HomeMy WebLinkAboutCAMBRIAN AVE. N., 309
e PERMIT e
CITY OF BREMERTON BUILDING DEPARTMENT
PHONE: 478-5281
JOB ADDRESS
3 tJ 1 IV, [, A ;t.../l IS 121 A/AJ
OWNER J MAIL ADDRESS
uJ 1 ,( Iv I~ 4- 3 cf8 /-I t? AD A-
CONTRACTOR MAIL ADDRESS
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ZIP
PHONE
LA-,vd
PHONE
LICENSE NO.
Class of work: 0 NEW
o ADDITION
~ ALTERATION
o REPAIR
D 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._ LPG. _) Oil_ 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 ~ ~O
Under 100,000_ Over 100,000_ WATER HEATER
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_ 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 .< DO
AIR HANDLING UNIT CFM_ BTU_ POST & BEAM
FANS Exhaus~ Supply_ Bath_ S ~O
RANGE HOOD Residential_ Comm._ PERMIT $
CLOTHES DRYER Res._ Comm._ TOTAL $ 14- 00
Incinerator NOTICE
ALTERATION TO DUCT SYSTEM THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
Heating/Cooling_ Exhaus~ 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
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
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 $ SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY
OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOR-
MANCE OF CONSTRUCTION.
(SEE OTHER SIDE)
RECEIPT NO.
PERMIT NO.
-"N~
FINAL APPROVAL
(White-ORIGINAL, Yellow-INSPECTOR, Pink-APPLICANT)
BUILDING "ERMIT
, N!
5605 AI
~/
City of Bremerton, Washington
Phone: (206) 478-5281
OWNER'S VALUE
BLDG. DEPT. VALUE
PLAN CHECK FEE
RECEIPT NO.
PERMIT FEE RECEIPT NO.
$ 1?4.J33- 7;. t)
/62 ~oJ- 3-og~...
DATE
$ / &Jt)t; , tf!.!!.. $
SITE ADDRESS! LOCATION '1 t:) f
OWNER'S NAMEh /&~'f
CONTRACTOR ~~~~~~
ADDRESS
4/ C~N,#~,#
ADDRESS
PHONE
STATE CONTRACTOR'S L1C. #
PHONE
~ RESIDENCE
PLANNING! ZONING
o BUSINESS
o OTHER
o NEW
JP
REPAIR
o REMODEL
o ADDITION 0 DEMOLISH
o SIGNS
OCCUPANCY
STORIES
THIS PERMIT ISSUED FOR:
/l~o~ d 4.//~.p/~ ct I?~;/c:rf
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 ~ Framing ~ Plumbing 0 Electrical 0 Wallboard 0
SEPARATE PERMITS ARE REQUIRED (WHERE APPLICABLE) FOR PLUMBING, MECHANICAL AND ELECTRICAL.
FINAL ~
FOR INSPECTORS USE ONLY:
REINSPECTION:
NOT
TYPE OF INSPECTION DATE TIME APPROVED APPROVED
COMMENT
DATE
TIME
APPROVED
FINAL INSPECTION APPROVED BY
ISSUANCE OF OCCUPANCY CERTIFICATE REQUI
Building Inspector
OWNER'S SIGNATURE
BY
~"'"'
BUILDING ~~ ___________