIT Electric_ Gas Elec. Combo~, BTU_ HEAT. PUMP Single Package_ Spli~ : Add, on_ BTU Ton_ MIXING OR REHEAT BOX CFM~ BTU~ AIR HANDLING UNIT ,eMF _ 'BIU-.',- FANS Exhal:l~ Sl:Ipply_ Bath_; " RANGE HOOD Residential~, Comm._ ROOF ,DRAINS CLOTHES DRYER Res,_ Comm._ INCINERATOR Ai..TER~"fI()N TO DUcr SYSTEM HeatiaglC9Qlin9-- ExhausL....,...,,' TANKS Oil_ GaB- Propane wlOK from Fire pept.~ Gallons ' , REFRIGERATION UNIT :':._ ~ c;n ,', 15.00 , 'PERMIT $ / l0001/ 'ToTAL 'FEE $ , 21;50: ' FINAL APPROVAL, , , ZIP , ,PHONE LICENSE NO. D REPAIR D' 'PLUM"BI'NG 'No.' l\'pe of Fixture or Item Fee WATER CLOSET (lOILEt)- Ii3ATHl'UB LAVAlORY,(WASH BASIN) SHOWER .. KITCHEN SINK & DISPOSAL DISHWASHER LAUNDRY TRAY CLotHES WASHER WATER HEATER 'URINAl:. DRINKING FOUNTAIN FLOOR - SINK OR ,DRAIN SLOP SINK, WATER PIPING & TREATING EQUIP. WASTE INTERCEPfER (Grease) VACUUM BREAKERS ~ BLACKFLOW DEVICE LAWN SPRINKLER SYSTEM SWIMMING 'POOL -, Private~ Public~ GRO,UND~~RK SUMP . ALTERATION KIDf\.!EY MACHINE '" PERMI:T $, . 1'0.00' TOTAL $ NOTICE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRucnON OR WORK IS SUS- PENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT AN~ TIME AFlER WORK IS COMM,ENCEb. I HEREBY CERTIFY THAT I H,AVE 'READ AND EXAMINED THIS' APPLICATION AND KNOW 'tHE SAME ,10 BE T~UE AND CORRECT. ALL PROVISIONS OF ,LAWS AND . ORDIN1\NCES GOVERNING THIS TYPE OF WORK WILL BE COM PLED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES' NOF' PRESUME 10 GIVE AUTHORITY 10 VIOLAtE OR CANCEL THE PROVISIONS OF. ANY OTHER STATE OR' LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF , , CONSTRl:JeTlON, , , SIGNATURE OF CONrRAcroR OR AUTHORIZED AGENT "p~,h~ I. "g~~. , SIGNATURE OF QWNER (IF ER BUILDER)' , , (DATE) RECEIPT NO. 7(00 ~ 7 :', " ~hite-ORIGINAL, Ye!loW-INSPECTOR, Pink-APPLICANT) ~ PERMIT N\l lJ-ilYfI (DATE) 320-1 . --p-~ R M "'TREME. A-I-' ~GL I,~ AE'N- 'TT- 0" CITV.- B nlON BUILDIN DEPJlfM .., '.. - ';' '._,. ' PHONE: 478-5281 It} (}r!"lfurwt// (/1/, SITE ADDRESS ASSESSOR'S ACCT. /I oWNER MAIL ADDRESS , J rfar/;;?IrIJ c: ll'{'tJ {AlI1 J ~ tJrI OkrlAA?1! L MAIL ADDRESS Class of work: D NEW I/LI ADDITION D ALTERATION D REPAIR CONTRACtOR ZIP ~,jJJ/P PHONE PHONE ~ '7 /~tj "1;-- LICENSE NQ D MECHANICAL ,0 PLUMBING No. 1'ype of Equipment ~TOVES Gas--:..... OiL- WOOd.J)..... / FIREPLACE INSERT FURNACE Gas (Nat._ LPG.-> Oil_ Wood add 0"- Other_ Electric_ BTU Type: Up f1ow_ Down flow_ Horizontal_ Wall_ CONVERSION BURNER: Gas_ (Nat._ LP-> Under 100~OO_Qyer100~OO~ Oil_ UNIT HEATER BTU_ Gas_ Elec._ BOILER Gas_ OiL- Electric_ Other_ HP_ GAS SYSTEM Max. 5 outlet Total_ EVAPORATION COOLERS Roof_ Wall_ BTU_ AC UNIT Electric_ Gas Elec. Combo_ BTU_ HEAT PUMP Single Package_ SpliL- Add on_ BTU Ton_ MIXING OR REHEAT BOX CFM_ BTU_ AIR HANDLING UNIT CMF _ BTU_ FANS ExhausL- Supply_ Bath_ RANGE HOOD ResidentiaL- Comm._ ROOF DRAINS CLOTHES DRYER Res,_ Comm._ INCINERATOR ALTERATION TO DUCT SYSTEM Heating/Coolin9-- ExhausL- TANKS Oil_ Gas_ Propane wlOK from Fire Dept._ Gallons REFRIGERATION UNIT COMMENTS Fee No. 1'ype of Fixture or Item WATER CLOSET (lOILET) BATHTUB LAVATORY (WASH BASIN) SHOWER KITCHEN SINK & DISPOSAL DISHWASHER LAUNDRY TRAY CLarHES WASHER WATER HEATER URINAL DRINKING FOUNTAIN FLOOR - SINK OR DRAIN SLOP SINK WATER PIPING & TREATING EQUIP. WASTE INTERCEPTER (Grease) VACUUM BREAKERS & BLACKFLOW DEVICE LAWN SPRINKLER SYSTEM SWIMMING POOL - Private_ Public_ GROUNDWORK SUMP ALTERATION KIDNEY MACHINE Fee r:::. .::5 0 PERMIT $ TOTAL $ NOTICE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS SUS- PENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT f HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT, ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLED 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. PERMIT $ T<:^. c~ TOTAL FEE $ ::J /.< (') FINAL APPROVAL SIGNATURE OF CONTRACTOR OR AUTHO~/ZED AGENT (DATE) (DATE) SIGNATURE OF OWNER (IF OWNER BUILDER) RECEIPT NO, (White-QRIGINAL, Yellow-INSPECTOR, Pink-APPLICANT) PERMIT I -- ,~ . N~ 42908 , - ,,,,...,,, I ' <';;J c:.."-"\ ,::;:.r-~ ~ ~ ,. ... .... ...1. Fee '_~~~____:-::_::_::~,~.._____m:m__m'm.._..m_m__..:m__m Receipt No. ___,_-,..-::~_,L,l,:_:;:'_:m___mmm_m.._.._' , . , B,U I L DIN G' PER M IT' CITY OF BREME'RTON BUILDI,NG DEPARTMENT / F. E. JRISH, Building Inspector . ESsex 3-1411, Ext. 36 Owner's Valu,e Bldg. Dept. Value DESCRIPTION: f Ifrl!/ .c /-7-1. ,~] ',' ..,,, l ~ Lot Bloclc Addition~ , ,;r . Z"'7 Address on Job __,,(_ ?:2f___.!..~~~-'i-:"_~-f!:...f____n__________..___ _____n___________'_______________ Date __::t::=_:L-:__Z_?...::'_:..n__n___u__ Building _____________n_ x _____mm__m and __n_m__mn_ stories _m_mnnm_n___m basement, Lot m__m____U__ x ____n___~----n Front Yard n______um______m__ Rear Yard _mun_m_n___n____ Side Yard _n__nnn_nun___m Garage __mnmmm_m__.__m__ Occupancy _n ___ _ _ ___ _______ ____ ___ _ n__ ___ __ __ __=. _ ......L'<<'? _ __. _ __. _ ___, __ _ n__: _ __ _ 00 __ _ ___ _ __ __ ___ _ ___ _ _ n __ __ __ Zone ___ __ ___ n_ _ ___ n ____ __ __ __ __ __ _ _ __ n __ _ n 77"~- ~t:;.:-' ~ ,,'-' /:1/9 Owner ________-__n_______~__n__(~~d.l!:._n___n___/;?L<fi2.~2:4_~"'_"_:_n___ Address __-t:~4..~~_:_~f__:f.._&.._,r:.:e.__:e:_____ Phone n_.__________.._ . - - .. , (' - - Contractor _ _ _ ___ __ __ _ _ __ _ _ n _ __ ~ _ _ _ _ _ _ _ _ _ __ _ _ __ n _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ __ _ _ _ __ _._ Address _ n _ _ _ _ _ _ _ _ _ _ _ _, __ _ _ _ _ _ _ _ _ _ __ _ _ __ _ _ _ _ _ _ _ _ _ n Phone _ _ _ _ _ _ _ _ __ _ _ _ _ _ __ This permit 'is issued for: ..,,--24 ) ~ ,---",""::: A~../......./ n A-,~,"'::~-'" ~~~~~~~~~~~~~~~~~~:~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~:~=~~-~~~~~:~~~~~~~~~~~~~~~Z~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Al~ work to conform to all applicable building ordinances and. amendments, Please note the following special instructions. and requirements, DETACH HERE, AND POST THIS SECTION ON JOB INSPECTION - Reinforcing steel must be inspected after placing and before covering. FORMS shall be inspected and approved before pouring. All pl'u'mbing, wiring and th,e fralme of all buildings must be inspected a,ncl approved before covering. Wood preservative to be used on all wood ~ainst masonry. Ventilate foundation and attic. Sepa~ rate permits required for plumbing, wir~ng a,nd heating. * City Engiineer before working on streets or sidewa,lks. --..--......------..--....-......----..--......-....---..----..--..-..-......-......--......--..-..--..--..-..---....--..--..---..-------..-..-..--......---..-..----..-----------....---..--..---..-..----......-....----..-..--------....-- -- ....-- -.... -.. -- -- -- -.....-- - -- -.. -.. -- --.. ....-.... -..- -.. - - - -- -- -.... - -- - -.. - - -..-..- ---- -.. - - -.. - - --- - ---- - - - - - - -.. - -.. -.. -- --.... ....- - - -..... - -.... - -.. - - - - - ........... - - -.. - -- ....... --..........-.... -..- - ...--.. ...-.. ....--.... ----.--- ...--...-.....--..---..-..-..--..--....--..---....-..........----..---..-....----~_.._---.._---......_......_----.._------......_---.._---..-.._..-.._...-....---------....--........-....---------..-----..--..-----------..------..--...----- - - ---- ..-....-..-......- ----- -.. -.... -.... - -.. - -..- -- -.... --- -- ..-- - - - - -...... - - - - -..-- - - -.. ....- - --.. - - -- -.. --- -- - -......-.. --- --- - -- -- --- - - - - - ....-.... -...... -..- ...... -.. ..-.. ..--- - -.... - -.. -~..- - ....-- -... -- - - - - - --.. --..-...-.. --- ---..- - --..-.. -..-..-.... --.. - -..- - --- - - -- - - -- - ---..- - - - - -- - -..- - -..- - - -.. -- --- - -- - - -- -.. ...-- - --- - -.. - - - .. -.... - - - --- --- - ---- --- - - - - - -..-.... --.. - -- - - -- -.. - -.. -.. -.. -- -...- -- -- - - - - -- - - --- - --- - --.... --.. -----.. ... - --- -- --.. ----- -- -- - - - - - - -- - - -- -- - - -- - - -- - - --- --- -- --- ---- -- -- - -- - - _..- - --- - - - - ---- -..-.. - - - - -- - - - - - - --- - - -- - -..-.. - - - - - - - - - --- - - -- - -- -- -- -- --- - -......- -- -- -- - ---- - -- - - ---- ..-- - --- ------ .. - -- -- ....- -.. -.. -....-.... -..- - - -.. - - -.. -...... --.. - - - - - - -...... --.. - -..- - -...... -.... --.. - - - -.. -.... -.. -.... - -- -- -.... - - - - -.. - - - -.. - - -.. - - - - - --- - -.. - -.. --.. - --.. - -- - - -- -- -- - - --- --- --.. --- -_.. - -- - - -..- - -- - - ---...-..- ---.....- - - - - -- -..- -.. -- --..- - - --.. - - - - - -- -.. ---.. -- - - --- -...- - -.. - - - - - - - -.. - -.. -- --- - - -..-.. -- - --- - - -- - - -..- - - -.. - - - - - --- - - -.. - - - - - -- - - - -- - -- - - -- - - -- - - -- - -.. - - - -- -- - - - --- -- -- -.. --.. - -- -- -- -.. -.. -- -.. -- -..--- -.. - - - -- -- - ---- - - --- --- -- - -- - -- --- - - -- -.. --.. - -.. - - -- - _...- - -.. - - - -.. - - -- - - -- - -..- - - -.... - --- _..- - -.. -.... - - - - -..-.. - - -.. - - -.. --....-.... - -....... -.... - -- - -..- -..... ...:- - -.. - -..- --.. - - ....-.......... -.. - - -- - -..-.. - --..- --.. -.. - - - --- - -- - --..- - - --....- -.. -.... - -- --..- - - ....... - -- -- --- -.. -.. - -- -.. -.. - - -- - - ---.. - -- -..-.. - -- - -...... - ....- -- - - - -.... - -.. - - -.. -- -- -.. ..-- - - -.... -.. -.. --.. - -.. - - -- - -..- - -...... ........ - --.... - -- - --.. - -- - - -- - - -- - ..--- -.... -..- - - - -.. -.. -- - - - -.. - -..- --- - - --- ---... - -..- - -- - - -- -.. -- - - - -- -.. - - - -- - - - - - - -" - - -- - - -- - - -- - - -.. - - - -- -- - - - - - - _..- -- -... - - -.. - - -..- -- - - - ---- --- -..- - -..- - - - -.... -.. - - -- -- -..- -..-- --.. -- -.. - - -- - - - -- - ---- ---.... - - - - - - - ..-- - - _.. --.. - - -- - - -- -.. -.... - -...- -..- - - - - -- --.... -.. - --- - - - - -- - -.. - ..-- --- - - -.. - - --.. - .._- - -- - -- - - - - - - - -- - - -... - - -.. - - - - - - - - - -.. - - - -- -.. -- - - -- -- - -.. - -.. - - -... - - - - - ..-- -.. -.... -..... ---- - --- - - --- ---...-... , - --.... -.. - -.... - - -- -.. -- ....... -.. -..... --... - - -- - -.. - - - - -.. - -... - - -.. - -... - - ...... - - -... - - ---- -.. - - - -- -..- - - -- -- .....- -.. - - - - - - ---- - - - -- - - - - - -.. - - -.. -... - - - - -.. - - -- - - -.. -- -- - - - -- -- - -.. --.. -.... - ---.. --- - - --.. - -- - - --- ------ - ' "" ~ ..... - - - - - - - -.. - --- - -..- -.. - -.... - - -- -- - - -- - - --.. ---... - - -- ---.. ..-- - - -- - -.... - - --- ---... -.... - - ....- -.. - -.. -- - - - - - -.... -.. -- -.......... - - -..... -.... - - -.. - --... - --... - -... - - -.. -- -- - -.. - -.. -" -.. -- - -- --.. --- - - - - - -- - -..- - ---- - --- -- , ~~~fij~p.~~.:~Q~::~~~~:~::r~J~~2;a:~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~:~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~: Or.fljlD P, r,!!'t'f nFor n'T U~\a JIm:) I l _~u! ..... DF HEremt rnp;;:,-.r'T\ rUn!:. UfJi.lJa' I ;itJ Owner's Signa ture_ n _ _ _ _ _ __ n_ n _ _ _ _, _ _ _ _ _ _ _ _ __ _ n _ _ n _ _ __ _. _ __ _ _ _ _ _._ _ _ _ _ _. _ _ By ~ _ _ _ _ _ _. _._ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ n _ __ _ _ n _ _ _ n _ n _ _n _ _ _ _ _ _ _ n _ _ n n n_ _ _ _ _ _ __ _ ___ . , His AllthorizeJ Agent . " ' - lIF B 'ld' I ........ ,/ ",y-, . -;/' ~ ru'l ,,!lrD UI 109 nspector _________________,____________..'_=:,'______;:-.::!'____-:_~.___n_____________________________ nL~:J:n[' ~ , ~.,-4-~; ',J"-: ./~:~~i;:':~./:.~.,~";~~.- - ~ ~- ...-.- I'm ~ln;\IG By - -- ______L._-~:'~:':_(d_:~~_:~~,,:i~:1~~~,:~~$:~2 --- ------- -.- -- -- -- ------ ----------- UUI !-JIll coOl.;..-....;..-r - " - -