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Home My WebLink AboutCALLOW AVE. S., 245 INSPECTION RECORD CARD CITY OF BREMERTON BUILDING DEPARTMENT 8258 ADDRESS & DIRECTIONS PERMIT NUMBER S. Callow, 245 & 247, and Rodgers, 2706 OWNER Kitsap Transit CONTRACTOR Olympic Construction PHONE PHONE 479-5680 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 -- COMMENTS: FOUNDATION INSPECTION APPROVED BY: 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-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 -- 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 FRAMING INSPECTION APPROVED BY: M MECHANICAL 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. WIR 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: ..1 - .: ~ ' t - BUILDIN PERMIT · 1\12 8258 r L City of Bremerton, Washington 98310 Phone: (206) 478-5281 Assessor's Tax Account No.: 3732-009-025-0001 Date of Application: 7/29/87 Site Address: 245. 247 S. Callow & 2706 Rodgers St. Phone No.: Owner's Name: Kitsap Transit Address: 234 Wycoff Applicant: DOwner o Architect ~ Contract~r o Tenant Architect Firm: Representative: Address: Phone: Contractor: Olympic Construction Co. Representative: John Symington Address: 3233 Chico Way NW~ Bremerton Phone: 479-5680 Contractor's License No.: OLYMPCK*241KP Exp. Date: 11/12/87 -Q... nssiElel'lsc 0' Business o Other: 0 New o Repair o RemodellAddn W Demolish 0 Duplex o Multi-Family (No. units ) o Sign o Parking Lot o Grading (cu. yds ) o Bldg. Move Nature of Work Proposed: To demolish three buildings on two lots to create parking for Kitsap Transit. Sq. Ft.: Utilities: o Water o Waste o Sewer o Septic o New o Existing [i] Storm Valuation of Materials/Labor: Plan Review Fee: Permit Fee: Surcharges: [UBC Sec. 304(b)] $ 01 $ 60.00 $~ ~O [KJ 0 State {$~ .50 x (Fee based on 2000 sf x $.03) Receipt No.: Receipt No.: Energy $10/$15 0 Date: Date: 7/29/87 Zone Designation: Occupancy Classification (UBC): R3 No. Stories: Minimum Req. Setbacks: Front: Side: Rear: Height: Heat Source: Comments/Conditions of Approval: Area to be cleaned of all debris within 30 days of issuedolBfpermit. ~~'-~ k" r-;:.~c h '/t;P/lJ7 ( ------~ ~ No.-' ',(\--.. -, -.... ) I I C INSPECTIONS REQUIRED: Foundation 0 Framing 0 Plumbing 0 Mechanical 0 Wallboard 0 FINAL [i] OWNER OR BUILDER SHALL CALL 478-5281 FOR ALL REQUIRED INSPECTIONS AND RECEIVE APPROVAL PRIOR TO CONTINUING WORK. SEPARATE PERMITS ARE REQUIRED (WHERE APPLICABLE) FOR PLUMBING AND MECHANICAL. All provisions of laws and ordinances governing t,his type of work will b~.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 anroth~r state or local law regulating. construction or the performance of construction. SEE AND READ NOTICE ON REVERSE. ......Signature~ V~'t#T:;t;v - Lfdk ./ Date 7/28/87 / -,'7 // ~ ~ . v Copies to: White-owner: Yellow-file; Pink-Assessor: Goldenrod-Building Stat. Code ~ BUILDING ~RMIT APPLlC!TlON ,. " City of Bremerton, Washington 98310 Phone: (206) 478-5281 Assesso"s T~ ~3'2. -DCA - 01.5 - eOO I Site Address Z. I /0 So ,~u.otJ 't '2.1010 ~e.1Iii Sit, Phone No.: Owner's Name::J( (ISM 'I ~t:T Address: '2.3~ ~ff F""l D Architect ~ Contractor D Tenant Applicant: ~4...:r Owner .. X 'fJ~1 " Architect Firm: Representative: I' - ~ Address: Phone: Contractor: OUI rn ~{~ QofOSTRl..l(!:TI ~ (jQW\ p ft,;)'-I Representative: JJ7tj -5ftiO Add'ess 321>3 Crtleo W~ /J Phone: Contractor's License No.: OJ... '1m pe.;.. ~Il.o Exp. Date: ~ Residence D Business D Other: D New D Repair D Remodel/Addn Demolish D Duplex D Multi-Family (No. units ) D Sign' D Parking Lot D Grading (cu. yds ) D Bldg. Move Nature of Work Proposed: j) .o~ -- Sq. Ft.: Z-COb Utilities: D Water D Waste D Sewer D Septic D New D Existing D Storm Valuation of Materials/Labor: Plan Review Fee: Permit Fee: Surcharges: [UBC Sec. 304(b)] ;:0' $ :lso~ ':;:)"0 $ ,3- 51 State --$t:5& c...""J ~~ -t. ~ Cy~ :;: D ~ Receipt No.: Receipt No.: Energy $10/$15 Date: Date: Zone Designation: (? ('))-.->;-..,., Occupancy Classification (UBC): No. Stories: - Setbacks: Front: Side: Rear: Height: Heat Source: Comments/Conditions of Approval: 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 requirements of the City of Bremerton will be met. "- Signature Date .J Copies to: White-owner: Yellow-file: Pink-Assessor: Goldenrod-Building Stat. Code [ I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I .1 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I CIT' OF BREMERTON, W ASHINGt,N DEPARTMENT OF PUBLIC WORKS NQ 17 , ERMIT ""'1 Date // '~ / I PLAN CHECK FEE INSURANCE PERMIT FEE , ~"(:i.' ,/"")1 f' / , , " b_J) ~... .. .,,! ~./. .~ ~/ :-../ I ')>/. I Certificate of Insurance on file: 0 Certificate Not Required: 0 / f"./ ' I APPLICANT: l' / !// / /. / C . ",' I AI" / / ~. . .I ... .j, /..' ~ ... '1 ./' ~., i Address: ) )... .J J {" /'.1 (~() i ~- ( I I I ) :/; t.' f. /,1 '" : /,. , , .' C. (1 For: .,' i . , .." ". I ..' ; / Address of Work' ,'i/l<:../ '.1 .-'/ " ......:.Phone No. :'.:~~, ('>',~ it! ,the same being: Lots Add'n., or If Metes & Bounds location at which the following is to be accomplished. '~ ./ ,f"() .:)./f 5- , ) -1 /' , Blocl< being the A PERMIT IS HEREBY ISSUED for the performance of the following: o SIDEWALK CONSTRUCTION 0 STORM SEWERS o CURB & GUTTER CONST. 0 SANITARY SEWER o STORM DETENTION 0 DRIVEWAY o EXCAVATION AND GRADING 0 USE OR OCCUPY A PUBLIC PLACE o STREET REPAIR DEPOSIT.___m...mm_. (Deposit Amount) ........~,. MOTHER ..) (>'/ ;:./"~'~ / ......., (.0' /::;::1 ", Will work require blockage of any street or alley or cut off access for any property from emergency vehicles? DYes Zf NO This permit is valid for 90 calendar days commencing with the date of this permit unless specifically called out under limitations below. This permit must be posted on the job site in a location accessible to City Employees. The Engineering Department must have 24 hours notice of the need for required inspection. An inspection must be made prior to any work co cing and after completion of the job. Phone 478-5270. ~?-\:.ME'A 0 Limitations: Work to be Completed: (Time) (Date) (Time) INSPECTION RECORD by by by by by Preliminary Preliminary Preliminary Preliminary Final . / . 1,_.:' //;~lU~/>;i;)/:I:</:/L,./ ,.;lj~:~/.: // (Signature of Appllcant) .: ,.: . / I~.. / I. (Signature of Person Issuing Permit) "-;::7' , Distribution: White - Book Pink - Cashier Yellow-File Hard Copy - Applicant I I , I I I I I I I I I I I I I I I CIT'OF BREMERTON. WASHING~N DEPARTMENT OF PUBLIC WORKS N~ >,', ~;;;- R Date 7" r,~' Cj ..,-~ s.- ) I PLAN CHECK FEE INSURANCE PERMIT FEE 5 ,,' 'I 'ff~ ,,f ",.' J" ","f , ,1 / '/" I ," ,) /' ..~' ~"I r" I Iff t. f..r" Certificate of Insurance on file: 0 Certificate Not Required: 0 i, " APPLICANT: ( '/1/ /.' I,'" C. ,. 1/ For: J 'I 7, ./,' ';' if ;~' ~/ -/>/ ,', / ':' ./ Address:' ,.J {/ i,it, (' /i:/: 'c/ /;//// Address of Work' .J '? {J (, .) ( . ,/T (', /':',-';:'/ S ".... / / /'// ;;/1,' -/ ' C ./ ...' r:' .J { ," (~-') I I ,I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I '" ;/ r.'~.//I ,/) j ',/,;;, Phone No. ,<~:f )", I /' / / .-,,, , -. ._.J (,) (., , the same being: Lots , Block / Add'n., or if Metes & Bounds location at which the following is to be accomplished. being the A PERMIT IS HEREBY ISSUED for the performance of the following: o SIDEWALK CONSTRUCTION 0 STORM SEWERS o CURB & GUTTER CONST. 0 SANITARY SEWER o STORM DETENTION 0 DRIVEWAY o EXCAVATION AND GRADING 0 USE OR OCCUPY A PUBLIC PLACE o STREET REPAIR DEPOSIL_____.mmuu (Deposit Amount) EJ OTHER ,~) ( ~,.~< t,J..,L<':" /~ ( .,."'7 .! .,;) /' Will work require blockage of any street or alley or cut off access for any property from emergency vehicles? DYes Ii1 NO .' This permit is valid for 90 calendar days commencing with the date of this permit unless specifically called out under limitations below. This permit must be posted on the job site in a location accessible to City Employees. The Engineering Department must have 24 hours notice of the need for required inspection. An inspection must be made prior to any work ~ after completion of the job. Phone 478-5270. O~ Work to be Completed: (Time) (Date) (Time) Limitations: WORK SCHEDULE Work to Commence: INSPECTION RECORD by by by by by Preliminary Preliminary Preliminary Preliminary Final _i ,,/ ;'/):'{/ I' / ,')/ /7, ,1 / (,/1 '('6'[/ ./ ~ ,., J " /,' f' i ' l :; J '. r./ l.f ( ,. . ~' ...._ '..: iI-- ,',/ t,. ...fA (Signature of Person Issuing Permit) Distribution: White - Book Pink - Cashier Yellow - File Hard Copy - Applicant BUILDING ~RMIT 6160 AI f'! City of Bremerton, Washington Phone: (206) 478-5281 ASSESSOR'S ACCOUNT #3732-009-025-0001 OWNER'S VALUE BLDG. DEPT. VALUE PLAN CHECK FEE RECEIPT NO. PERMIT FEE RECEIPT NO. DATE $ 1 200.0 $ 1 . 245 S. CALLOW 26 $20. SITE ADDRESS I LOCATION OWNER'S NAME FRANCIS BROWN ADDRESS 2745 LINDEN LANE PHONE377-3533 CONTRACTOR ARVID'S ROOFING STATE CONTRACTOR'S L1C. # ADDRESS 5821 KITSAP WAY, BREMERTON 98312 PHONE 377-6196 o RESIDENCE o BUSINESS o OTHER o NEW ~ REPAIR o REMODEL o ADDITION o FENCE OCCUPANCY o DEMOLISH o SIGNS PLANNING I ZONING STORIES THIS PERMIT ISSUED FOR: BUILT-UP ROOF ON OFFICE BUILDING TYPE M BUILDINGS NOT TO BE USED FOR HUMAN OCCUPANCY 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. INSPECTIONS REQUIRED: Foundation 0 Framing 0 Plumbing 0 Electrical 0 Wallboard 0 FINAL IX] SEPARATE PERMITS ARE REQUIRED (WHERE APPLICABLE) FOR PLUMBING, MECHANICAL AND ELECTRICAL. FOR INSPECTORS USE ONLY: REINSPECTION: NOT TYPE OF INSPECTION DATE TIME APPROVED APPROVED COMMENT DATE TIME APPROVED FINAL INSPECTION APPROVED BY Building Inspector ISSUANCE OF OCCUPANCY CERTIFICATE REQUIRED BEFORE OCCUPYING BUILDING OWNER'S SIGNATURE~~_-A' d"./>-.,.-c.- BY Authorized Agent BUILDING DEPT.~M BUILDING ~RMIT ~~ 6160 A] City of Bremerton, Washington \ ASSESSOR'S ACCOUNT #3732-009-025-0001 Phone: (206) 478-5281 OWNER'S VALUE BLDG. DEPT. VALUE PLAN CHECK FEE RECEIPT NO. PERMIT FEE RECEIPT NO. DATE $ 1.200.00 . $13.33 73426 $20.50 73426 11-29-84 SITE ADDRESS I LOCATION 245 s. CALLOW \ OWNER'S NAME FRANCIS BROWN ADDRESS 2745 LINDEN LANE PHONE377-3533 CONTRACTOR ARVID'S ROOFING STATE CONTRACTOR'S L1C. # ADDRESS 5821 KITSAP WAY, BREMERTON 98312 PHONE 377-69196 o RESIDENCE 0 BUSINESS o OTHER 0 NEW ~ REPAIR o REMODEL o ADDITION 0 DEMOLISH o FENCE 0 SIGNS OCCUPANCY STORIES PLANNING I ZONING THIS PERMIT ISSUED FOR: BUILT-UP ROOF ON OFFICE BUILDING TYPE M BUILDINGS NOT TO BE USED FOR HUMAN OCCUPANCY 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. SEPARATE PERMITS ARE REQUIRED (WHERE APPLICABLE) FOR PLUMBING, MECHANICAL AND ELECTRICAL. INSPECTIONS REQUIRED: Foundation 0 Framing 0 Plumbing 0 Electrical 0 Wallboard 0 FINAL IX] FOR INSPECTORS USE ONLY: REINSPECTION: NOT TYPE OF INSPECTION DATE TIME APPROVED APPROVED COMMENT DATE TIME APPROVED FINAL INSPECTION APPROVED BY Building Inspector ISSUANCE OF OCCUPANCY CERTIFICATE REQUIRED BEFORE OCCUPYING BUILDING OWNER'S SIGNATURE .~~~~ ~~". 00' ~ ,v :r--:;,%' /.~c:..-44- / !-~.!.-:;:>?-..,::~-;::.'-?-~i;,... BY Authorized Agent BUILDING DEPT.~Q,D -....... '\. It " '\ N<} 45467 !;'~ . 3 3 Cf If S- ://, Fee $mh......~..__.....h...._...........n.........n..............n... ReceIpt No. ................:..............n..__...................... . BUILDING PERMIT ! CITY OF BREMERTON BUILDING DEPARTMENT l F. E. IRISH, Building Inspector . ESsex 3-1411, Ext. 36 .' Owner's Value I Bldg. Dept. Value. DESCRIPTION: $ "<I'iA 013 ]Ot) ~. Block '<""VV Lot Additions Address on J ob ______._~_4j_ff"___._~___~_~\~. _.._______________ ___..____________...__._______ Date u_u7__-::___~_!____= .7:.r::.__ Building _o.______um__ X u____.______m and .__mo.m_u__ stories ____u______m_________ basement. Lot .__________.m_ x _m.mu______ Front Yard u____onu____.m_____ Rear Yard u_m.mum_____u_. Side Yard _m____._________u____ Garage _______________m_m__.m__ :OCCUPANCY PERMIT REQUIRED BEFORE OCCUPYING BUILDING '. _ Zone o..___u__.__.m__m.___.____u_u__."__ g, Ownefle:r.-!1~.~'___(3f~~bu:':'__.~k_N~.tt_W1_~. Address m_u_:-!.:__~~_~_____~.~~J~__ Phone }']!l.:_~.~ 7 Con trac:tor __. __ _. __ __ __ _ _ __ __ __. _ _ __ __u _. __ _ _ _. _ _. _ _ _ _ _ _ _ _. _ _. _ _ _ _ _ _ __ _ _ _ _.. _. Address _ __ __ _ _ __' _ __. __. _. __ u _ __. __ __ __ _ _ __ _ ___ __. Phone . _ _ _ __ _ _ __ __ _ _ ___ This Permit is issued. for: ~,(,,4bvJ ~ () 11<:' "" - - - - -;;. ~- - "-l~'-' - - -- - h r ~-~:-.- -..-' --- -- -- .-. -- -- -- .-. --- .--- -. -.-. --. .-"'- -. -. -. --.. - -. -. --.. - -. -.' -. --.. - -. --- -- - -- --.- ---.. --. - -- -- -. -..- - - ... .-.. - --.. -... .-- -. __ - - - __. __ ___ - - __: .__--. _. - - _ij" __ - - _. - - __ __. _. - - u _ _ __ _ __ __.. _ _.__ _ ___. __. _ u __ ___ _ .___ _ . _ _.__ ___. _. _ _ _ __ _u.u___ _ __. _ _ _ _ _ __ _ _ _ __ _.. _ _ __ _ _ __. _ __ _ _. _ _. __ __ __ u __ _ _ __ _..__. ___ __ 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. f'-' O.,~i _. - - - - - - - - -.-. _ __ ~ -.- - _ _ _ __ _ __ _ _ _ _ _ __ _ _ _ _ _ _ __ __ __ _ _ _ _ _ _._ _ _ __ _ _ .__ _ _ _ _ _ __ ~ _._ _ _.. ~ 4 __.._ _ _. __ ~ ~ __ _ _ _ _ _ _ _ _. _ __ _ _ _ _ _ _ __ ~ ~ __ __ ~_ _ _.. _ _ ___ __ __ _ ____ ___ _ ____ ___ ~_ __ __ ___ _ ___ ____ ______ - - - - - - -.- - - -- -- - - - - -- - - - - - -.- - - -- - - - - - - -~.-'- -.. - - - - - - - --.. -. - - ~ - - - -- - - - -- - --- - -- - - - - - - ~-- -- - - - - - - - - -- - - -- ~- -~ - -- -- -- - ~ -- - - -- -- -~ - - - - -.. --- ----- -- -.. -- --.- - ---- - --- -.-- - --- - - -- --" - -. "", - - - _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ - _ _ _ __ _ _ _ _ _ _ _ _ _ _._ _ _ _ _ __ _ 4.. __ __ _ _ _ __ _~ __ _ _ ___ _ ___ _ __ _ _ _.. _ _ ___ .._ _ _ _ _ _ _ _ _ _ _ ~_ _ _ _ _ _.. _ _.... _ _. _ _ 4 _ _ _ _ _ _ _ _ _ _...... _ _ _... _ _ _ _. _ _ _ _.. __ _~.. _ _ _ ~ _._.. _ __ _ ~ __. _ __ _ _ __ __.._ -..- Owner's Signa ture_{1?~?J___7Ut1t0!rt1.:-J:~- __ ..____ By __u_._ ___ _..___.._.. __ __.u __.___.._____._____._____. __.._ __ __ _._ __.__u____ c:;:f His AUJhorized AgenJ __ "' Building In,pee;; -~4;~;>:i~;;:::::::-::-::-::-::-:::::::::--::::::::: ,'. . .......-r-~.~...;.,= ::-_~.--" --:~~CI~-- ,. \) ~ /' r- (I I ~ .(; "\ VJ I i , j~~. , .. - (- - C> ~ ~ ~\ - /(OP?.€J!.S IJ--v~ --....-.....-- ------ /// /' / /,' ,// ~. ) , , , 1 \ i' I~ I I, I " I .,.../ . / --" -?'N R ?/~flrJ sng r---,\ \. .' '~ .......--" ,~" . \1 Ii .( i / / / / ~~ ~S\ ~ ~" ~ ~ - I il -"- ,1.'0 ~ \ , 67 ~ I,J"\. :J> )- )- \3"\ '<. 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