HomeMy WebLinkAboutCAMBRIAN AVE. N., 1519
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER
DATE ISSUED:
286 Fourth St. Bremerton, WA 98337
(360) 478-5275 Fax: (360) 478-5278
3774-005-010-0005
BORSETH SHANE L
BORSETH SHANE L
KITSAP LUMBER & HARDWARE INC
ZONING:
PHONE:
PHONE:
PHONE:
)479-4414
SITE ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
1519 N CAMBRIAN AVE
618 CONIFER DR NE
618 CONIFER DR NE
450 NATIONAL AVE
ASSESSOR NUMBER:
APPLICANT NAME:
OWNER NAME:
CONTRACTOR:
LENDER NAME:
SF-3
SUBMITTED:
11/14/2003
APP.
EXPIRATION:
05/12/2004
VALUATION:
Mechanical Fixture Fee
$68.95 2215
INSTALL A NEW GAS FURNACE INSTALL 2 GAS PIPING STUBS & 1 GAS
WATER HEATER
Building Code Edition:
Occupancy Group:
Type of Construction:
Flood Zone:
Setbacks:
Sanitation Method:
Number of Bedrooms:
TOTAL FEES:
Inspection Requests
DCD: Building Inspections
L&I: Department of Labor and Industries
(360) 473-5870
(360) 415-4000
Fire Inspections
HID: Bremerton, Kitsap County Health District
PW: Department of Public Works
(360) 473-5380
(360) 337-5285
(360) 473-5270
This permit shall become null and void if the building or work described and authorized by this permit has not commenced within 180 days from the date of issuance, or if this building or
work is suspended or abandoned at any time after the work is commenced for a period of 180 days. Obtaining inspections at intervals not exceeding 180 days identifies that work has not
been suspended. 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 provisions of any State or localloaw regulating
construction or the performance of the construction. If listing the owner as general contractor, I certify that I am exempt from the requirements of the State Contractor's Registration Law
under Section 3, Chapter 126, Laws of 1967. Ali revisions to an approved plan require DCD review and approval prior to performing work. All building and tenant occupancy permits are
required to pass final inspection prior to permit expiration and obtain a certificate of occupancy prior to use or occupancy.
PRINTED NAME:
DATE: JfJ
,
11.- /C/.- 0 ~
CONDITIONS
City of Bremerton's approval of this application pertains only to the City's regulatory jurisdiction, and thus compliance with City
regulations does not necessarily ensure compliance with federal or state laws.
1. Prior to performing any renovation or demolition work, puget Sound Clean Air Agency (Clean Air Agency) and
Washington Department of Labor and Industries (L&I) regulations require an asbestos survey be performed to
determine whether there are asbestos-containing materials in the work area or structure. The asbestos survey must
be conducted by and EPA-certified (AHERA) building inspector (except renovation or owner-occupied single family
residences ).
2. For more information, please contact Clean Air Agency through their web site at www.cleanair.org or by phone at
800-552-3565 or 206-689-4058. The L&I web site can be found at www.lni.wa.gov/p-ts/asbestos/asbestos.htm.
#
#
Page 1 of 2
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER
DATE ISSUED:
286 Fourth SI. Bremerton, WA 98337
(360) 478-5275 Fax: (360) 478-5278
ASSESSOR NUMBER: 3774-005-010-0005 ZONING: SF-3
APPLICANT NAME: BORSETH SHANE L PHONE:
OWNER NAME: BORSETH SHANE L PHONE:
CONTRACTOR: KITSAP LUMBER & HARDWARE INC PHONE: ( )479-4414
LENDER NAME: PHONE:
SUBMITTED: 11/14/2003 APPROVED: 11/14/2003
SITE ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
1519 N CAMBRIAN AVE
618 CONIFER DR NE
618 CONIFER DR NE
450 NATIONAL AVE
EXPIRATION:
05/12/2004
MINIMUM INSPECTIONS REQUIRED
Inspection requests must be received by 8:00am in order to be scheduled for same day. To request an inspection, please call (360) 478-5275 and be
sure to provide your permit number, name on permit, site address, contact phone number, and inspection type.
Mechanical
Plumbing Rough-In
Final Inspection - Building
Qty
Description
FIXTURE LIST
Qty
1
2
1
Descriptior
Gas Water Heater Vent & Combustion Air
Gaspipe System LPG/NA TL/OIL
Natural Gas Furnace +/- Ducting
Page 2 of 2
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
Receipt Number:
286 Fourth St. Bremerton, WA 98337
(360) 473-5275 Fax: (360) 473-5278
8803 00695
Mechanical Fixture Fee
1/2215
$ 68.95
Total:
$ 68.95
$ 68.95
$0.00
Total:
$ 68.95
$ 68.95
CASH
Page 1 of 1
[--select Area-- iJ'" Help
-~--------_._,,,,,, Document
An Initiative of
the Kitsap
County
Land
Information
System
Kitsap County Parcel Search Map
Kitsap County Parcel Search
"-L....-l__.J
-r----:-, r-j,j--l ....
I j l---1! I I ~--JI )
I . i It--'--, i Ii I
1-----,-1 ~ ! ~-_.uJ :~ J Ii
-I II ~_._~L-I 'II ! !~~lsearCh
I ' ! - .1 'T ~
) Ir------j'll1'--1 ! ax ~
fl' II ).--1 ~I---'Il~; j i I AI ccount: . f
! -i ! ! I' j !
r f r I ~ -1 Ie- IL I .________...____J
1'1............,...."-.. -- ....11 ---I t--'- -~ I --~( Address:
1,{~4 i I I' I
II r1!;j}---{ _ f----H-! Street No:
I li~:j 11----.1! "\-.-11 !
J !'.'~{l. .11. !! II I ___...__________...___-1
j .1;~L(,--<---.--'1 r--------i r-.---'......J, Street'
I 1.......,.k....''''.........'J-....._--j', I I,' ill I' '.
J._...... ,:~{l I I I ill
'-_ II 1 J' II -------.---~
-''--~! i 11'---1 I II' I Note: Do NOT enter St:eet Direction
l II I ~........ I 1 (E,W,N,S) or Street SuffiX (St., Ave.,
tr~<_.<; . , ---., .'~5W'$~~;'fiSr--j Blvd" etc.). A list of potential matches
-'"'' ._.--.<'.,.".,~.>.., will be displayed,
-1 r~--ir-----:-'~'I' 'll;~~rr. '.1'
-.----' i II I"
II I Il--'-'-i' ..'----1_
~~~lk6g~'ii!ioo;_~i ~~ I I ; Show Imagery
Pan
Show Land
10:
Page 1 of 1
o
... GIS Home
Ill- Assessor
II> Auditor
ill' Community
Development
~ Public
Works
I!I' Treasurer
ill' Related
Links
... Comments
o
Please Note:
. Copyright Kitsap County
002
. By law this information may
not be used for commercial
purposes,
. THIS MAP IS NOT A
SUBSTITUTE FOR FiELD
SU RVEY ,
'Imagery proviMe
Imaging 2001 fI "
(Imagery tolerance is
plus/minus nine feet)
http://kcwppub3,co,kitsap.wa,us/website/parcelsearch/presentation/chameleon/map,asp?C.., 11/14/2003
Kitsap County Assessor's Property Report
Property Report
Tax Account No. Process No.
13774-005-010-0005 1/1449347
Property Class: 1111- Single family residence
-~
Parcel Information
- ~
Tax Code Area:
Jurisdiction:
Sec- Twp-Rng:
Neighborhood:
Last Inspected:
10010
IBREMERTON
115 24N IE
17100541
108-oCT -02
Taxpayer Information
~-
Name:
Mailing
Address:
IBORSETH SHANE L
Page 1 of 1
Situs Address
111519 N CAMBRIAN AVE
--- ~
1# of Buildings:
I Acres:
I Zoning:
I Account Status:
I
-~
.-
-
-
IlwA
1198311
11
1.1
ICity
IA - Active
-- ~- ._~
-
1618 CONIFER DR NE
IBREMERTON
II
http://kcwppub2.co.kitsap.wa.us/pls/ilisw/lis.online Jis _info _pkg.acctjnfo?p jn JP _ acct... 11/14/2003
'D,s"\ k>
s-C: - ~
...........................::::...:....:::................;::.........:.....'...11111.;;.;.;.:...;;;:............:.......:::..:.:...:;.....:::..:........t.:......:.....
B 8D3 DOC::. C(~
D..:...::.ll.:.:l:..:..::l::..::...:.:.....:.:.~IIJ..:.:.::.......::........:...:..::..::.:....0..:......:..;;.::.::..:.....i.:....::I:.........:.:_li__~:.:........:..:......:I..:..............:..:...l....:...~
o. APPLICANT: C$1 OWNER D CONTRACrOR .cO OTHER:.
COMMENTS:
SITE ADDRESS: "Is I <1. N . C~W\ ~(?;'(\N-C .co. 3f7..'I- 005'-0.' D-Q)6S-..
. - -
OWNER: ~Skf\vJ fL. ~oR SEldAD~RESS: .- 0
CONTRACTOR: KvtsA(J Lv ty\~ . ADDRESS:
CONTRACTOR LICENSE # . K' \7\<5,4 L ~b ~I~TION DATE:
OWNERPHONE# (3(,,0) (..:;"0 - 77/7 CONTRACTOR PHONE #
12-/?,1 b3 .
I' 0 .
)(,04 74Lf If(tf'
NttlM .............mY1?;g(jIr1!~JillPM1tNrrr..... ..PEE ..:.:SQ~:.: :..::.::::.:::;::::.I:..:::I.:.::;:..~~lgle..~~...:...;......::.....::..;::.1:...:::.. ..o~mr.
..................... .".. . . . . .........-............ /t~ :.;: :_: . :ft ..... ...
uu.................. . .."... ... _ .,... .....................
..-....."..."......,...."..............,....".. ".-. .".. ..... .".-' -.... -, .", ,'... '." --. .', .........................................-.... ..... . ..
..... - .. ...
::~:~:~:~:~:f~:~:~:~:::~:}~:~;::~:~:~;~::._.}:...:::...::::...::.}:...:::.:.:...:{::...:...:..::'-.::..:::..:...::....:::-..:......::...:..:..:::...:t..:~:}}~:~:~r:~:~:~:~:~:~:~:~:::~:~:::: ..... ...
;:;=;:::: ..:' '.. . <:;:::
.....-....---...... ...................
. -.. -.......... - -.
RANGE . WATER CLOSET
WOOD/PELLET STOVE BATHTUB -
{f' GAS FURNACE htu I: pq~o~:L l/o~ LAVATORY
'-'" CONVERSION BURNER htu I: SHOWER
UNIT HEATER htu I: KITCHEN SINK
BOILER htu I: ... DISHWASHER
..-
r'J.A GAS PIPING -=-=- LAUNDRY TRAY
'-" EVAPORATION COOLERS htus: .-. CLOTHES WASHER
AC UNIT htu I: lil WATER HEATER--- -
HEAT PUMP htus: tims: -- URINAL
REHEAT BOX htu I: DRINKING FOUNTAIN
AIR HANDLING UNIT bUI S: .. - FLOOR SINK OR DRAIN
EXHAUST FANS SLOP SINK
RANGE HOOD (residential) WATER PIPIING & ALTERATION
RANGE HOOD (commercial) GREASE TRAP/INTERCEPTOR
CLOTHES DRYER HOSE BIBBS
INCINERATOR LAWN SPRINKLER SYSTEM
DUCT ALTERATION SWIMMING POOL
TANKS type: BLDG. SEWER (mobile! moved house)
REFRIGERATION UNIT ROOF DRAINS
/" OTHER: . OTHER:
( I ) MECHANICAL PERMIT FEE $15.00 PLUMBING PERMIT FEE (15.00 or 4.50)
APPLICANT'S SIGNATURE:
MECHANICAL FEES:
PLUMBING FEES:
TOTAL FEES:
~ L_.. k ~~f\ot)
-
. .
DATE:---1(- /l-(_ 6 .~
llltEMEIITON BUIWING DEI~AlITMENT
J>lmnblllglMech<llllcnllllspectloll Iteport (f) .
2-Cc4-S PiP' ~G I u...~ ~ r'"
Scope ofworl{: ::tflSrfiLL l (;~S~u nltJ.l4-Ct:. Penult Nwuber: . BE D~ COloq~
Address! /5/7' AJ CM-VV1t3J?IA-tJ Owner: gcJleS'e- f-h Sltp:jfvc- I"
Contractor: tv I-s~P LtAM b e.vc- l}hone: 3(;,0- 47 9- ~/.'/
v ./,
Umler leH (lOr~~0J--'!inu~~) Propcr siz.ing & sU}'jJOrt
12" H1_i~l~n Ix:lo~~~: whct., unJc:rti!ouml C<?~_t~!Wr;tI'IX;(1 whcn IlnJcl1;rowlJ or wiLhih 6" of earth
Ground-joint Ilniom I'rohibiled in cc:ruinlOClliom HlIshill~' not "Hawnl in wllcc::tk,l :lrC"S
GAS PIPING
M:tllufacturcr's..!!'ecilio.u-':?'Cl O!! site LoaUOIl, a=s, mpE.ort
CIc:t...n<.x: to wlIILuslihks Ve~llinJ;: ckuancc to wllIbuslilJb
Velll si:Li_I~~~_:lUpporU wllllCctiom Vent lermillalioll
Combustion "ir Chillll..!9': liner alldJor scpu:tle OUt3;U required
G:t.'l shul-offwitltill 3' Pi_lol e\cval<<l off f_'oor i!, g:Jrage
--,---
Ducts: siJ.(: & mpl'oruimulaled when rcquire<l lklurn air
COMMENTS:
FURNACE APPROVED:
MISC. AltltLIANCES
M:t.llubcturer'~ spccific.:ttions 011 sile Loc.:tt}OIl. ac<<:::'lS, sUEl'orr
Cku:lIlce to wmLustilJ1es ~~I!.,!.~.~!;Ulce to wmhllslihks
Vent si1.i\l(; & supporuwllncctions
Vent Icrmilulioll
ComlJuslion air Chimney: 1~K:r al\{lJor scl'uate nUd a..!l rCfl'UrcJ
G"-'l shut-off within 3' WOO4l stave & fi~I:t~: pro(}Ct" LC:Jrtll
\VooJ ~tav~: EPA 21'r.rovcd Gas log~: s:t!cty ~hut-{)ff
W()()(lstovo &firel'bCC8: lighl filling doors Gas slll\l-off within 3' .
. ",'.,
COMMENTS:
&~
.{i~(J~ !ltP/
f/- tq-65 1J
MISC. APPLIANCES APPROVED:
WATEIl DHA1'EIl
Mallllraclurcr'~ Sj><:cificaliolU on site
Ckuallcc 10 wmlmsribks
Venl Siz.ill & 8U IOrU conoectiorCl
Combuslion :tir
GB shut-off within 3'
Gate yalve on wl,l W:JlCr ~uffly
Co ) )er to g"lV3niz.eJ cormoctiolll
&islI1ic stT'" ---
Loc:l.tiOIl, a=s, su )otl
Velll~: cbuncc to conrhustiLks
Vent lerrnilulion
CIJnmey: liner lmJior 8Cp:antc flues :I.lJ fe<}uire<l
Pilot ckvaleJ off floor in ':tr:l e
Ildie(Yalve dr:ur)C(1 to outside
Unions 011 water pi~
COMMENTS:
~> "
ALL \VOlt)i UNDElt TillS l'mtl\U'.' AI).)Il.OV
WATER HEATER AI)PROVED:
/~
,y
'.
eY-f~ ~
'. ....-"'..
...,~/
IBlRlEMERTON PERMIT CENTER
286 4th Street~ Bremerton~ WA 98337
Phone: (360) 478-5275 FAX: (360) 478-5278
BUILDING PERMIT
Job Addr~ 1519 N CAMBRIAN AVE
Location:
Parcel No~ 3774005-010-0005
Permit No: 03-0196
Status: ISSUED
Applied: 04/22/2003
Issued: 05/13/2003
Expires: 11/09/2003
Applicant: BORSETH SHANE L 360-620-7717
618 CONIFER OR NE BREMER TON WA 98311
Owner: BORSETH SHANE L 360-620-7717
618 CONIFER OR NE BREMERTON WA 98311
Contractor: SELF
Lie #: SELF Exp:
Subcontr:
Oesc: PORCH ADON, NEW SIDING, NEW ROOF ON RESIDENCE
Vi; ~.........,
**~~~*********~********~**~***'****************~***********************~**********************
Valuation * Permit Fees: 181.25 Total Calculated Fee: 484.81
10,000.00 . Plan Check Fees: 117.81 Additional Fees: .00
* Other Fees: 185.75 Total Permit Fee: 484.81
*******************************:K*****************************.*.**.******.*****......*..**...
MECHANICAL/PLUMBING FIXTURES--
*.***.*..***.**..**....*...*..****.**.************..***.*****~****************************..*
This permit shall becOMe null aid void if the rnJildi\19 01' work authoYi~ed by this peymit is not commenced within
180 days from the da,te of such permit, o~- if this buildill9 01' woyk authodzed by such permit is $uspended 01'
abandoned at any time aftey the woyk is commenced for a period of 180 days.
NOTICE - It is the responsibility of the peymH holdeI', not the City of Byemerton or Buildill9 Official to see
to it t.hat requiyed inspections an~ made. The peymit holder 11ll.J.St. notify t.he Building Official when read>' '1'01'
inspections. Failuy'e of the peymit holdeI' to notify the Buildill9 Official of ye-qui red inspections may result
in the stoppage of the wo~'k until such time that the permit holder can substantiate to the building official
that the concealed woyk meets or exceeds code yequirements. Any demolition, t.esting, or financial burden shall
be 'borne diyectl>' by the peymit holder. Failure '1:.0 substantiate code yequiYement.s will indemnify the City
against any and all responsibility 01' liability connected with the consh'uction.
p~ ~,
~~)
,':';.~ ~;.;:~ ',\ ""'; .
..~,', . "'1
!\\!t:.~' : BREMElRTON PERMIT CENTER
286 4th Streetg Bremerton~ WA 98337
Phone: (360) 478-5275 FAX: (360) 478-5278
e___~; r~
Job Address: 1519 N CAMBRIAN AVE
Location:
Assr Acct No: 3774005-010-0005
Building Permit No: 03-0196
Status: ISSUED
Issued: 05/13/2003
Expires: 11/09/2003
R E QUI RED
INS P E C T ION S
Item: 01100 FOUNDATION-FOOTINGS
Item:. 01200 FOUNDATION--WALLS
Item: 01700 FRAMING
Item: 01900 SHEETROCK NAILING
Item: 02700 FINAL--BLDG
Dept: 8LDG
Dept: 8LDG
Dept: BLDG
Dept: BLDG
Dept: BLDG
Division:
Division:
Division:
Division:
Division:
*********************************************************************************
TESTING: Must be recognized by the Washington Association of Building Officials
SPECINSP: Must be registered with the Stat.e of WA
5T OF WA: State of WA Dept. of Labor and Industries 478-4921
HEALTH: Bremerton/Kits~p Health District 478-5235
>>
ALL INSPECTIONS PERFORMED BY THE CITY OF BREMERTON MUST BE SCHEDULED THROUGH THE.
PERMIT CENTEe. (360) 478-5275. .
************,*********************- *********************************************
Permit Ho r 's /J ~ r / J
SIgnature:. _.__._~_ t:.~..___ Date:~_::"_ :::::> - 03
/
../
'.,
-:l.l'
2., f-r I C'~.~
"'"
{; ',':1:\
. ' $if!
~~ " tJ~ll
......w . ..,IL /f:!!1'
"qm.\: _Yl-__ ..~
""''''..,
====~==~~~=====~~=========~================:=====~======:===~===~====~==~=~~=
BREMERTON PERMIT CENTER
PERMIT CONDITIONS
Permit No: 03-0196
Page:
1
===~====~====~~~=~~========================:=============::===:===============
Job Address: 1519 N CAMBRIAN AVE
Assr Acct No: 3774005-01&-0005
Location:
Applied: 04/22/2003
Approved: 05/13/2003
Issued: 05/13/2003
Applicant: BORSETH SHANE L
Owner: BORSETH SHANE L
Contractor: SELF
Description:
PORCH ADDN, NEW SIDING, NEW ROOF ON RESIDENCE
Conditions:
1 .
APPROVED PLANS, SITE PLAN AND PERMIT MUST BE ON SITE AND
AVAILABLE FOR INSPECTION. ~
2. SMOKE DETECTORS REQUIRED IN ALL SLEEPING AREAS, ADJACENT
HALLWAYS AND FLOOR LEVELS.
3. WINDOWS IN SLEEPING AREAS MUST MEET EMERGENCY EGRESS
REQUIREMENTS.
4. PRIOR TO PERFORMING ANY RENOVATIO~ OR DEMOLITION WORK,
PUGET SOUND CLEAN AIR AGENCY (CL~N AIR AGENCY) AND
WASHINGTON DEPARTMENT OF LABOR A'ND INDUSTRIES (L&I)
REGULATIONS REQUIRE AN ASBESTOS SURVEY BE PERFORMED TO
DETERMINE WHETHER THERE ARE ASBESTOS-CONTAINING MATERIALS
IN THE WORK AREA OR STRUCTURE. THE ASBESTOS SURVEY MUST BE
CONDUCTEDBY AN EPA CERTIFIED (AHERA) BUILDING INSPECTOR
(EXCEPT RENOVATION OF OWNER-OCCUPIED SINGLE FAMILY
RESIDENCES) .
FOR MORE INFORMATION, PLEASE CONTACT CLEAN AIR AGENCY
THROUGH THEIR WEB SITE AT www.pscleanair.oTg OR BY PHONE AT
800-552-3565 OR 206-689-4058. THE L&I WEB SITE CAN BE
FOUND AT www.lni.wa.gov/wisha/p-ts/ssbestos/asbestos.htm.
5. PLAN REVIEW:
APPROVAL IS SUBJECT TO THE ITEMS SETFORTH IN THE PLAN
REVIEW LETTER DATED 5-1-03, BY ROBERT DOOBOVSKY.
~~~~;~u~~\'~&:-;~ __'
;5- /)...~....()~,.".,
De't'e cO..... " ,-,.,;..::..,.> ,;,";' ,,' , ..,.;' .
" - . ,.>>" .
.' . . ~ '
. --.....------....-------..
0"3 /' ulq~
'2v~.7
;~ ((; ~ n w ~ If)) C /lli:- ..J F 3
APR 22 2003 ~ERMIT CENTER
BREMERTON
[;U!LDlNG DEPARTMENT
Department of Community Development 'c 286 4th Street ::" Bremerton ::" W A::' 98337
(360) 478-5275 ,:- Fax (360) 478-5278
APPLICANT:
I Site Address
Building Permit Application
,gj OWNER D CONTRACTOR D AUTHORIZED AGENT
I Tax Account Number:
I
\
License #
Contact Name:
Contact Phone
)
City, State, Zip
CONTRACTOR: 0 u...:>N €
Address:
City, State, Zip
Phone #:
OWNER Name:
COMMERCIAL REPAIR
NEW MULTI-FAMILY
TENANT IMPROVEMENT
City, State, Zip
Phone #: () ') i) ')nn')
rr 00 e5 . , ~~?;l;IW
J i{ (J..o '~'3 Y BRE IERTON
NEW tO~~ERCIAL - D NEW GARA~M~gl r. ~~~~TMENr
COMMERCIAL REMODEL D NEW AC
SIGN
D STRUCTURE DEMOLITION
D GRADING (Cubic yards: _ )
or OTHER
YES 0 NO gr
~
D
D
D
D
~
NEW SINGLE-FA
NEW DUPLEX
NEW MANUFACTURED HOME
RESIDENTIAL REMODEL
RESIDENTIAL ADDITION
RESIDENTIAL REPAIR
IS THIS PROPERTY WITHIN 200 FEET OF A SHORELINE?
Scope of Work Proposed:
D
, .~5 'f.. d-- +.5 0 .
Applicatio for which no permit J i~sld"with'~ days follow g ~ date of application shall expire by limitation, and
plans and other data submitted for review mayr~ereafter be returned to the applicant or destroyed by the building official.
The building official may extend the time for action by the applicant for a period not exceeding 180 days on request by
the applicant showing the circumstances beyond the control of the applicant have prevented action from being taken, No
applicant shall be extended more than once, In order to renew action on an application after expiration, the applicant
shall resubmit plans and pay a new plan review fee,
APPLICANT'S SIGNATURE: JJAA1J2 -g~xfl.. DATE: ~ -j b - 03
.R~~~.*J.WQ*..*~*..A*...*..t~*..~.W.W.*...R~....*.R.........*.*.
li!$CEIPT
~*R.~*w~~*n**~**~*~~~k***~*~***A***~R.~*.*_Wh**~*~*~****.*~*.A*~
~CZ:;:1"T l';'.mher: O;;,OOOB8 .1'.!J),ount: 111, C1 (~4/22:/03 :"0: ,,3
P".Y'i~'~'(:;t i'i'Etho:i: t1\; ~(jt<l t:i:-m: JOBES CASM Ini t: V!IIl
PerM t No; 0>,(>196 1,'\1'1'(1: i3!.OO Sr.J:X;PEx..MIr. 111/i:iioJCH!P
l?o.r':sl ,We: 371~:()C': -(l},O- M05
S"ie Addnv.s: 2519:N c..!l.MI:3RIAN AI!'F.
~otal F~es: 4B4,8~
Tlde k>rt.~'l';:0nt ).3,7 .In Totel Al.i, PInts: 117,81
B4\lr.mc<t'<: 31l-7,O(,
**~.UW*~~~**~..***~~**~*W*****&*_**~W*~W**~*~*~*~~W*kt*.*uu****~
16-3~5.830D (4~80j
DGliiCJr1::>tion
B'U!Lrm<<; PLl\.~ CHECK FEES
J'41.ll0unt
J:l1.81
)k';J~~.mt C'od&
~**~*.*~*t.~***I*.~**'****~..***..**r*..~...*..**..*..******...*
RFCEIP r
*Wk~****~*~********~.*<<*.*.*~*%*~****t~*I****~*****.****~*~**~**
PLCE.JP'1 NumtH:T: 03000421 {lmoun't ~ 367.00 OS/L.VO':i JO: 0(;
PaYID8nt Method: CASH Notatiun: BORSETH CASH [nit: vw
PI~nui t ND ~
I'M (. el t~(~.
Sit e Addr r;.:3:~::
03-0196 lyre: SLUG
3??400b ..0.1 0- OOO!)
151~ N CAMBRIAN AVf
1 ()\ 1;11 r'('e~;:
Total. (4LL Pmts:,
8a.l.ance;
BlDG PfRMIT W/MlCH/P
Thi,-; P<.<.;J'lllPilt
~j6? . 00
484.Rl.
413<<1 .131
.00
l*****.***~**.*~~******.**~.*~*~****S*****~***.'.**.**.**~*.**.*
:0":(:()llnt Cod.:' D,-1'~~cr ilJl ion Hmount
10" 322.1001 (2211) BUILDING PERMIl flES 362.50
(,'n. >'31 ".13 (0;;::16) ',Hill Of W?'; SURCH{~F~GE ,f). ~)O
,
I'
ti;1
#-(}l(_C:;3
~\~'fr ~ '2_
77(17
~;f- V #'""
f"73 - 5-d 7 f?
I S-/9 j\J I C'A W\ ~e ';A.~ A v g R~n1I"If~~,
cC Ie Tt- IV \)
(V\'i
(a C-e-7
p (f;';/C' ; cfrl
o ,,~ #6s--Di9lu
\J eR)/Y' J'
fER M ,"'T:
.,..--------"----
--
../,..
)
{O) ~ ((; ~ B \Y! ~ fill
I1l1 NO V 0 4 2003 /fJJ
BREMERTOJU .
/BUiLDING DEPARTMElUT
S~'\1rSE h. Go<cSZ:T1f
~~1Xn~
O\JJl\j[~
~ /u7
\ tx
\J ~I
~~iiTi"'-:',
'" ,>, ',. ~>;,. ~ "B "i g., ~
~,..... ;!-~""""'u -".. G)'"
/.:~,,~t.' > v!, '
~ ~~.(t) .
L, .A ~1!"<lD1'''O%.~ ~'\
I. .cS' n~.,~""'. :F'Nfi,' 'e<i~n ~'l\
. ~ . ,,,,,,,il,,J .... ~.\
DEPARTMENTOFCOMMUNITYDEVELOPMENT,286>"FOURTHSTRf.ET,98337 ~s MA't1;j 1 n ~'OO.3 S'
_L- \ /
Permit # 03-0196 Applicant: Borseth Shane Job Address: 1519 N cambrl0~ () " ,
PLAN REVIEW APPROVED WITH THE FOLLOWING CONDITIONS ~e:<: 6 I a
Smoke Alarms: LY....::_L./[ ,
. Shall be interconnected 11 O-volt with battery backup, one in each bedroom, adjacent hall, and on
every floor. (U.B.C-310.9)
Foundation:
. 1st floor foundation shall be 12" below undisturbed soil (D.B.C-1806)
. The ground under the floor may be excavated to the top of the footing and no lower (D.B.C-
1806)
Insulation Requirements (over 12% Glazing)
. Walls R-21 2x6 construction
.. Ceiling R-38
. Vaulted Ceiling R-30 2x12 construction 2" air space above insulation
. Floor R-30
. Concrete floor R-I0 perimeter insulation
Egress Window
. Egress escape windows are required in basements in dwelling units and every sleeping room
below the fourth floor.
. Escape rescue windows shall have a minimum net clear opening of 5.7 sq. ft.
. The minim net clear openable height dimension shall be 24".
. The minim net clear openable width dimension shall be 20"
Code Compliance
All work performed in the City of Bremerton shall adhere to the following codes:
. 1997 UNIFORM BUILDING CODE
. 2000 UNIFORM FIRE CODE
. 2000 UNIFORM PLUMBING CODE
. 1997 UNIFORM MECHANICAL CODE
. 2001 WASHINGTON STATE ENERGY CODE
. 2000 WASHINGTON STATE VENTILATION CODE
Check for notes on approved plans
Buildin Ian review a rovalonl other ci de artments are reviewin
department when the approval or disapproval decision has been made
% 'Sf R ~'1 -:YO \l, Ji. f ,--, a/"ad ~;nderstand the above comments.
Applicani Signatu~\~ ( .// '/jtN>l1i i/Dat~ j17Jr7 I J t?3
~ u~ D
Robert Doobovsk-Y, Plans Examiner, Building Inspector. Phone (360) 478-5286 · Pager 337-3553 · Fax (360)
478-527S . e-mail Doobovskv(a)Ci.bremerton.wa.us
'/
l"
':
O~- Q (cr0
~ ((; ~ D Wl ~fu1IT CENTER
APR 22 2003 10
BREMERTON
BUILDING DEPARTMENT
Department of Community Development ::- 286 4th Street ::- Bremerton ::- 'v,'lA ::- 98337
(360) 478-5275 :;- Fax (360) 478-5278
RESIDENTIAL SITE PLAN REVIESV QUESTIONNAIRE
Permit applications are reviewed by our staff to make a preliminary detennination of the presence or
absence of unique areas on the property. To help us make this detemunation, please supply the fol1owing
infonnation with a scaled and dimensioned site Ian.
Applicant:
SkANL
sErH
Description of Proposal: Abj)/7/oA/' 7b €-'AS/ S~iJ>~ €1C'T'E-/l/P~D ~R-a~
15""1 ?' IV' eA';! iJI! ,''' tV II I .
Street Address (or street name ifno address has been assigned): ;>'?.")".. 911 > ,'J....
Tax Account Number:
Criticall:\rea Questionnaire:
1. Is there any standing or running water on the surface of the site at ANY time DYES [MNO
during the year? HYES, please describe conditions:
.
"
2. iue there wet areas on the site? If YES, please describe: DYES ~'NO
..., Is the site characterized as: o Forest D Cleared ~ Developed
.J.
4. Please give the overall slope of the parcel 5' % and the slope at the building site J2... %.
5. Is the property within 200 feet of a shoreline? o \'ES ~ NO
6. Will the proposed structure be aesthetically or functionally disruptive ~ DYES [gJ NO
slli'Tounding properties, the neighborhood or the community?
See diagram explaining the slope calculation on the back.
The applicant hereby certifies that an of the above statements and the information contained in any other
transmittals made herewith are true, and the applicant ac1mmvledges that any action taken by the City of
Brernerton based in whole or in part on this application may be reversed if it develops that any such
statement or other information contained herein is false.
~9- ~;tA _
Signature of Applicant
!i-I/;; -03
Date
~
,..
Z ~'6Bd
~.1!BlJUO!ls;:m(j'^:'\d!^g(1 UBld ;;)lT8 IBTlllgPTSdu
~
._t, "
"
{~-[~
\. '
"\(~. /f
\.../;:.....1
.~. -----
'-~~ ~ -----------
~~~ .
. ~'-~, ~ ---------
"'~ ~ \:,j'%'1
~~ biv""
'- ~ ,J 0
~ " ~
......... ~------:, ..' %0 E
~ \&D
~ );1'
" (.,) ....1 %09
\:/'U
;idOlS %Ol = 001 x Z' = l:;1:;1J 001 JO ;iJuqsTG jU1UOZTJOH
1;i8J OZ JO ;iJUUfSTG jU8p..m A
:alduLDxg '00 r t.q
IjllSd.J. dlfl 2wt.jdmnUl ualfl 'a;JWJ1S;p lvlUOZ,1.J.olf alfJ t.q
dJUVlSlP p);J,1l.J.a(\. alfl 2U;pM,1P t.q paJvln;Jlv;J S,1 adolS
UOPV/ll;J/V:J iJdOlS lUd;J.JiJa
SdJll131.t1 ~UdUIdopAda dHS
...
'.'
to.
VICINITY MAP
fD)g~~DW~/f1l
lnl APR 22 2003 ~
BREMERTON
BUILDING DEPARTMENT
/'" 6/5/
/' if flV! ;Y fI UI tf;)
~
~\
~
~
'\
~ II ~.g~CA'L E'
i I / '
; ;)..~.~l-f .5kYLI6Hr
13 I
I
t)
. 5 J-<.'v
/...ICJHT
lOT
/
-rUB ,.
SkY
LI C,HT
-'
(,' PR WAC'!' F" NC1 'o~o
~ . "m
! ;l ~'
>-.
T' I
. -J 1
"
. ;..
t
(0, r=)!~ N
-~~ I L_-__
__ m!. !._
! ~
I'
I;
>j.
I,
it
; !
TUBi
. I
--->
HOT
J___ _ ,
I i /
7.5" x.:;.5
_ . LL .
I ... :
! 3 -_._-~
r::-D nN T
I ;
I
\ '
. ....Q~L
. t .J'
UP
I
1
_n -...-------:-r
)I
~
Z
o
<:
<t
-J
.lJ/?"
t__L
. ON
.PLAN
15 I
r
I
i
I
j
i
(
~
iI
~
/i
fJ
t
t;
!i
r,
!
f:
,
i
1
1
i
f
,
.
I
..,.....
I
! S,kYL.IC;HT I
E f\ ':Ie L O' ,
} \/4.. ._~" _.5Li 0
PORe H
~
~I ~
'~l .,
,xl
d
/.---------.---.----.--.---,
5~Y i
Ll~HT i
APR 2 ~ 2003
BREMERTON
. BUILDING DEPARTMENT
I I
~x--,'"i._.S.~~k.J_~ liI_~_~_6..n
!
~
i
1
~I
.0
t
I
J.- 'i( ---
C='.' t=" \' ~ A'"T'" , /"\ I\. i
I
I
I
i
f
. I
. -~-~ ';b.l'Yl-----'-.
i .
i
I II. ;
Yo IIAR.D" $IDIN(;
Rl
o
ENCL.OSEO PORCH
FLOPR
. l'
/ _,
5 --_.
p...r.oUNDJ<lTI9N
.. '.. 'n j..L.. . --I
--..-----,
@
!__~_____~___." __._.._~.__..____________ .______~______~. __.~_ .__.u___.__
i
I ~/L('5C~LEf
I-~]
I
T ~------ - .. uu U_ _Uun__
I OpeN
I ________n__'______ - ,
I '
I ;
i
I
I
8' w t.u
lor- ~
, "Z ..
110 ' CW I
I' ; ~- II
S/All I~______j____--.LI
r- 3' ___+--) I ,
CONCREr:E
~
1~~1
OPEN
FE t}C r
b' --
L[ FT C- L ['v~L\TI ON
,
I
L_____
I
I
I
I
t
!
i
i
I
- ~ V ~-:~I::~-:=:::-: d-" "'-_=_""'1:-' A
115/1 lRJ' 0
OvE.R.HAN& x
J,O
[J
D
~'
I
i
I
I
I
I
I ________....
f---u------- I d..'--u.....-.----..-.-..-...-~ F() U N o~ T 1 c;i 1'../
RIGHT [L[VJ~1-lor\1
i
!
I
-----d
2x6 stud wall constuction
on 16" centers )
R-19 Insulation between
walls. >
"li;:;;'!:; .
:;.~
;
.,.".., '<~',.,
",,:,~!i ;;'jiS $i~~}ij.. >
y5" '"":J,~;:??: > . (, ...........,.,c
.i~~::~~,'...:~,:,i~:.,: :~~I~~;,o/0;r',:.~;, ~':'/;~ '~,;:;~~:.~;JR:.~;,:~
.;"L~5:~:... .;,..;;;;" "".,:;;;8!:~~~(~;':,;,t~
',l :-,. <" ,,: ,'i;; ,;;;::jf,~,;;:F' iri".:<;';;J,j'
'.- ,",/
1
I
.-:::r~__"
~::;'"f ';-~"'::~---. ,: "
i; , I :'~~.~~~ '~::-'~::-' . ',-'
:', I, ." I..! ~ I 1
;. f'l: .1 l' b LL "<~
II flnilill, II d Ji I,n i: '. I
i. [ r ? r 0;r?l ~~~ JI;~n' ~ ;0 ~:; Y:~~f,~,!i,f>.:
; ~ ~ ~ ;'; ~<f': r;~~0:~Y}j:f;': ~~' ; [. :. ; f~ ~ }!1 '~'~:i:iJ~g, 'J/
: .' " ~ , . ;s ;'i,' }D'11;'~i;:;R: i',; ~ "~; ir~~.,;\'
",.,;"',, ,;_,. ,;,';,';; ',. ,':0,: :"",' ,"" :"';,'
:'.: ,....... ;:~ "'..c)'](;:)':/'
'.; ...... :;,';:,<,,-',';3 ;:., , 'i.:" ,; ....;::',;.' :>,;.,
,:,/~:.:;c;, .:......... :......},..'; f~::,,'./,.
"',':'.:':';',: .,,) '..:'., . ';'c ,:".:.,'t:. ";:;" ; .
:,.,.':c:': >,:" ;.'>':~..:,.:;' ;.,:.:;:;''';,'::;:', ::,;,,;:;X.'
::.: " ,~.;. ; ,;.<c':C.'.:',:i~:~S.'-'~:~:,:;:': ';;.:/':,,~~;'~;;i:;h1j";~.:~;.;~2i":'
" '(P'. "'5":' '. ..'.;.'; . ; i,: '.' " ,'.:;i~:;;t;~~:;S,;;;:>52 ;f/:~
':c:';':/;; ,...... ,::: .........;,,:;;,,;;, ':..;:;,..:.,~ f)':,:,'F:);~:<
:;::,,> >.'''':" "c\.: ':;" ".t:.':',:';,'; 'it~":;;;;,').";;..<:,,,:.>:;:f!;' .
:{/. '..:,,", "',;:.:;.;:':::~~:; .:,<::;,:,:,~,~,;,'~; ::it';'.:;.,; .: .:..:::;:,".' :"'<.,>
>,. "..' . .... .>:> ..... .' ..'; . '''\;: ~,; "::i,::t ::",,"~:;;;'::';(;2',\::"1\;)~/~: ". J;'~:; . \ ",
'p.""'......'.'."..l,.. .
' J.
i , '
1"
1
. '
. ;'
.. ~ ::~'::. .,
~~~,~ 3,~:.....
~~.~::~~ ::""J !~z: ~'..' --:. -:::: . -
~ .::~~: '=.~ j ~ r- . ., ~-,,:~. --:':: '. .-=
~ ~' ~~':. ~.--~.. .-...~
:. --~-:~-,'~-~"^.->-' ,~. -_.~.~.,: ~\.'. !, ,,' (;~-......~ ,"':~-',-,.:,:~~
t ~,~"""..",::'
. ~.." ,-"^'Ii ,...",..,...,"! I' . , ,
;,.,_.,. (l _ ""..'~"."~"i~";
i~ :.=-.
House insua/ation raping ~
Hardy Plank siding
~
, ,
The Addition's Pre-Treated
Flooring Joits.
/
/
"
11~-8"
11 '-8"
11 '-8"
11 '-8" I
11 '-8"
11 '-8"
11':lf'
'.
::
~
~I
",
, "
I~ '"
-",
-,:--
0: C'J
.' t ...
<c ...
> a
. ...-
0:
.' 1.0
('
~
::
1.0
...-
0)
1-
/ I
/ -J'i1"--f
-
3'-0" x 6'-8"
15'-0"
6'-9"
.m.mmm..__
~/
3'-0" x 3'-0"
...
...
a
...-
"'"
12'-6" 1/
/ /1
"- I I~
I J~
fl
C\l
~
B s~
<:> -.10._
1\)-
-' ,_ C\l
C\l <:>~
~ ::~~
I <:>
-'
C\l
~
,
"- "-
I 27'-6"L 12"W 12"0
/ 12'-6" 'T'
B=10 #4 Bars
Crossed by 9
#4 Bars Wired
together and
lifted.
A- 3 #4 Bars
attached @
18" spacing
~
-.10.
I\)
,-
<:>
~
-.10.
I\)
-~
-.10.
I\)
tJ
A
~ ..' .
, .,
~~~:.,:. x;~ j.iit}/\}~ ir'i;;Jj.
~"""'~'~"<~' ~,""}:-o
. ...) . . ....~J
~J\ '.' _.~.<
"~
. -~",
..~~;~. ;
I, .
~ ~ ,
'J:'7'~1.
'. "f-'l
~l:: "4)
:~
~
"~:""--~
@ .:: .
.THE COST OF lVIN~ERIALS TO COMPI..ETE
ADDITION TO EAST SIDE OF 1519 No
CAlVIBRIAN AV BRElVIERTON WAo 98312
~
April 14, 2003
Material Expenditures: $ 2742.94
Shane Borseth
1519 N. Cambrian Av
Bremerton Wa 98312
4U'-a- P.L
r'~-~-~'-----'------~'-'--~-
\,
~
:,'--'--'15~.--.~----j
, ~J'9~~,:,~,.:.=~';," '1
W--'''''-X , ' I
- ,
~ -~ ~
'I' 1
II :~ New Addition L. -..-- ----- -,,""-- --. -~x.
I'i\
iil,' / '~-'
I .
, ---~12"'lO-----.-------- 1
'I~[ ::~)
~[
..; !
; ,!'
t. r~: i
,r---.---.",...--'it,
~13'.r---'--;-r"
!~
~:
~:
Ii
:r~
"j ;f
!...j
i~
:9
i~
oj
~ ~ '-S'f'/,v7
~vcTcJP(
i:'t
. ~
~' l
~,
~i
~
~
I
!
'1
:~
.-,",,-~
,
i
_.~._-
, --~-~~,...
:t-=r-6~====~~.~~=;~~====~~~.=-==~~
.p
~
.;
cR
. '
L___.....~
---~----_._-~-_._---_._._....:-._----~--.
<D'-il'PL
Scope of work:
Address:
Owner:
Contractor:
BREMERTON BUILDING DEPARTMENT
Inspection Report
Permit Number: · ()3 ~ () 'I q 0
~
i_ "
Phone:
Phone: 3 ((J.(J' ~dO 'f! 11
Inspection card/approved plans on site Setbacks
Footings: required steel placement Walls: required steel placement
Footings: required width & depth Walls: required size
I Bearing soil (soils analysis if applicable) Special inspector (when applicable)
FOUNDATION
COMMENTS:
FOOTINGS APPROVED:
WALLS APPROVED:
Electrical approved Plumbing & mechanical approved
Crawl space access (min. 18 x 24) Floor joists and beams/proper clearance to earth
Positive connections posts & beams Foundation vents
Posts properly supported Anchor bolts: nuts & washers in place
Mudsill: treated material Floor joists: size & span
Beams/girders: size & span Notching & drilling: joists & beams, studs
Smoke detectors: all required locations Exhaust fans: where required
Exhaust fans insulated: unconditioned space Whole house fan, outside air intakes each bedroom
Fans terminating directly outside Range hood
Dryer exhaust vent All vent terminations: windows & property line
Fireplace combustion air Windows: meets egress requirements
Windows: proper U valve Windows: safety glazed where required
Ceiling heights Stairs: headroom clearance
Stairs: rise & run; proper width Fire blocking wall to ceiliJ.lg, furred walls every 10'
Fire blocking: stairs, soffits, h?wered ceilings J ,', Fire blocking: tubs/showers"J
Fire blocking: lids in void spaces, shafts Fire blocking: stuff holes top & bottom plates
Sheet rock backing / Wall bracing
Rafters size/notching \ Trusses: specs, bracing
Attic access Attic ventilation
Wall & roof sheathing \ Shear nailing
Building dried in \
\
FRAMING
COMMENTS:
--
1-1!t~C:=>
cJK.
\
f(Jre-~
i~~ ,~J~I~
'...
APPROVED:
Insulation: proper R valve Insulation: proper fastening
Insulation: vapor barrier Bottom plates caulked to floors
Penetrations caulked as required Electrical boxes gasketed or caulked
6 mil black poly in crawl space .. ~
,. - '~ "
ENERGY CODE COMPLIANCE
COMMENTS:
UNDER FLOOR/FOUNDATION INSULATION APPROVED: ~/)
WALL INSULATION APPROVED: CEILING INSULATION APPROVED:~4' ~f tJl(
MECHANICAL
Appliance location and access, proper sUPlPort
Venting: clearance to combustibles
Vent termination
Ducts: size & support
Gas pipe size & support
Gas pipe: within 6" or underground-coated
Gas logs: safety shut-off
Wood stoves EPA certified
Wood stoves & fireplaces: proper health
Chimney liner: when required
Appliance clearance to combustibles
Venting: size & support
Combustion air
Gas pipe under test
Gas pipe: underground min. 12" below grade
Gas shutoff within 3' of appliance
Gas logs: damper permanently open
Wood stoves & fireplaces: Tight-fitting doors
Manufacturer's specs on site
Chimney: separate flues when required
COMMENTS:
GAS PIPING APPROVED:
OTHER APPLIANCES APPROVED:
FURNACE APPROVED:
DWV & water piping under test DWV: proper grade
DWV: proper sizing DWV: proper drainage frttings where required
DWV & water piping proper support DWV: required cleanouts
Vent termination All fixtures vented properly
Water supply: proper sizing Shut-off valves on all fixtures
Water heater: gate valve on cold water supply Vacuum breakers: where required
Water heater relief valve drain to outside Water heater: seismic strap
R-10 pad under water heater when required Water-piping insulated as required
Grease traps/interceptors: where required Proper indirect wastes: where required ~
~ -- (J t~
PLUMBING
COMMENTS.
S~l,r p'~M/f'
~J
fin
PLUMBING GROUNDWORK APPROVED:
PLUMBING ROUGH-IN APPROVED:
Proper fastening nails - 7" o.c. horiz. Planel Nails 8" o.c. vertical plane
Proper fastening screws 12" o.C. hortz. Plane (1/2") Screws - 12" o.C. hofiz. plane (1/2')24" o.c. framing
Proper fastening: screws -16" o.c. vert. Plane (1/2") Screws - 12" o.c. vert. plane (1/2") 24" o.c. framing
Proper fastening screws - 12" o.c. horiz. plan (5/8") Screws - 12" o.C. hortz. plane (5/8") 24" o.c. framing
Proper fastening screws - 16" o.c. vent. Plane (5/8") Screws - 12" o.c. vert. Plane (5/8") 24" o.c. framing
Area & occupancy separation walls Draftstops where required
Usable space under stairs (5/8" required) Waterboard where required (not on ceiling)
Corridors
SHEETROCK
COMMENTS:
.-..,......'
-:"---
Energy code requirements met, exhaust falns Plumbing & mechanical
Garage/dwelling door self closing solid core Smoke detectors where required
Handrails & guardrails, as required Fire ratings maintained
Exit signs when required Emergency lighting when required
Occupant load posted when applicable Building weatherlight
Wood siding to earth separation (6") Building address posted
Randon monitor when required
COMMENTS:
i
.1"-' ^ I ^ nru'''''\r'\\ I"-I''\.
.~!:S
/~-~3.8~
BUILDING Ap.lERMIT
.N~
095
AI~
City of Bremerton, Washington
Phone.: (206) 478-5281
OWNER'S VALUE
BLDG. DEPT. VALUE
PLAN CHECK FEE
$ It~
/$'/9 AJ.C~~"~/~M
Od~/'S
RECEIPT NO.
PERMIT FEE
$ ~ ~t'L
RECEIPT NO.
DATE
$:5 Soo
9
3- I~ 17
SITE ADDRESSI LOCATION
OWNER'S NAME 1./ 11"/11
ADDRESS
STATE CONTRACTOR'S L1C. #
PHONE
CONTRACTOR
11-
ADDRESS
RESIDENCE
D BUSINESS
D NEW
D REPAIR
PHONE
D REMODEL
ADDITION
PLANNING I ZONING ~ 1/
I'
FIRE ZONE
117=
",?'
.
STORIES /
dl(&.+J t^I1 f) ~
OCCUPANCY ~
~;r- ~-"'e-U.
,
THIS PERMIT ISSUED FOR:
~~~,f)~C1
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.
Plumbing J!!--
'I tf!J r
Wallboard~ FINAL -
... ~~ ~T"~r.
FOR INSPECTORS USE ONLY:
REINSPECTION:
PPROVEO NOT
TYPE OF INSPECTION DATE TIME APPROVED
COMMENT
DATE
TIME
APPROVED
FINAL INSPECTION APPROVED BY
Building Inspector
ISSUANCE OF OCCUPANCY CERTIFICATE REQUIRED BEFORE OCCUPYING BUILDIN
OWNER'S SIGNATURE
BY
BUILDING DEPT.