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HomeMy WebLinkAboutCALLOW AVE. N., 116 '.~ PERMIT' '"' -.-:-. . ;.j-'" CITY OF BREMERTON BUILDING DEPARTMENT 116 N. Callow PHONE: 478-5281 JOB ADDRESS Norm Shoop Same as above MAIL ADDRESS ZIP Mechanical Service 2512 6th St. MAIL ADDRESS PHONE PHONE OWNER Pe n I n~; u I a CONTRACTOR 373-9992 -< LICENSE NO. Class of work: 0 NEW o ADDITION o ALTERATION o REPAIR \ " I52S) MECHANICAL >~ PLUMBI NG - CHIMNEY (No fee information only) INSPECTION: Groundwork Gas Test Masonary Lines Unlined Wasted Vents 'Water Factory Mfg Type B Type L Htg. Ruffin Chimney Location: Internal Outside Wall Stove or Insert Refrig. No. Type of Equipment Fee No. Type of Fixture or Item Fee STOVES Gas~ Oil~ Wood~ WATER CLOSET (TOILET) FIREPLACE INSERT BATHTUB FURNACE Gas (Nat?<X LPG.~) Oil~ 4 50 LAVATORY (WASH BASIN) Wood add on ~ Other~ Electric~ SHOWER BTU KITCHEN SINK & DISP. Type: Up flow~ Down flow~ DISHWASHER Horizontal~ Wall~ LAUNDRY TRAY CONVERSION.BURNER: Gas~(Nat.~ LP~) CLOTHES WASHER Under 1 OO,OOO~ Over 1 OO,OOO~ WATER HEATER 3 50 Oil~ URINAL UNIT HEATERS BTU~ Gas~ Elec.~ DRINKING FOUNTAIN BOILER Gas~ Oil~ Electric~ FLOOR - SINK OR DRAIN Other~ HP~ SLOP SINK GAS SYSTEM Max. 5 outlet Total~ 5 50 WATER PIPING & TREATING EQUIP. EVAPORATION COOLERS Roof~ Wall~ WASTE INTERCEPTER (Grease) BTU~ VACUUM BREAKERS & BACKFLOW DEVICE AC UNIT Electric~ Gas Elec. Combo LAWN SPRINKLER SYSTEM BTU_ SWIMMING POOL - Private Public HEAT PUMP Single Package_ SpliL- GROUNDWORK Add on~ BTU Ton~ SUMP MIXING OR REHEAT BOX CFM_ BTU_ ALTERATION - AIR HANDLING UNIT CFM~ BTU~ POST & BEAM FANS ExhausL-- Supply~ Bath~ ~- RANGE HOOD Residential~ Comm.~ PERMIT $ CLOTHES DRYER Res.~ Comm.~ TOTAL $ 3 50 Incinerator _'3 - NOTICE ALTERATION TO DUCT SYSTEM THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- Heating/Cooling~ ExhausL-- IZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS TANKS Oil-'-- Gas~ Propane w/OK SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER from Fire'Dept.~ Gallons~ WORK IS COMMENCED. REfRIGERATION UNIT I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND 5 50 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHE- PERMIT $ THER SPECIFIED HEREIN OR NOT. THE GRANTING OFA PERMIT DOES NOT PRE- TOTAL FEE $ 15 50 SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY ,- OTHER STATE OR LOCAL LAW REG LATING CONSTRUCTION OR THE PERFOR- MANCE OF CONSTRUCTION// -I-.$~-z7~vl~/~ ;)j'r/s5 SIGNA TURE OF CONTRACTOR OR AUTHORIZED AGENT I I (DATE) FINAL APPROVAL (SEE OTHER SI DE) SIGNATURE OF OWNER (IF OWNER BUILDER) RECEIPT NO. ~1 fu 7 h PERMIT NO. '.~TO ['\1 .. (DA TE) 2571 (White-ORIGINAL, Yellow-INSPECTOR, Pink-APPLICANT) e PERMIT e CITY OF BREMERTON BUILDING DEPARTMENT 116 N. Ca I low PHONE: 478-5281 JOB ADDRESS Norm Shoop OWNER Same as above MAIL ADDRESS ZIP Mechanical Service 2512 6th St. MAIL ADDRESS PHONE PHONE Pl3ninsula CONTRACTOR 373-9992 LICENSE NO. Class of work: D NEW D ADDITION D ALTERATION D REPAIR [~ MECHANICAL ~ PLUMBING CHIMNEY (No fee information only) INSPECTION: Groundwork Gas Test Masonary Lines Unlined Wasted Vents Water Factory Mfg Type B Type L Htg. Ruffin Chimney Location: Internal - Outside Wall Stove or Insert Refrig. No. Type of Equipment Fee No. Type of Fixture or Item Fee STOVES Gas_ Oil_ Wood_ WATER CLOSET (TOILET) FIREPLACE INSERT BATHTUB FURNACE Gas (Nat?"X LPG. _) Oil_ 4 50 LAVATORY (WASH BASIN) Wood add on _ Other_ Electric_ SHOWER BTU KITCHEN SINK & DISP. Type: Up flow_ Down flow_ DISHWASHER Horizontal_ Wall_ LAUNDRY TRAY CONVERSION BURNER: Gas_(Nat._ LP_) CLOTHES WASHER Under 100,000_ Over 100,000_ WATER HEATER -:s 50 Oil_ URINAL UNIT HEATERS BTU_ Gas_ Elec._ DRINKING FOUNTAIN BOilER Gas_ Oil_ Electric_ FLOOR - SINK OR DRAIN Other__ HP_ SLOP SINK GAS SYSTEM Max. 5 outlet Total_ !j ')() WATER PIPING & TREATING EQUIP. EVAPORATION COOLERS Roof_ Wall_ WASTE INTERCEPTER (Grease) BTU__ VACUUM BREAKERS & BACKFLOW DEVICE AC UNIT Electric_ Gas Elec. Combo LAWN SPRINKLER SYSTEM BTU_ SWIMMING POOL - Private Public HEAT PUMP Single Package_ SpliL- GROUNDWORK Add on__ BTU Ton_ SUMP MIXING OR REHEAT BOX CFM_ BTU_ ALTERATION AIR HA~\IDLlNG UNIT CFM_ BTU_ POST & BEAM FANS ExhaUSL-- Supply_ Bath_ RANGE HOOD Residential_ Comm._ PERMIT $ CLOTHES DRYER Res._ Comm._ TOTAL $ 3 50 Incinerator NOTICE ALTERATION TO DUCT SYSTEM THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- Heating/Cooling_ ExhauSL-- IZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS TANKS 0;/_ Gas_ Propane wlOK SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER from Fire Dept._ Gallons_ WORK IS COMMENCED. REFRIGERATION UNIT I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND 5 50 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHE- PERMIT $ THER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRE- TOTAL FEE $ 1 S- ')() SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY ~ \ \ FINAL APPROVAL \ (SEE OTHER SIDE) LATING CONSTRUCTION OR THE PERFOR- (DA TE) SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) RECEIPT NO. 73&//,t:, PERMIT NO. ~ (White-ORIGI NAL, Yellow-I NSPECTOR, Pink-APPLICANT) .--"...-, . . ~. . ", . ". , ' -......--~--._----.,._......~_. . ," "';.:';';;';-~'~~~~~~~%T'~'" CITY OF BREMERTON BUILDING DEPARTMENT 11:: N. Ca I low PHONE: 478-5281 JOB ADDRESS \hrm ::hoor: Same as ab:>'1e OWNER MAl L ADDRESS ~ec~~nical Service MAIL ADDRESS ZIP PHONE P :3 i! I n ~;~J , a CONTRACTOR 2512 6th St. PHONE 373-9992 LICENSE NO. Class of work: 0 NEW .D ADDITION o ALTERATION o REPAIR [;] MECHANICAL .[] PLUMBING ,,.", ,'r.. .,"\ " CHIMNEY (No fee information only) INSPECTION: Groundwork Gas Test Masonary Lines Unlined Wasted Vents Water Factory Mfg Type B Type L Htg. Ruffin Chimney Location: Internal Outside Wall Stove or Insert Refrig. No. Type of Equipment Fee No. Type of Fixture or Item Fee STOVES Gas_ Oil_ Wood_ WATER CLOSET (TOILET) , , FIREPLACE INSERT BATHTUB FURNACE Gas (Nat?<X LPG._) Oil_ 4 50 LAVATORY (WASH BASIN) Wood add on _ Other_ Electric_ SHOWER " BTU KITCHEN SINK & DISP. Type: Up flow_ Down f1ow_ DISHWASHER Horizonr.al_ Wall_ LAUNDRY TRAY " CONVERSION BURNER: Gas~(Nat._ LP_l CLOTHES WASHER '" " ,', " " .,' -, 3 5,') Under 100,000_ Over 100,000_ WATER HEATER ,.....- ' , OiL- URINAL ' ' " >- " " " ".'-<, UNIT HEATERS BTU_ Gas----':"'" Elec._ DRINKING FOUNTAIN BOILER Gas_ Oil_ FLOOR - SINK OR DRAIN " Electric_ " . .., " Other__ HP_ SLOP SINK '.'.' ,';',;'" ' . ~ GAS SYSTEM Max. 5 outlet Total_ 5 SO WATER PIPING & TREATING EQUIP. ' , ' " .. " " EVAPOBATION COOLERS Roof_ Wall_ WASTE INTERCEPTER (Grease) ''<; ,'- " BTU__ VACUUM BREAKERS & BACKFLOW DEVICE AC UNIT Electric_ Gas Elec. Combo LAWN SPRINKLER SYSTEM " ,,' p" : , , BTU_ SWIMMING POOL" Private Public " " GROUNDWORK " ' '.- HEAT PUMP Single Package_ SpliL- , ' " Add on__ BTU Ton_ SUMP .. " ' ' .... " MIXING OR REHEAT BOX CFM_ BTU_ ALTERATION AIR HANDLING UNIT CFM_ BTU_ POST & BEAM " . , " FANS ExhauSL- Supply_ Bath_ RANGE HOOD Residential_ Comm.~ PERMIT $ CLOTHES DRYER Res._ Comm._ TOTAL $ 3 5U Incinerator NOTICE ALTERATION TO DUCT SYSTEM THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR- Heating/Coolin9-- ExhauSL- IZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS TANKS Oil_ Gas_ Propane wlOK SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ., '. from Fire'Dept,_ Gallons_ .' REFRIGERATION UNIT I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND 5 50 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHE- PERMIT $ THER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRE- TOTAL FEE $ 1 5 -Ii SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY ),~ TlNG CONSTRUCTION OR THE PERFOR- I 'I -.., :J f J--:'::' (DA TE) ~ F1NALAPPROVAl ~ \ (SEE OTHER SIDE) SIGNA TURE OF OWNER (IF OWNER BUILDER) RECEIPT NO. 7~ 0 7? PERMIT NO. N<? (DA TE) 2571 ItMhi+.o_nc It:: I P\1.d I Vall......u_II\.IC:::DcrTnc D;....Lo_^ DDI IrA MT\ INSPECTION R_ORD CARD CITY OF BREMERTON BUilDING DEPARTMENT ADDRESS & DIRECTIONS 116 N. Callow e 2571 PERMIT NUMBER OWNER Norm Shoop CONTRACTOR Pen I nsu I a Mecha n. Serv. PHONE PHONE 373--9992 1 FOUNDATION 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: COMMENTS: 2 FRAMING COMMENTS: CORR O.K. 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-H EADROOM -- 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 I M MECHANICAL 1. FURNACE SIZING 2. FURNACE LOCATION 3. FURNACE CLEARANCE 4. 'B' VENT SIZING 5. 'B' VENT CLEARANCE 6. 'B' VENT SUPPORT 7. COMBUSTION AIR 8. DUCT SIZING 9. DUCT CLEARANCE 10. DUCT SUPPORT 11. DUCT JOINTS 12. GAS PIPING TEST 13. GAS PIPING SIZING 14. GAS PIPING SUPPORT 15. OTHER e e CORR O.K. CORR O. K. 1. WOOD STOVE CLEARANCE 2. CHIMNEY CLEARANCE 3. HEARTH EXTENSION 4. CHIMNEY HEIGHT FURNACE APPROVED BY: HEAT PUMP APPROVED BY: GAS PIPING APPROVED BY: WOOD STOVE APPROVED BY: 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 BY: NOTES: PLANNING: c) e e N9 36224 ,0 'J Fee $ooh",:1___~~_:-:-hhh_ mOOh__hm_m_mOOh___OOhh_"'__' Receipt No. _h__~o/...9.~h'--"-mmmhhhhmhmm_. CITY OF BREMERTON BUILDING PERMIT BUILDH4G DEPARTMENT / / F. E. IRISH, Building Inspector . ESsex 3-1411, Ext. 36 Owner's Value I Bldg. Dept. Value I DESCRIPTION: $ ~ (;) I I Lot Block Additions Address on Job --h-/..L??nh?J~f."l..~_e-dLJ!.,f.-_f?":.Id)_m_hn____.mn_hm_m.nmm_hn__n_ Date _uum~-~-m 196___~- Building m_h___um._ X _umhh____u and _n_m____um stories m___mmnmm_n_ basement. Lot h_m__m_nu X __n__mm_n_ Front Yard nmmh.__._m______ Rear Yard h_mh___m___.___u_ Side Yard __.m__.._mh_h.hn Garage _m_mmnn_n_n.___mn__ g:~~~~~_~Svi1~::-:~~~b~!:::::::::::::::::::::::::: -Add;~~~n:::::::::::::::::::::_~~~~_-_-_-_-_-_-_-_-_-_-_-_-_-_-hph~~~~~~~~~~~~~~~~~~~ Contractor -- ___.__n_____ u_!S___y=k(l_______ __ _______ _n__.____ Add ress ___ ______ _____.___________.___nn_n_ _n_u Phonen__n__n___ ___ This permit is issued for: ::::::::::::::::::::::::::::::::::::::: 4J~ ~::: ~ j/::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: - -- -- - - --- --- - --- -. -- -- .--- --- -. - -- -- - - -- - - -__ - __ __ __ ___ - - __. - _._ ____ __ __ - - __ __ - __ __. - - w'. _ _ ___ _ _ __ _ _ _ _ __ _ _ _ _. _ ___ _ _ __ _ _ _ _ __ __ _ _ __ _ _._ _ _ ___ __ _ ___ _ _ __. _ __ __. _ _ __ __ __ __ __. _ __ ___ _H. All 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 plumbing, wiring and the frame of all buildings must be inspected and approved before covering. Wood preservative to be used on all wood against masonry. Ventilate foundation and attic. Sepa- rate permits required for plumbing, wiring and heating. See City Engineer before working on streets or sidewalks. .. - - - -... -.. - - -- - - - -- -- - - -.. -... -- - -- - -.. --.. -.. -.. - -- - -. --.. --.... --.... -- --...... ---.... -_.. ---- ----.. -- -- ...-.................... --.... --.............. -_.................. --.......... ---.. ---.. ---.. ---- ---.. ----.. --.. ---- ---- ---- ------ ...... --...... -- --.............................. --- --...... -- --...... ---.... ---.... --.... --.. -_...... --.. -- -- -- -- ---.... --.. --- -- .................................. -.......... --.......... --...... -_............ --.... --.... --- ---- --_.. -- -- ------------- ---- ----- .--.................... --.... --....................-.. -- --.. __ __ ___.. __ __ ___ __ __ ____ __ __ __ __.. __.... __.... __...... __.. ___.. _,w............ __.............. __...... __ __ __ __........ __ __ __........ __.................... ___.... __.. __ __ ___ ____ ____ _______ __.. .------------------------------------------------------..-----------.-------.....---.-.-...-..-------.---.----------..-..-.--.--....-...-----.-----...---.------..-----------.--.- ~._---..._-------.__._----.._-----------------_.-----------..---..--------.--.---..-------.-------------------.-----------.-------------.-----------------...----------------.----- - - - -- - - - - - --- - - - -- -- -- - --- - -- --.- - --- - - -- - - -- - - -- - - -- -- -- -. -- - - -. - --- - - .-- - -. - - -- -- ---- _.- - - - - - - - -- - -- - - -- - - - - - - - - - - -- - - - -- - - - - - - - - --- - - -- -- -- - - -- - - --- - -- -- --- -- -- ---- - -- - - -- --- - - - -- - - - -- --- - -- -- -- -. - - -- --- - - --- - -- -- - - - - -- - - --- ---- ---- -..- -- - - --- - - - -- __A - - __ - - __ - - - - - _. - - - - - - - __ __ - - - - __ - - __ - - __ - - - - __ __ - __ __ - __ - ___ - - __ __ ___ ____ _.__ - __ - ___ - ___ __ __ __ _____ -- - - -- - - - - - ---.- -- -- -- -- -- - -- -- -. - - -- - - -- -- --- - - - - - -- - - -- -- - - - - - - - - -- - - -- - - - - - - --- - -- - -.. - ~ - - - - - - - - - - - - - - - - - - - - - - -- - -- - - -- - - - - - - - - - - - -- - - -- - - -- - -. -- -- - - - - -- --- ---- -.. -. -- -. ----- - - - -- - - -- - - -- - - -- - - - - -- -- -- --- -- -- - -- -- -- - - --- - - - - - -- - - -- - - - - - - - - - - -- - - -- - - -. - - -- -.. -- - -. - - - - - - - - - - - - - - - - - - - -- - - -- -- --- -- -- --- - - -- - - -- - - -- - - - - - -.-- __A - - _.. ____A ___ - ___ _._. _.___. -----------------------------------.---.------.---------.------.------------.----------. ---------------------------------------------------------------------------------------- ----------------------------.-.-.------------------------------------------------------- - -------------------------------------------------------------------.-------.----------- ---------------------------------------------------------------------------------------- ----------------------------------------------------.----------------------------------- ------------------------------..------.-----------------------------------------.------- ---------------------------------------------------------------------------------------- - - - -- - - - -- - -- - - -. - -- -- - --- --- - - - -. - -. -- -- -- --- -.. - - - -- -. -- -- -- -- - - - -- - - -- - - -- - - - - - - - - - - - - - - -- - - -- - - -- - - - -- - - - - - -- - - -- - -- -- - -- - - - - - --- - - -- - - --- ---- - -- - - -- -- __A ___A - ___ - ___ ____ __ -- --- ---------- ---- ------------------------------------------ ---------- ------- ---------- - --------- -------------------------------~------_._----------_.--------.---.-.------..--. --._------ --------..------.----.---.--------.--.---.----------.--- - ------_._--------~--- --------. -.-------- ---- ---.--------.-.--------- ---.-.--------.---.------.--------------- --._-- ----. --------.-------------------------- ------- -------- ---.--------- -------------- .. -- ------- ------_._-----~-._-._oo_-----._-- .___._______.___________ ____.___ __._ __._______ ..----oo--------.---.-..--------------.--------..------__._________.________.____._____...________________________oo____.__.____oo______________________.oo_________.._.____..___.____. .. - -. -- - -oo - - _.. __ __ - - __ - - ____ - __ - - - - - __ - __ _. _. - - ____ ___ __oo_ - - - - _. _... - - - - __ __ - __ - _.._ - - - __ - __ _. - - - - - - - - ___ __ - - - ___.._ - - - __ - - __ - - __. - - - - - - - - - - - - - __ - - - _. ._.. - - __ __ - - - __ _. - __ - - ___ - _. - ___ -----.--------.----------.--------.---------------------------------------------------------------.-.-.----------.--------------------------------------------------------------- Owner's Signature ___n_______. __ ____________n_ _____n_ _______________ ______. By .__ n__._._n_ _ 00__._.__.__ ____ ________n_ __n______n___________ _____ _ ____. His Authorized Agent Building Inspector ----------------~<___94?__.~------.--.----n------n--n---__.____00___ 4n By ._ ____ _uu _._ __Uu __. uu __u_ u_ _ ___. __ n n':)"u U _ _ ____ n_ _ ____ _ __ _ _._ _ _ _. _ _ __ _ _.____ ~DF