HomeMy WebLinkAboutCAMBRIAN AVE. N., 2120
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BREMERTON PERMIT 'CENTER
286 4th Street? Bremerton~ ~A 98337
Phone: (360) 478-5275 FAX:: (360) 478-5278
BUILDING PERMIT
;}'ob Addr:
Locat:l.on~
Parel'..d NCl~
2120 N CAMBRIAN AVE
2120 N CAMBRIAN AVE
Permit No:
St;atus~
(~PP J j ed :
Issued:
Expires:
96,",,0542
ISSUED
0I31;l.f1l1996
00/28/1996
02/;:::4/1.997
Applicant:
AMERICAN HTG SERVICE INC 539-1702
7503 B PORTLAND AVE SUITETACOMA WA 98404
O~~nel: S r. NN PAUL.
2120 N CAMBRIAN AVE 8REMERTON WA 983].2
Contractor: AMERICAN HTG SERVICE INC 539-1702 lie #= AMERIHSOB3M5 Exp= 7/25/97
7503 B PORTLAND AVE SUITETACOMA WA 98404
Subcontr:
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Case: GAS FURNACEJ GAS HWTJ GAS PIPING
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Valuation * Permit Fees: 41.70 Total Calculated Fee: 46.70
.00 * Plan Check Fees: .00 Additional Fees: .00
* Other Fees: 5.00 Total Permit Fee: 46.70
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f'lECtjANICAL/PLUMBING FIXTURES-- MECH-Gas Furnace to lOOk btu.: 1 MECH-Gas Piping (outlets)"..: 2
PL8G"':Water Heater."...,.....:
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This pellTiit shall become null and void if the building or work authorized by this permit is not commenced within
180 days;from the date of such permit I or if this building or worK authorized by such permit is suspended or
abandoneq at any time after the work is commenced for a period of 180 days.
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NOTICE - ttt is the responsibility of the permit holder, not the City of BremertOI1 or Building Official to see
to it that\requiredinspections are made. The permit holder must notify the Building Official when ready for
inspections\ Failure of the permit holder to nDtify the Building Official of required inspections may result
in the stoppage of the \~o'(k until such time that the permit holder can substantiate to the building official
that the concealed work meets or exceeds code requirements. Any demolition, testing, or financi'al burden shall
be borne direbtly by the permit holder. Failu'f!e to substantiate code requirements will indernnify-.the City
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against any an'd all responsibility or liability connected with the construction.
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r hereby certifx that 1 have read and examined this permit and know the same to be true and correct. All
provisions of la~s and ordinances governing this type of work will be complied with whether specified herein
or not, The gral)ting of a permit does not presume to give authority to violate or cancel the provisions of
any ot~ate :\ l~,law regulatIng co~uction ~ perfor..nce of const ruct} on ,
SignatuJ. '~.4~lj.L:k1;,/-~uM-~---- Dat.,__BA~Lq_~_________
! cert{fY that I am e'xempt frtl the re~rements of the state contractor's regiatratlon lat~, under
Section 3, Chapter 126, laws of 1967.
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Si gOat ure.. /1 Dat e: _________.._____ ____-.____...._____--_
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BREMERTON PERMIT CENTER
286 4th Street fI Bremer-ton", MI:} 98337
Phone:: (360) 478-5275 FAX:: (360) 478-5278
Job Address: 2120 N CAM8RIAN AVE
location: 2120 N CAM8RIAN AVE
r1f.~~H' Ace'\'; No::
Building Permit No: 96-0542
st at us: I :::;E:;UF])
Issued: 08/28/1996
Expires: 02/24/1997
'R E: I:) U I F~ E D
INS P E C T ION S
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Item::
It em :
01.400
01550
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O~:~70()
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CROSS CONf'..JE:C'T' I ON
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SPECINSP= Must be registered with the State of WA
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BLDG: City of Brsmerton Building Department 478-5275 .
PLANNING: City of Bremerton Planning Department 478-5275
PUBWDRKS= City of Bremerton Util:l.tiee Department 478-5318
FIRE: City of 8remerton Fire Marshal ~a Office 478-5380
~N~i 6ity 6f ~f@M~ftHn ~nlina0r1nQ Department 478-5270
N~ALTHI Br@merton/K1t8ap Health Depa~tment 478-5235
ST OF WAI State of WA Dept. of Labor & Industries 478-4921
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f<Fel :I ITT Nwnber:: \~6(JOO/16 Amount:: 46, /0 On/;';>fV9,~) J 0 f, 0/
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APPLICA1~T: D O\VNER ~NTRACTOR 0 OTHER:
COMMENTS: ;::;)aIllAC~ IIw- U+rtFe! MItJ.1t- .J- cJn.5 LJ/.o-E
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SITE ADDRESS: 2/ 20 Ai. CJ1111 BL /,4,.J
OWNER: PI.a. .5/NA/
ADDRESS: e?~9-/41,L(
CONTRACTOR: ,41#~g/{d-~ /~, ~LY/C€ ADDRESS: 75lJ3 r: A"?'r?ffN!) /1-/t::
CONTRACTOR LICENSE # II-t11Et.. I H.5tJ 8- ~ /J1 ~ EXPIRATION DATE: 7,/ 2. 5 ,/ 96
OWNER PHONE # '373 - 1749 CONTRACTOR PHONE # 5"3f-/ 7~Z
..NOt . ."?illYl?:E(J.EE.Q.lJI.PM~m?:d.tF.E.ENQ~E IiU:J41?fjOEFm1JRE .>I'.BEE.
RAi~GE WATER CLOSET l,...-........".~
WOOD/PELLET STOVE BATHTUB D j ~ (f;.J f2 n M'C" ~
./ GAS FURNACE btu's: a/")()()(:) LAVATORY n L:::iI \!!.J 1:51-0- TJ 15 11
CONVERSION BURNER btll ~.: I SHOWER '- ;..01
UNIT HEATER btu's: KITCHEN SINK JIDG:.? R Jqq,
BOILER btu's: DISHWASHER
".- GAS PIPING LAUNDRY TRAY ....... _ 'm.~IVIt;n I !J/V
EVAPORATION COOLERS btu's: CLOTHES WASHER I1U,J."JJJllU rJff;fARn~ENl
AC UNIT btu's: ./ WATER HEATER
HEAT PUMP btu's: tons: URINAL
REHEAT BOX btu's: DRINKIN G FOUNTAIN
AIR HANDLING UNIT btu's: FLOOR SINK OR DRAIN
LXHAUST FANS SLOP SINK
RAt"l'GE HOOD (residential) I 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:
MECHANICAL PERMIT FEE $15.00 PLUMBING PERMIT FEE (15.00 or 4.50)
MECHANICAL FEES:
PLUMBING FEES:
a TOTAL FEES,
APPLICANT'S SIGNATURE, .. ~7 id<!~
DATE: ~/z8f4!p
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BREMERTON BIDLDING DEPARTMENT
Plumbing/Mechanical Inspection Report
Scope of work: Gas Furnace, Gas HWT, Gas
Address: N CAMBRIAN AVE, 2120
Contractor: American Htg Service Inc
Piping Pennit Number:
Owner: SINN, PAUL
Phone: 539-1702
96-0542
GAS PIPING
U nJer Wit (I O.f:iL~~!...~~~.~...ute1l) p'rt!E_~iE..!.~ & support
12" minimum below grade when undergrol!~~ C03.~c:dJwral.pctl wl!5" ur..~erg~-':'J1d or ~dijh 6" of <:arclt
Ground-joint unions prohibited in certain locations BushinKs not allowed in concca.bl areas
COMMENTS:
GAS PIPING APPROVED:
Manufacturer's S~caciOIlS on site Locacion, ~~~rt
Ck:arance to combustibles Vencing: dearance lO combuscibles
Vent sizi!!lL & supportl conneaions Vent termination
Combustion air Chimney: Ii.nee and/or se.l.'aratc:..~ues as required
Gas shut-off within 3' Pilot elevated off floor i_~~Ufl:C:
Ducts: si:r.e & support/insulated when required Ikturn air
COMMENTS:
FURNACE APPROVED:
MISC. APPLIANCES
M~nuf!._d.ur~cifications on site Loca~on, access, support
Clearance to combustibles Venting: dearance (0 com~~sri~1es
Vent siz~~~port/ conllCctions Vent termination
Combustion air Chimney: liner andloc separate flues as required
Gas shut-off within 3' Wood stove & fireplaces: p':.~rth
Wood stOVell: EPA ajlproved Gas logs: saf~hl1t-oLT
Wood stoVe1l & fireplaces: ti..s.ht fitting Joors Gas shut-olT within 3'
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COMMENTS:
MISC. APPliANCES APPROVED:
Manufacturer's specifications on site Location, access, support
Clearance to combustibles Venti~ dea.rancc to combustibles
Vent siu'.lf; & support/conneaions Vent termination
Combuscion air Chimney: liner and/or separate flues as required
Gas shut-oLT within 3' Pilot elevated off floor in g~e
Gate valve on cold warer supply Iklief valve drained to outside
Copper to Ralvanized. COnnecriOIlS Unions on warer pipes
Seismic strap
WATER BEATER
COMMENTS:
WATER HEATER APPROVED:
ALL WORK UNDER THIS PERMIT APPROVED:
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BREMERTON PERMIT CENTER
286 4th Street t1 Bremer-tong lJA 9833.7
Phone: (360) 478-5275 FAX: (360) 478-5278
BU I LD I NG PERl'lI T
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Job Addl': 2h~?O N C~lMBRIAN AVE
i Location: 2120 N CAMBRIAN AVE
(Parcel No: 1024014-067-2007
(
PE:rm it No;
Status:
';;6-,,04;>,7
ISSUED
07/16/1996
08/27/1996
02;;'.3/19fn
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\App 1. 1. ca nt: BOMAN CONST a73-:30()~-3
, I 3207 RIDGEVIEW DR NE BREMERTON WA 98310
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~ontractor: BOMAN CONST 373-3003 Lie 1= BOMANC*099KG Exp: 7/12/97
3207 RIDGEVIEW DR NE BREMERTON WA 98310
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I Oese: ADDN T' ES. (EXTENDING 8EOROOM~ ADD BATHROOM) _
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f ,,_. Vi':dtli:iU /"'* Permit Fee:!s: 321.15 Total Calculated FeE::: 51O,m:'l'\
;e,,/ 25,00 if Plan Check '1:;':t~(ef3:'"".. 180.18 Addi.tionalFees: .()()
* Other Fees~ -~. 9.50 Total Permit Fee: 510.88
*~~~ **********************************************************************************
ICAL/PLUMBING FIXTURES-- MECH-Exhauet Fans.,.."..".,: 1 PlBG-Water Closet...........,: 1
PLBG-ShowElr . . . . . , . . . . . , . . . , . , : 1
Applied:
lssued~
Expires;;
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Owner: SINN PAUL C
2120 N CAMBRIAN AVE BREMERTON WA 98312
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This permit shall become null and void if the building or work authorized by this permit is not: commenced within
: 180 days from the date of such permit, or if this building or work authorized by such permit is suspended or
;'abandoned at any time after the l~ork is commenced for a period of 180 days.
i~TItE - It is the responsibility of the permit holder I not the City of Bremerton or Building Official toase
i~O it that required inspections are made. The permit holder must notify the Building Official when ready for
:~nspections. Failure of the permit holder to notify the Building Official of required inspections may result
:In the stoppage of the work until such time that the permit holder can substantiate to the building official
~that the concealed work meets or exceeds code requirements. Any demolition. testing, or financial burden shall
~be borne directly by the permit holder. Failure to substantiate code requirements will indemnify' the City
;~gainst any and all responsibility or liability connected with the construction.
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YI hereby certify that I have read and examined this permit and know the same to be true and correct. All
:~rovisions of laws and ordinances governing this type of work will be complied with whether specified herein
~~r not. The granting of a permit does not presume to give authority to violate or cancel the prOVisions of
l~ny' other ata~~~c,r-laJl regulating construction or the performance of construction.
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jSi gnat ure: ~__~,_,_::::_:::.:_______:::,"~==___________ Date: ____~__:_?!:.~_:__..~_f:::.______
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tI certify that-'r am exempt from the requirements of the state contractor's registration law, under
fSection 39 Chapter 126, laws of 1967.
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Si ghature: _______________~..~_________________,______..________ Oat e: ________._______________________
***************************
Pem:l t Cent er ""'.flpproved By: .""."".._"..",.."....".........~" Dat; e:... "d..... ......_._........" ".._.".._
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i, Permit No: 96-0427
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BREMER TON PERMIT CENTER
PERMIT CONDITIONS
Par;l(:;)::
],
2120 N CAMBRIAN AVE
1. ()~:~40 14,....067'.....~:~OO?
2120 N CAMBRIAN AVE
Applied: 07'/16/1996
Approved: 08/27/1996
Issued: 08/27/1996
BOMAN CONS'r
SINN PAUL C
BOMAN CONST
ConcH t :i, cms ::
1. B U I L DIN G
A. PLANS APPROVED AS REVISED.
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BREMERTON ~ERMIT CENTER.~
:286 4th Street; Bremertoni1 WA 98337,
Phone:: (360) 478-5275 FA,X:: (360).478-5278
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Job Address: 2120 N CAMBRIAN AVE
Location: 2120 N CAMBRIAN AVE
Assr Acct No~ 1024014-067-2007
Building Permit No: 96-0427
St i:1t u~!.,:: I !::;SUE:D
Issued: 08/27/1996
Expires: 02/23/1997
F~E(;;)UII~ED
INS P r C T ION S
Item: 01100 FOUNDATION-FOOTINGS
Item: 01200 FOUNDATION-WALLS
Item: 01400 MECHANICAL .
Item: 01500 PLUMBING GROUN6~ORK
Item: 01600 PLUMBING ROUGH-IN
Item: 01700 FRAMING
Item: 01800 INSULATION
Item: 01900 SHEETROCK NAILING
Item: 02700 FINAL
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BLDG: City of 8'r'emerton Building Department 478-5275
Pt..ANN I NO: C J. t y of By'emer-t on P], ann i nr;l Depa'r"t me:nt 47B....!::i~;:~7!::i
I F:jUBI,.J CH~I\ S :: C :I. t y 0 f B rem f.H' t em ut t 1 1. t :l.t:('H:1 D ((::If) I:n"l: m E:lT'l t 4'7 B..... !:, ::H B
F1REc ctty of Bremerton FiTe Marshal Us Office 478-5380
I' ENG:: City' of 1:~I~:~me.)y.tc)n 1::::nqtneey':!.nSl D(,~1par.tment; 471:3".,52'70
i HEAL.'rl,,'I;: 13y'emert (.:In/l\ :1. t Bi~P Hea.l t h Depart ment 47t.1.....~:)~?:J~::l
l S~ OF WA= State of WA Dept. of Labor & Industries 478-4921
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il: ~';r:mH Holder .,,-X;- L'" . . . . is - 2 7 - T'
Slgnarurs: ~ . Date: ~ .
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CITY OF BREMERTON - BUIL.,DING DEPARTMENT
478-5275 - 286 FOURTH STREET, BREMERTON, WA 98337
'INSPECTION REPORT PERMIT NO. fb-OVZ-7
I have this day inspected this structure and these premises and have. found the following violations
of City, County and/or State laws governing same:
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You are hereby notified that no more work shall be covered upon these premises until the above
~;iON;; CR;;~~;n Thi;oni-;ve b::~Em;(i?q':or re-inspeClion~
9 INSPECTOR FOR BUILDING DEPT.
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CITY OF BREMERTON - BUILDING DEPARTMENT ~- ~
INSPECTIO~8'5;~8;~;;T' BREMERTON, W:::::: NO. Q{/J'*7
, I have this day inspected this structure and these premises and have found the following violations
,Of 6)' County an~/or StttDS g,OVernin~ /;.. '1-170" 1J.(W-nIt~~
~ ~&Dt SiR \3J\a?tiJ . M ~L ~n) ()F 4faw~~
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You are hereby notifieCl that no more work shall e covered upon these pre.. i es until the above
violations are corrected. When corrections have been mad, I for re-insp . on
Do Not Remove This Tag DATE 0 '
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Scope of work:Addn to Res.
Address: N. CAMBRIAN AVE.,
Owner: SINN, PAUL C.
Contractor: BOMAN CONST.
BREMERTON BUILDING DEPARTMENT
Inspection Report
(Extending Bedroom,
Add Bathroom)
2120
Permit Number:
96-0427
Phone:
Phone: 373-3003
Inspection card/approved plans on site Setbacks
Footings: required steel placement Walls: required steel placement
Footings: required width & depth Walls: required size
Bearing soil (soils analysis if applicable) Special inspector (when applicable)
FOUNDA TION
COMMENTS:
WALLS APPROVED:
FOOTINGS 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
f-- ,
Fans terminating directly outisde 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 Firebfocking: wall to ceiling, furred walls every 10'
Fire blocking; stairs, soffits, lowered ceilin9s . Fire blocking: tubs/showers
Fire blocking: lids in void spaces, shafts Fire blocking: stuff holes top & bottom plates
Sheetrock backing Wall bracing
Rafters size/notching Trusses: specs, bracing
Attic access Attic ventilation
Wall & roof sheathing Shear nailing
Building dried in
FRAMING
COMMENTS: rN:s U
~ " tD\6\% - 5~t(<'\t~'"
APPROVED: See- /11A? ~- tYfi-. 10 ~ .<
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ENERGY CODE COMPLIANCE
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Insulation: proper R value 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
COMMENTS:
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Ay? l}l1.cE,@NG INSULATION APPROVED:
V \
WALL INSULATION APPROVED:
MECHANICAL
Appliance location and access, proper support Applianc~ clearance to combustibles
Venting: clearance to combustibles Venting: size& support
Vent termination Combustion air
Ducts: size & support Gas pipe under test
Gas pipe: size & support Gas pipe: underground min. 12" below grade
Gas pipe: within 6" or underground-coated Gas shutoff within 3' of appliance
Gas logs: safety shut-off Gas logs: damper permanently open
.
Wood stoves: EPA certified Woodstoves & fireplaces: Tight-fitting doors
Wood stoves & fireplaces: proper hearth Manufacturer's specs on site
Chimney liner: when required Chimney: separate flues when required
COMMENTS:
GAS PIPING APPROVED:
FURNACE APPROVED:
OTHER APPLIANCES APPROVED:
PLUMBING
DWV & water piping under test . DWV: proper grade
DWV: proper sizing DWV: proper drainage fittings where required
DWV & water piping: proper support 6K DWV: required cleanouts a~
. Vent termination All fixtures vented properly
Water supply: proper sizing c-K 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: siesmic strap
R-10 pad under water heater when required Water-piping insulated as required
.
Grease trapslinterceptors: where required Proper indirect wastes: where required
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COMMENTS:
PLUMBING GROUNDWORK APPROVED:
. . . /o..e"94
PLUMBING ROUGH-IN APPROV~
SHEETROCK .
Proper fastening: nails-7" o.c. horiz. plane nails 8" o.c. vertical plane
,
Proper fastening: screws-12" o.c. horiz. plane (1/2") screws-12" o.c. horiz. 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. plane (5/8") screws-12" o.c. horiz. plane (5/8") - 24" o.c. franiing
Proper fastening: screlNS- 16" o.c. vert. 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
COMMENTS:
Energy code requirements met, exhaust fans
Garage/dwelling door self closing solid core
Handrails & guardrails, as required
Exit signs when required
Occupant load posted when applicable
Wood siding to earth separation (6"
Radon monitor when required
Plumbing & mechanical
Smoke detectors where required
Fire ratings maintained
Emergi;lncy lighting when required
Building weathertight
Building Address posted
SHEETROCK APPROVED:
COMMENTS:
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'JUL 16 1996
BREMERTON
BUlLOlNG OEPARTMENl
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BREMERTON BUILDING DEPARTMENT
1991 WSEC CAmpliance Worksheet-Nan-Electric
Ilf
APPliCATION NUMBER;
APPliCANT: p~ L.. C. C;:r ~ rJ
DATE:
7-11- 9 J,
SITE ADDRESS: 2. f "Z.. 0
iJ . CA+t gILl. 1E3-,J
II SCOPE OF WORK:
D~i::i::::~~::.NEV. .. .::::::::N:::D'::::~N:::*'t:tr;t~ON:.-.. .'::;::::;.f:D:::::::;::::::;::::::::;::;::::;:~:REM. :. 0.:..0. -m- /:::::::::::=::::::::::::::::::::::;::11
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HEATING SYSTEM: (!) (I- J?o VL-(..<U) 4-UL..
BTU RATING: ~ l'V'Z,trl AI \000 ~ c,...lfS. IN -5 ft '0 S. .
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TOTAL HEATED SQ. FT. /3 S' 0 -.r /J1Jf.rlJ. ~~~t1l?urTOTAL GL\ZING SQ: FT. ~gglJ IIJ,-, ~a.W A-Op
-+- 2- lOCI />J e.....J *" D .
1 s- b 0 -0 "'3'Ooq-l4 I-
COMPLIANCE OPTIONS
111.....111111_111&111..
1. 10% 0.70 0.40 R-30 R-30 R-15 R-15 R-10 R-19 R-10
2. 12% 0.65 0.40 R-30 R-30 R-15 R-15 R-IO R-19 R-IO
3.... 11% 0.75 0.40 R-30 R-30 R-19 R-19 R-IO R-19 R-IO
(4~) 21% 0.65 0.40 R-30 R-30 R-19 R-19 R-IO R-19 R-10
Y 21% 0.60 0.40 R-30 R-30 R-19 R-19 R-IO R-19 R-10
6. 25% 0.50 0.40 R-38 R-30 R-19 R-19 R-10 R-25 R-IO
7. 30% 0.45 0.40 R-30 R-30 R-19 R-19 R-IO R-25 R-IO
"Thia option requires the HVAC to h:a-c:a. high d!icic:aq ruing (AFUE of 0.88). Applianc _ pnmd.e doc:zun==ion..
To comply with the WSEC you 17tIly choose one of the ahove options. Indic.ate which option is equal to or greater
than the pei-centage obtained by dividing your glazing square footage.by your total he4.ted square ftotage. Follow
the line across to detertnine the required insulation values of building elements for that option. A heat loss
calcukrtion. may be submitted in lieu of choosing one of these optUrns, but win be subject to rlWiew and approval by
the Building Official
.WHOLE HOUSE VENTIIATION Outdoor air shall be supplied to the conditioned space at the rate of 15 cfm
for each bedroom Ius 15 cfm for the r' area.. Choose one these tions:
M~:~W:~W>RWStt llf;W'~::mllXS:l@ t~:P.P.;WU&tI:t.R~~:~~:::~{4t~twA:d:$iW'.:.::::?::;?~:~Gii:j
WINDOW SCHEDULE ON FOLLOWING PAGE MUST BE COMPLETED
BREMERTON BUILDING DEPARTMENT
WSEC Wmdow Schedule
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TOTAL WINDOW SQUARE FOOTAGE:
(gO
Brand arid model/type must be submitt~ on windo~ schedule. Any changes must be resubmitted to the
Building Department.
BREMER~DN PERMIT CENTER
286 4th Streetv Bremertonr ~A 98337
Phone: (360) 478-5275 FAX: (360) 478-5278
BUILDING PERMIT
Job Addr: 2120 N CAMBRIAN AVE
Location: 2120 N CAMBRIAN AVE
Parcel No: 1024014-067-2007
Applicant: BOMAN CONST 373-3003
3207 RIDGEVIEW DR NE BREMERTON WA 98310
Permit No: 96-0427
Status: PENDING
Applied: 07/16/1996
I 8SLH~d :
!:::xp:i,res:
Owner: SINN PAUL C
2120 N CAMBRIAN AVE BREMERTON WA 98312
Contractor: BOMAN CONST 378-3003 Lie I: BOMANC*099KG Exp: 7/12/97
~l;;:~07 1:U1:X~EVIEW m~ NE m~EM,ERTON WA 98310
Subcontr:
Desc: ADDN TO RES. (EXTENDING BEDROOM~ ADD BATHROOM)
*********************************************************************************************
Valuation ~ Permit Fees: 321.15 Total Calculated Fee: 510.83
25~000.00 * Plan Check Fees: 180.18 Additional Fees: .00
* Other Fees: 9.50 Total Permit Fee: 510.83
*********************************************************************************************
MECHANICAL/PLUMBING FIXTURES-- MEC~ Exhaust Fans............: 1 PLBG-Water Closet............: 1
PLBG-Lavatory................: PL
'-Sh,,\......~ It
FlL~
/ ~ ( 2- ~ erG
*********************************************************************************************
This permit shall become null and void if the building or work authorized by this permit is not commenced within
180 days from the date of such permit, or if this building or work authorized b~ such permit is suspended or
abandoned at any time after the work is commenced for a period of 180 days.
NOTICE - It is the responsibility of the permit holder~ not the City of Bremerton or Building Official to see
to it that required inspections are made. The permit holder must notify the Building Official when ready for
inspections. Failure of the permit holder to'notify the Building Official of required inspections may result
in the stoppage of the work u'ntil such time that the permit holder can substanti~te to the building official
that the concealed work meets or exceeds code requirements. Any demolition, testing, or financial burden shall
be borne directly by the permit holder. Failure to substantiate code requirements will indemnify the City
against any and all responsibility or liability connected with the construction.
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 the provisions of
any other state or local law regulating c:onstruc:tion or the performance of construction.
Signature:__________________________________________________ Date:_______________________________
I certify that I am exempt from the requirements of the state contractor's registration law, under
Section 3, Chapter ,126, laws of 1967.
S i gnat ure: ____._.___________,__________________________________
***************************
Permit Center--Approved By:_______________ Date:
Date:
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BREMERTON PERM~T CENTER
286 4th Street. Breme/ton. WA 98337
Phone: (360) 478-5275 FAX: (360) 4.78-5278
BUILDING PERMIT
Job Addr: 2120 N CAMBRIAN AVE
location: 2120 N CAMBRIAN AVE
Parcel No: 1024014-067-2007
Permit No: 96-0427
St at UEl: PEND I NG
Applied: 07/16/1996
r ssu€!d :
Expires:
Applicant: BOMAN CONST 378-3003
3207 RIDGEVIEW DR NE BREMERTON WA 98310
Owner: S r NN r.JAUL. C
2120 N CAMBRIAN AVE 8REMERTON WA 98312
Contractor: 80MAN CONST 373-3003 Ltc I: BOMANC*099KG Exp= 7/12/97
3207 RIDGEVIEW DR NE BREMERTON WA 98310
~1ubc:ont r :
Dese: ADDN TO RES. (EXTENDING BEDROOM, ADD BATHROOM)
~******************~(:*************************************************************************
i Valuation * Permit Fees=321.15 Total Calculated Fee: 510.83
. ~ ;?'5,OOO"OO ,It Plan Cheek Fees: 180"lB Add:lt:l.cmal Fe(~f.l: ,,00
* Other Fees: 9.50 Total Permit Fee: 510.B3
*********************************************************************************************
MECHANICAL/PLUMBING FIXTURES-- MECH-Exhaust Fans.....,......: 1 PLBG-Water Closet..........,.: 1
""1lLBG-Lavatory, . . , , , .. . , , . . , . .: 1 PLBG-Shower. , . , . . . . . . . . . . . . . . : 1
ZON )tJG
*******~*~*;;**~*~*:**~f:****************************************************************
This permit shall. become null and void if the building or work authorized by this permit is not commenced within
180 days from the date of such permit, or if this building or work authorized by such permit is suspended or
abandoned at any time after the work is commenced for a period of 180 days.
NOTICE - It is the responsibility of the permit holder, not the City of Bremerton or Building Official to see
to it that required inspections are made, The permit holeer mllst notify the Building Official when reddy for
inspections. Failure of the permit holder to notify the Building Official of required inspections mal' result
in the stoppage of the work until such time that the permit holder can substantiate to the building official
that the concealed work meets or exceeds code requirements. Any demolition, testing, or financial burden shall
be borne directly by the permit holder. Failure to substantiate code requirements will indemnify the City
against any and all responsibility or liability connected with the construction.
I hereby certify th~at I have read and examined this permit and know the same to be true and correct. All
provisions of laws imo..ordinances governing this type of work will be complied with whether specified herein
or not, The granting oT 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.
S i gnat u r e : ________________,_____________________,_____________
***************************
Perm:l. t Cent er-."'Approved 8y: '.,"~".."",."'""_,"..,,,",,..,,_",,.,,"_, Oat e:
Date:
'v~tJ vc,~
of
6' 1;~'W
S i gnatur e: _~______________________________________________.._ Dat e: ________,_______________________
I certify that I am exempt from the requirements of the state contractor's registration law, under
Section 3, Chapter 126, laws of 1967.
~,.{,
.... ~~\
BREMERTON PERMIT CENTER
286 4th Street!) Bn~.me.,.torLJ bJA 98337
Phone: (360) 4.;78-52.75 FAX: (360) 478,-5278
BUILDING PERMIT
Applicant: nOMAN CONST 373-3003
~170/ RJDGFVJFI>J Df< NF mWMFRTON WA 98::110
Permit No: 96-047/
Status: PENDING
Applied: 07/]6/J996
I13suerl:
F':xPln::s:
.J ob Addr': ;? 1 70 N CAM!m J AN AVF'
L,oGat:lon~ :~~1.~!O N CAMB~HAN AVE
Parcel No: 10?4014-067-?OOJ
Ownc~Y': SINN PAUl. C
71?O N CAMFlR J AN AVE' Bf~Ff'IFRrON WA 983] 7
Contractor: BOMAN CaNST 318-300a I.te f= BOMANCM099KG Exp: 7/t~/9J
~1?07 fHDGFVJFW m~ NF m~FMn<TON l~A 9m)10
subcc:mt r :
D€:)~1G: AnnN TO f<FS, (FXTFND:r NG BEDROOM>> Arm BATHROOM)
l...,.1
~*******~****************************************************************************~******
; Valuation 1\ P!;,'l'f'm:it Fees: 371,lt) Tntal Calcu.lated FEi~): blO"B3
25,000.00 * Plan Check ~eeB= 180.18 Additional Fees: .00
* Other Fee8: 9.50 Total Permit Fee: 5JO.83
-~~ *****************************************************************K***************************
/.~. MECHANICAL/PLUMBING FIXTURES-- MECH-Exhi'.lust Fans............: 1 PLBG-Water Closet............: 1
,~.PLBG,tav!tory. ..... . . . ,. " , . .: PLBG-Shower.. ,. . . .. . . .. .. ....: 1
bLDb
7r(~-c;~
*MM******"M***MM***********M**R****M***MM****M**"M**************MM*"*********H*************"*
This permit shall become null and void if the building or work authorized by this permit is not commenced within
180 days from the date of such permit, or if this building or work authorized by such permit is suspended or
abandoned at any time after the \~ork is c'ommenced for a period of 180 daya.
NOTICE - It is the responsibi lity of the permit holder, not the City of Bremerton or Building Official to soe
to it that required inspections are made. The permit holder must notify the Building Official when ready for
inspections. Failure of the permit holder to notify the Building Official of required inspections may result
in the stoppage of the work until such time that the permit holder can substantiate to the building official
that the concealed work meets or exceeds code requirements. Any demolition, testing, or financial burden shall
be borne directly by the permit holder. Failure to suootantiate code rElqulrements will indemnify fie City
against any and all responsibility or liability connected with the construction. r
Signature; __________._____"_______.___________,_____,__,________ Oat e: ~_,..______.._~___________.._______
*******M*.*M***************
PCY'mJt C€:mter"",Appn:lVfld Byr , , , , Drite;:
:~
....
&
BRFMERTON PERMIT CENTER
:~r:M. 4th~;:trf.;et 1 Bromeri.:on $ 14f.l 9f:1:J::~;!
;.Nmm'" ~ t 860) 478-~5;;:',;I.~i P'AX: ('St6('}) 47fJ'-!J."?'7f.{
R\JILDING PFRM1.T
AI"I'! l ! (""""1"""
Y' 'l?' ,. ,d::J.i ,"
\
\ (J1i.)nr'lY :
cr)t r I,i t,:t;!'ir ~
JIJ.bcnntr ~
!
nOf11~1~.1 CONS r ~:r/;'l <:iOm1
:;)?O'l HWCiFVlTt;J llH NI nWl111nON Wi (/n::110
Pf.:rmH No~ tl()""04.;'!'j
Stnl:!!8: PiiNDINCi
{')rlp Ii cd :: lJ'//l t-/ 1 9W,
[FlHI,l\~rl ~
f":)(PJ.nm~
Job Add)": ? l?O N U'il'mr<l I~N (>,\.Jr
I.Or:;i,t: 'Ion: ? 1 ;:':0 N U\INr~i~ I AN ()~K
Pi:lfcr,:l Not 10::.14014,,,06/ (lOC)'!
SINN PAUl, C
~,\ 1 ~,,\() N CAMnF~ I AN AVt. Hm ~lf.lnON W\ ',lIX:ll?
11l1M('lN CI'JNSr ::1/:3 <JOe):,
::110'/ 1(1' nLH','~JHl~ nl< Nf nlJfr11!~ ION t,JI\ 9f!330
I t r,; fl;: HOMANCJW':!9Kn I: xl': 1/1 ~Y9 I'
01")1;;[;: AnnN TO PF !:;, (FKfF"N1l:l NG IlF nrWC1!'1, ADD FlI'ilHIWr.m)
~~MNM****MM*.****M*********M***~*N~~***M**N*K*M**.M***XM*H*****NN*X*~KX~*~*M~MW"MK*"**~~XH*~M
r" VrdwrtJon 'f;( perm1t If.le::l~ ~l?) ,l!) TntI'd CI1JcH.ltltcd HlC; ~)10,H~j
::'::i1000,GO 1{ pl.;'m chw:;k l'emn I,BO.l.B liddHim\i11. F'(~ns:.OO
J* otht;;Y fflf)H~ 9,:':)0 'loUd Permit: rf;:e~ ~dl),g~1
N~~~**M*H***.*M*M~M**~.M***K***~M~~M*~"**XXH***~M*MM*~X*K*KMMH****~K****X*~***KM.~*X~**M*~*M*
!'lECHMHC{\L!PLUMBlNG FlXTUFiES. - MECH-Exhallst Flms,..,.,...,..: 1 PLBG-14ater Ch'Si3t....."."...: I
"PLSG"Uwflt0ry. .. ., ,. .. ..... . .:
U\L
(~l??/ C[G,
PL8G~Shcnqer ~ t! II Il .. /r l! tl II e ,W , If ~ .. , . It: 1
~*~~**~N****U**M**H*M***~~*M~*~**M*~MMMM.M"*M~~**K*MMM*MM~~*H~X~*~~~*~MKMM~M****~~*~*K*MM"*MM
ThL'i pen'llH shall become null. and voId if th~ huilding or !IiOYK authorized by this permit in not comm€H1cnd within
180 daY8 from the date of such permit, or if this buildIng or vlOfk author! zed by Bouch permit is S!uspended (1'(
abnndoned at any time after the work is commenced for a p€:riod of 180 df.l)/f),
NonCF It i~ tho reEPcl!1~dbJ1Hy of the pormIt holder, not the City of Bremerton or Bulldln9 Offkia! to see
tD it that requin:d inm:'Eictions an: made. ThEl porrnit holder tlIlJBt flotU)' the Bl..dlding Official t'jhE:n n,ady tnr
imlPcctioflS. FBJlufc of thle permit holds'( to notify the auildin(J Official of r\;quired InspecticffN may resnl.t
In tht1 i1toppage of the \~oyk until t~uch time that the pr:.rrmit holdor can QUb8tantiate to the building offir.ial
that the concealed work meetB or exceeds code roquirements. (my demolition, testing, or financial burden shall
be porno dIrectly by the permit holder. Failure to sub~tl:lntii1te COdf: requlremBnh Nill imJr.:mnify the City
a[li'llllst allY and ell n;;spcm~dbi1 ity or ! i,7Ib1 lity connected ~Jith the constructiorl.
I heroby certify that 1 hi.lvel H:ad and examined t;hi~) permit and know th() sums to bf~ tnw and cotr~1c;L All
PrDvialons of laNs i!mo ordinances governing thh~ type flf work wUl be complied with v.Jhether sped find heHdn
I)Y nut. Till:: granting 01' ii permit' dOHt, tlt1t PT!%4JIMl to giwJ tlUt.hOiity to violntl.:l nY' Gt.lflCel tht! provision!} of
ill'\)' vthil'r titat;f.~ or loctll la~1 rfJQlJlating crmstr!Jci'iofl QY' thfJ perrOrmilf!Ce of r:onstructIon.
S i gHtlt ute: "._.'~___" __ __ .~"....,~,~~_~~__,,,.,___~, __~ _~._.,,___,,=..~.,~__w.. Dllte: __~___~ _.,___,_",_~,<,___.._,==__.~"'__~
I certHi' that t am exempt frmn thr.: requirements (:If the state contrac.tor's n~gietrutioflla~l. und{rr
Section 3, Chaptm' 126, Im~s of 196:7.
Si qnature: Oat. e: '__'-_'_'0'.- __,._ ,___, ._._"...." ____"... _.. .,"__
~;;:f~" ;;,:,~:,;~';~~~;~~:j;;~t-~.-?..74----;,~:t-~, . 7: ;~:?~ - - -- u__
,
CITY OF BREMERTON · 239 4th Street · Bremerton, WA 98337
BREMERTON PERMIT CENTER
Jul 29, 1996
BOMAN CONST
3207 RIDGEVIEW DR NE
BREMERTON WA
98310
SUBJECT: Application No: 96-0427
site Address: 2120 N CAMBRIAN AVE
We have reviewed your application and find we do not have the information
required to process it promptly. Please provide the following
information as soon as possible. .
1. PLEASE PROVIDE THE FOLLOWING INFORMATION IN REGARDS TO YOUR
BUILDING PERMIT:
A. INDICATE THE SIZE OF THE RAFTERS.
B. SHOW FLOOR CONNECTION AND FOUNDATION ON ATTACHED (AREA
CIRCLED) i.
For further information, please contact Valarie Wolf at (360) 478-5275.
Sincerely,
Vala;,rie Wolf
Building and Development specialist
· Celebrating 50 Years of Freedom ·
)
//
CITY OF BREMERTON PERMIT CENTER
Application Revievv
Type of Application: An O/\} To Rc~ Applicant: YSOfV\ A AJ (.0 ('Js-r-
SiteLocatiort~\&O N CAVV\ 0>(2 (AN Application# crCn ~ a+-J-l
Submittal Date:"/ ,- (~ ,,- Ct Co Committee Review Date: -, -- { ~...- cr (:,
Building
SIMPLE. >A.[JPROVEIl:
::<:y< ;:}A'I'MfG.;;:::.
YN
... ....:.....:.DEPARThIEtVF
YN
Zoning
YN
YN
YN
Environmental
YN
YN
YN
Engineering/Streets
YN
YN
YN
Engineering/Utilities
YN
YN
YN
Fire
YN
YN
YN
YN
Other
YN
YN
YN
YN
<..v.-----,
C
Additional
Comments: ")/?. e
of,/) ~--t'" ~ ::how
~'M y-;J~Ju.
o
~'
~i
Y
~**~~~**MN"~~NM~K."M.*MR*K~MM~**HM"*M*****N***~MM*X****M*~M***~M
C:r 'I Y or Ht~i tlFTH ON FliT!' } PT
**K~*MK~**MX*~MK*****H*~**M~H*MM~***.MM*MMMY****.**~H~*****MMHMM
r<Fer .Ii1'! tlqmbel': ~~f.;(l006;.':_l f'\mount: S 1 0. fm (P /16/'1(, 11: () 1
flijYfflimt tif)thnd~ Cl\ Notatton~ nllI'1{lN~f4,H()l \nlt~ ~}~J
96 '-O~,:,)? fypo ~ IJI,DCi
1 Q?40 1 t1,.Ot,/- ;,'1)0/
:~, l. ;~O N Cf~MI:lH (AN NJI'
? j?n N Ct'lf1nf<) AN (,,,'I'
" ot i'l J f r:en ~ ~) j \1 " m-l
rntul .'\Ll, PmtF;~ :;(() ,n:l
Oal fine\: ~ .00
M"~*X*KKMM~*KM*~~M*H~****XX**~K**K**k*M*~X~K**~**H**M*MK~**M****
i'H:cntmt: Codf: Ik:r',crJrrL:lDll Af(l(ilmL
I, ',"""',1 '\ ('f)! (' ','v,,'\ I 1) '''IJ 'j" f')' 1..1(" 1"1':\""'1 ['I' 1.~'I';'I:\: "\ I' .~...
.t:~ !F,J, <I .. .':... t ~,.'., f}, ,.' 1,p,fJ ,'f t,-I, l.d ~<' /q/,('
,le:,- ::M,~,.m100 (4~lnO) nUJlllJNf-i PI AN elll Cl\ 1I'I'~:; 'ISO, ltJ
16 <l?/ " I OO~5 (?? t ::i ) MI- CitrIN J l:()l, PI "Hl'"lI T I'VI'~':; ;~ l I #1 ~i
; I, t 1 (Jf:i~i c;.I? nl) PI U~11 n 1'1U PII!f'1lf II! ~j j.l~;l , :l(J
f:,-1.3 .;,.;;.p . 1<1 ( ()?:3(~ ) STi"d'F CH t')I~ ::;tll~r;H{JWA': .1, . ~;O
H j ~(\~), 1, C09 (,>? 1 9 ) PI Hf1 J '! ~;UnCf !rll~CW' h ,00
Penn 1'1; No ~
Parc~:':J No~
;':l !. t C~ flddr (~~;:n ~
I O(;i'~ t. j Of I r
HI.!)!'; Plql~M t r 1~/!'ll"U l/P
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"
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~~~~~~~~~~~;>;''':.:.m~'~~''~~~;-o.,~~~,.....",~<><,~~~;~~",<;,;;~~~~$.~~~~l~'i;;.~",~,~""",~..,,,,::i.~~~~~,m,.~~~;~~;;"\~~~
.:[~tt!~m~~~_~S5It1"~~9~~~:I~~i~~~_~_s.~~!~~
APPliCANT: 0-0WNER 0 CONTRAcrOR OoruBe
SITE ADDRESS, 2: ( "- <> IJ ' ~~ "n. .. J COUNTY ASSESSOR P.UCEl" 10 Z- "0 I _ L( - Dr.. '7 _ 2.00 '7
OWNER: ~\Jt- C. <;; (tJtJ' ADDRESS: 2/2...::. "LC&4M~ ~i4-J
CONTRACTOJ .-8,.. L I N 0,,- J ADDRESS, S.>.a "l i2. tl> G.<1 U ( -.) ~n. N. "'.
o P.> CA-. ~n. 14-1.) ~o..s ~ 'r
CONTRAcrOR UCENSE; >( 80 M A-ty c.~ (5)'l'l KG- EXPIRATION DATE: K
CONTAcr PERSON: ;;;;..J( /-, . ~ (/oJ tOt'1-J CONTACT PHONE I
7 - .I Z- -' 9..7
t/?f-'-'(DOg'"
o SFR 0 DUPLEX 0 MULTI-FAMILY 0 BUSINESS 0 OTHEJC~W m(ID
o SIGN 0 DEMO 0 MOVE BLDG. 0 MOBILE 0 GRADfNG(yd.,): .
rbr . . 'JUlO 3 1996
o NEW 0 REPAIR DREMODEL ~DmON 0 OTHa 9REMfRTON
/ BUILDING DtfJAIUMENT
INTENDED USE, ~ tr..;.) / I~ ZONING CLAsSIFICATION, COUNCIL D1sriICT'~
NATUREOFWORKPROP&ED~ LiKJD (O'y ~ l' ~ l[X.L~) ~.
1;:t
2.l 0 Gange:
Decla:
SQUARE FOOTAGE: Owl:lling: .t4Dn
For De arlment Use On/v
::::{~:rtlVAtt1ATI:()f~~\mHit @}RtxNE:ItEVIEW=:EEEt:; :;t;@r:f?:EI$tltr!:Effi~{0@t: .{tk::~KSlJR~GESt:tI::t rt:mtt;rOTA.!i::F.EES:tnt~:t
s . --- $ $ ENERGY: $50.00 $ r::::: C' .-z .
z~ ~ STATE: $4.50 '::..-)(0, 0 ~
Applications for which no permit is issued within 180 days following the dare of application shall expire by
limitation, and plans and other dara submitted for review- may thereafter be returned to the applicant or
destroyed by. the building official The building official .may extend the time for action by the. applicant for a
period not exceeding 180 days on request by the applicant showing that ciraunstances beyond the comrol of the
applicant have prevented action from being taken. No application shall be extended more than once. In order to
renew action on an application after expiration, the applicant shall resubmit plans and pay a new plan review fee.
APPUCANT'S SIGNATU
ove infonnation is correct to the best of my knawledge,
DATE: '1 "~r-- ? L .
.....
/
, ,
ii
D--~.J3_-D.-J:J.1~J1lfiwl
APPLICANT:
o OWNER ~ CONTRACTOR 0 OTHER'-ffiU ffi 0 WI ffi lID
'JUlO 3 1996
COMMENTS:
SITE ADDRESS: 2, 2.. cO N ~~t1. P>()., ~J
OWNER: PAC,) c... C "- c;: ( N N
CONTRACTOR: ~es>K 41J ~S"f.
CONTRACTOR LICENSE # kMl<\N C~ <' cr q KG
OWNER PHONE # -:s 7 ~ - If} t.( 1
a~fIYJtf( I v,~
BUILDING DEPARTMENT
ADDRESS: 21 2-.::> lJ ..~ 8 ({ I ~
ADDRESS: 32.0 ~ /ILl ()~111 '"/i-...) ~~Il-. dj.~.
EXPIRATION DATE: ? - , Z- - '( j.,
CONTRACTOR PHONE #
4--'7 <1 -'10 0 ~
NOi ::~:SQ~:E.:QIm?M$N'JJ:m:::iiIFEE :-:.NQg::.:::;~$~gi-t~Ke. .-::E~:
RANGE , WATER CLOSET
WOOD/PELLET STOVE BATHTUB
GAS FURNACE btus: I LAVATORY
CONVERSION BURNER bms: / SHOWER
UNIT HEATER btus: KITCHEN SINK -
BOILER btu s: DISHWASHER
GAS PIPING LAUNDRY TRAY
EVAPORATION COOLERS btus: CLOTHES WASHER
AC UNIT btlls: WATER HEATER
HEAT PUMP btlls: tOllS: URINAL
REHEAT BOX btlls: DRINKING FOUNTAIN
AIR HANDLING UNIT btlls: 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:
MECHANICAL PERMIT FEE $15.00 PLUMBING PERMIT FEE (15.00 or :i.50)
APPLICANT'S SIGNATU
\
DATE:
~-3~?~
e
-
Nc]
41805
~
d ____
Fee $.-11..............__........___...............................__. Receipt No..:l:....~__~.=~.=..7..._____._._.
BUILDING PERM IT /
CITY OF BREMERTON BUILDING DEPARTMENT
F. E. IRISH, Building Inspector . ESsex 3.1411, Ext. 36
Owner's Value I Bldg. Dept. ~hle I DESCRIPTION:
$ ~ 00 Lot Block Additions
Address on Job .0J0..Q__!J__:__.fl:~mmm.m.m..----..m.m. Date __~:::./,r~2.Im..mm.
Building .mm__.__.m x m__mm__... and .__.m.___.m. stories ____m.m.mmmm basement. Lot __mm.m.m x ________.mm.
Front Yard ____m.m.m.____.__. Rear Yard m.m.____.__.m__m Side Yard .__.______..____m.m. Garage ____________mOOm.mmm
g~:~~~:1~~~ ~~~~ ~~:~~~~~~~~~~~~:::::::::::::::::.Add.;~.~~--.......-.......:.......................__~~~~.::::::::::::~.Ph~.~~. :......:..........:...--.....:
Contractor __ __. __.mm__.m____mm ________ m __ 00 mm.__.m. __. 00' __ __ Address __ mm.__ ___. ____ _______.m.m__m.__ __ Phone mm _____.m 00
This per,mi;i~:
:::::~:~::::::::::::r::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
-------------...----..-------------------------------------------------.--------------------------------------------------_.---.---.--------------------------------------_.----
All work to conform to all aPIJlicable 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
befo.re covering. Wood preservative to be used on all wood against masonry. Ventilate,foundation and attic. Sepa-
rate permits requ-ired for plumbing, wiring and heating. See City Engineer before working on streets or sidewalks.
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:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ZZ:::::::::::::::.
Owner's Signa tu re__ __. _..__ __. __.00 _.__ __ __ u.. - m.. - u ___. m m -- -- u -. -- -. Byr----71l,~~~-:. -- .{.;;!;;~ -- .~~--
His Authorized Agent
Building Inspec;; ::::::~::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
~DF
'~:< ~i--.;;f-:&:_:F ~-,;.~
.;.
_ ",'_' ,~~.}, tI-'~ ',<.