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CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER
DATE ISSUED:
02W@'l200'4
,',,,,d,,,~,,;
286 Fourth 51. Bremerton, WA 98337
(360) 478-5275 Fax: (360) 478-5278
ASSESSOR NUMBER:
APPLICANT NAME:
OWNER NAME:
CONTRACTOR:
LENDER NAME:
3732-002-037 -0002
GMAC MTG CORP
GMAC MTG CORP
LYLE SIMMONS CONSTRUCTION LI
ZONING: DR SITE ADDRESS: 107 S CAMBRIAN AVE
PHONE: ADDRESS: 500 ENTERPRISE RD STE 150
PHONE: ADDRESS: 500 ENTERPRISE RD STE 150
PHONE: (253 )927 -0539 ADDRESS: 34413 28TH PLACE
PHONE: 0- ADDRESS:
APPROVED: EXPIRATION:
TOTAL FEES:
[:' i1P66~
~(Q)\J5\1
Building Code Edition:
Occupancy Group:
Type of Construction:
Flood Zone:
Setbacks:
Sanitation Method:
Number of Bedrooms:
UBC: 1997
SUBMITTED:
02/02/2004
VALUATION:
$26,000.00
Building Permit
Plan Review Fee
$401.35 2211
$260.88 4580
$4.50 0236
REPAIR OF A FIRE DAMAGED RESIDENCE
State Surcharge
Square Footage:
Bid Price from Applicant
1 TOTAL
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 examjned 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 Contracto~s Registration Law
under Section 3, Chapter 126, Laws of 1967. All 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.
I have read, and agree to abide by the conditions of this permit including all conditions of zoning, building codes, and State and Federal laws.
SIGNATURE OF OWNER OR
AGENT:
PRINTED NAME:
DATE:
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.govfp-tsfasbestosfasbestos.htm.
3. Approved Plans, Engineering, Site Plan, Permit, and Conditions, Shall remain on site and be available for inspection.
4. Smoke detectors required in all sleeping areas, adjacent hallways and floor levels.
5. Building Plan Review:
Code Compliance-All work in the City of Bremerton shall adhere to the following codes:
1997 Uniform Building Code
1997 Uniform Fire Code
2000 Uniform Plumbing Code
1997 Uniform Mechanical Code
Page 1 of 2
'"
'Ill
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER
DATE ISSUED:
02Z@B!20@l:l:::'~'"
l&%lfuD&llilli8w.~.v::
286 Fourth SI. Bremerton, WA 98337
(360) 478-5275 Fax: (360) 478-5278
ASSESSOR NUMBER:
APPLICANT NAME:
OWNER NAME:
CONTRACTOR:
LENDER NAME:
3732-002-037-0002
GMAC MTG CORP
GMAC MTG CORP
LYLE SIMMONS CONSTRUCTION LI
ZONING:
PHONE:
PHONE:
PHONE:
PHONE:
(253)927-0539
0-
DR
SITE ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
107 S CAMBRIAN AVE
500 ENTERPRISE RD STE 150
500 ENTERPRISE RD STE 150
34413 28TH PLACE
SUBMITTED:
02/02/2004
APPROVED:
EXPIRATION:
09/22/2004
2001 WA State Energy Code
2000 WA State Ventilation Code
1998 WA State Barrier Free Code
As of July 1, 2004 the codes will be as follows:
2003 International Codes:
International Building Code
International Residential Code
International Existing Building Code
International Fire Code
International Mechanical Code
Uniform Plumbing Code
International Fuel Gas Code
1998 WA State Barrier Free Code
2001 WA State Energy Code
2000 WA State Ventilation Code
Check For All Washington State Amendments
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.
Framing
Sheetrock Nailing
Final Inspection - Building
Insulation
Page 2 of 2
'.
-:t=:= I '1-(i':.;'~
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER
DATE ISSU ED: g6{,Q~Zg~O~.~~~111111
286 Fourth St. Bremerton, WA 98337
(360) 478-5275 Fax: (360) 478.5278
ASSESSOR NUMBER:
APPLICANT NAME:
OWNER NAME:
CONTRACTOR:
LENDER NAME:
ZONING:
PHONE:
PHONE:
PHONE:
PHONE:
3732-002-037-0002
GMAC MTG CORP
GMAC MTG CORP
LYLE SIMMONS CONSTRUCTION LI
DR
SITE ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
107 S CAMBRIAN AVE
500 ENTERPRISE RD STE 150
500 ENTERPRISE RD STE 150
34413 28TH PLACE
0-
SUBMITTED:
02/02/2004
APPROVED:
EXPIRATION:
08/01/2004
VALUATION:
$26,000.00
Building Permit
$401.35 2211
$260.88 4580
$4.50 0236
REPAIR OF A FIRE DAMAGED RESIDENCE
Building Code Edition: UBC: 1997
Occupancy Group:
Type of Construction:
Flood Zone:
Setbacks: (Front) (Side) (Rear) (Other)
Sanitation Method:
Number of Bedrooms:
Plan Review Fee
State Surcharge
TOTAL FEES:
Square Footage:
Bid Price from Applicant
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
1 TOTAL
(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 compiied 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'I~hapter 126, Laws of 1967. All revisions to an approved plan require OCD review and approval prior to performing work. All building and tenant occupancy permits are
required to pass~1 inspection prior to permit expiration and obtain a certificate of occupancy prior to use or occupancy.
--"'-
SIGNATURE OF OWN
AGENT:
PRINTED NAME:
CONDITIONS
City of Bremerton's a roval of this application pertains only to the City's regulat
regulations does not necessarily ensure compliance with federal or state laws.
~
jurisdiction, and thus compliance with City
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.lnLwa.gov/p-ts/asbestos/asbestos.htm.
3. Approved Plans, Engineering, Site Plan, Permit, and Conditions, Shall remain on site and be available for inspection.
4. Smoke detectors required in all sleeping areas, adjacent hallways and floor levels.
,.
Page 1 of 2
t- .
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER
DATE ISSUED:
286 Fourth SI. Bremerton, WA 98337
(360) 478-5275 Fax: (360) 478-5278
3732-002-037-0002
GMAC MTG CORP
GMAC MTG CORP
LYLE SIMMONS CONSTRUCTION LI
ZONING:
PHONE:
PHONE:
PHONE:
PHONE:
(253)927-0539
()-
ASSESSOR NUMBER:
APPLICANT NAME:
OWNER NAME:
CONTRACTOR:
LENDER NAME:
DR
SITE ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
107 S CAMBRIAN AVE
500 ENTERPRISE RD STE 150
500 ENTERPRISE RD STE 150
34413 28TH PLACE
SUBMITTED:
02/02/2004
APPROVED:
EXPIRATION:
08/0 1/2004
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.
Framing
Insulation
Sheetrock Nailing
Final Inspection - Building
~
.
,
. \"
<.:
Page 2 of 2
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BREMERTOlDEDl\lIT CENTER
BUILDING OEPAifMEN11:'Ll , . -"-
Departrrlent of Community Development :, 286 4th Street :, Breroerton :c \J,"IA:e 98337
(360) 478-5275 :c Fax (360) 478-5178
Building P.errnit Application
/
APPLICANT: D OW!\lER lLvtOI\JTPcACTOR D AUTHOPJZED AGEI\!T
Site Address D7 .5~..iit\ Uh~
Tax Account l\lumber:
, . ~-cD2- 6.3
Phone #:
License f,
Contact Name: L
City, State, Zip
Phone #: (JJq- ) L.. . '- '5 z... 5~
Contact Phone #:
Check the tvoe of aoplication for below:
o
o
o
o
o
o
IS THIS PROPERTrWfTHIN 200 FEET OF A SHORELINE? YES 0 NO [2d/"
, Scope of Work Proposed: .,.::> ((--e:".fNDV'~ ~L O~7L;:;) g(:;,,\-\u~>I(f~ul-~Y /
~6e> tl<-'j/;J""'\;) 0-07- c~ 'OJ;Y~';f jJc> Or:; ",vi' 1-< Ie. -e_" ';"~'1 .f"'~~
o
o
o
o RESIDENTIAL REMODEL
O ",RESIDENTIAL ADDITION
/
QJ- RESIDENTIAL REPAIR
NEW SINGLE-FAMilY RESIDENCE
NEW DUPLEX
NEW MANUFACTURED HOME
o
o
o
o
o
o
NEW COMMERCLAl
COMMERCIAL REMODEL
COMMERCIAL ADDITION
COMMERCIAL REPAIR
NEW Jv1Ul TI-FAMll Y
TENANT IMPROVEMENT
NEW GAPJ\Gc/CAR PORT
NEW ACCESSORY BlDG
NEW SIGN
STRUCTURE DEMOLITION
GPADING (Cubic yards: _ )
OTHER
Square Footage: Dwelling: LD~U Garage: ;.0'-' Oecks: It '6
Valuation Plan Review Fee -I Permit Fee -I Surcharqe I Total Fees
''L~1COD ~: ;2~D.8?J I 40/-.35'- I 'fl' s-\) I ~0,0/7~
~
p,pplicationjor which no p~rmit is issu~d within 180 days following the dat~ of application shall expire by limitation, and
plans and other data submitted for review may thereafter be returned to the applicant or destroyed by the building official.
The building official may exi:end the time Tor action by the applicant for a period not exceeding 180 da)fs on request by
The apollc:am shOWing the clrcums~ances beyond the c~ntrol of the applicanT have prevemed aCTion from being taken. I'Jo
applicant shall be e)jended more tha~n),\e, I~ ord~r to. rEmew action on an application a-;Ler expiration Lhe applicant
shall resubmiT plans and pay a new p)an i)f') n'/j~ _,.
APPLICANTS S'~~ ~~~ _ Dt:~~~Z-:; z-~"1
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
Receipt Number:
286 Fourth Sl. Bremerton, WA 98337
(360) 473-5275 Fax: (360) 473-5278
BB0400831 Building Permit 1/2211 $ 401.35 $ 401.35 $0.00
BB04 00831 Plan Review Fee 1/4580 $ 260.88 $ 260.88 $0.00
BB04 00831 State Surcharge 1/0236 $4.50 $ 4.50 $0.00
Total: $ 666.73
Total:
$ 666.73
$ 666.73
CHECK
5740
Page 1 of 1
G \?, ~ \?, ~ ~n\?' ~
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. -. .
Depanment of Community Development ::- 286 4th Streer ::. :Breme1ton ::- \,\'7A ::- 98337
(360) 478-5275 ::. Fax (360) 478-5278
RESIDENTIAL SITE PLAN RE'TIE\V QUESTIONN~AIRE
Fennit applications aTe reviewed by our staff to make a preliminary detennination of the presence oT
absence of unique areas on the property. To help us make this detennination, please supply the following
infonnation with a scaled and dimensjoned sjte Ian.
Applicant:
5~ i..vCl r.cl .
L
Description of Proposal:
Street Address (or street name if no address has been assi!med): i
Tax Account Number: b 7.3 2- - 00 '1--~o::> 'I ...; bD 0 L
Critical Jlrea Questionnaire:
Is there any standing or running water on the surface of the sire at _iV\I'{ time o l'ES ,/
l. [2j NO
during the year? If YES, please describe conditions:
. ~O
2. Are there wet areas on the site? Ifl'ES, please describe: DYES
,-
" Is the site characterized as: 0 Forest 0 Cleared 0~
.J. Developed
4. Please give the overall slope ,of the parcel WIo and the slope at the building site.L'i %.
.
5. Is the property within 200 feet of a shoreline? o \'ES [B"'"N 0
6. Will the proposed structure be aesthetically or functionally disruptive to o \'ES [ZYfJo
surrounding 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 contaD.ledin any other
transmittals made herewith are true, and the applicant acknowledges that any action taken by the City of
Bremerton 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.
Signature of Applicant
Date
Site Development Figures
Percent Slope Calculation
Slope is calculated by dividing the vertical distcmce
by the horizontal distance, then multiplying the result
by 100. Example:
Vertical Distance of20 feet
Horizontal Distance of 100 feet = .2 x 100 = 20% slope
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Residential Site Plan Review Questionnaire
Page 2
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19720 BOTHEll - EVERETT HWY, BOTHEll, WA 98012-8124
PHONE: 206-481-7101 OR FAX 1-800-8AlPINE
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BUILDING PERMIT
. I
INSPECTION
FILE CARD
Building
FILE COpy
Plumbing D
Permit # BBO
1L~K~-I-
FILE COpy
SITE ADDRESS
107 ~c.'aI"""
PROJECT DESCRIPTION
Fire Alarm/Sprinkler D
AeProved Date
Notes
Erosion Control In Place
1 st Foundation Footing
FOUNDATION Foundation walls
DO NOT POUR CONCRETE Plumbing Ground Work
PRIOR TO APPROV AL In Slab Mechanical
Footing Insulation
2nd PLUMBING Rough In
MECHANICAL Duct / Vent
GAS PIPE Support / Test / Meter set
Hold down connections
Shear Panel nailing
L&I Electrical Approved
Ventilation requirements
Framing
~
FRAMING
If pt & 2/ld are approved
SHEETROCK
i!!:
FINAL
Under-floor
walls
BUILDING
WATER MAINTENANCE
All of the
above
Must be
approved
Prior to
fin al
Grease Tra , Back flO}v. M etas
PUBLIC
WORKS
FIRE
473-5927
Driveway 473-5270
Sewer 473-5270
473-5384/538
ALL FINAL INSPECTIONS COAfPLETED
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
+?i .
PERM IT NUMBE/)~~\'Q~~~~::::;J
DATE ISSUED:
ASSESSOR NUMBER:
APPLICANT NAME:
OWNER NAME:
CONTRACTOR:
LENDER NAME:
3732-002-037 -0002 ZONING: DR
CITY OF BREMERTON PUBLIC WOI PHONE: )478-7253
GMAC MORTGAGE PHONE:
CITY OF BREMERTON PHONE: )377 -8373
PHONE:
10/21/2003 APPROVED: fl/
SITE ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
107 S CAMBRIAN AVE
286 Fourth SI. Bremerton, WA 98337
(360) 478-5275 Fax: (360) 478-5278
3451 HAMMOND AVE
239 - 4TH STREET
SUBMITTED:
EXPIRATION:
04/18/2004
VALUATION:
Demolition Fee
$6.00 2218
$4.50 0236
DEMO 200 S.F. DETACHED SHED
Building Code Edition:
Occupancy Group:
Type of Construction:
Flood Zone:
Setbacks:
Sanitation Method:
Number of Bedrooms:
State Surcharge
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 Contracto~s Registration Law
under Section 3, Chapter 126, Laws of 1967. All 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:
itJ 1 ~.( ,
I have read, and agree to abide by t
SIGNATURE OF OWNER OR,
AGENT:
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.
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 (36
sure to provide your permit number, name on permit, site address, contact phone number, and inspection type.
Final Inspection - Building
~_/cr-6
Page 1 of 2
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
Receipt Number:
286 Fourth 51. Bremerton, WA 98337
(360) 473-5275 Fax: (360) 473-5278
8803 00602
8803 00602
Demolition Fee
State Surcharge
1/2218
1/0236
$ 6.00
$ 4.50
Total:
$ 6.00
$ 4.50
$ 10.50
$0.00
$0.00
Total:
$ 10.50
$ 10.50
INTERFUND TR
Page 1 of 1
BREMERTON PERMIT CENTER
286 4th Street$ Bremerton~ WA 98337
Phone: (360) 478-5275 FAX: (360) 478-5278
BUILDING PERMIT
Job Addr: 107 5 CAMBRIAN AVE
Location:
Parcel No: 3732002-037-0002
Permit No: 00-0344
Status: ISSUED
Applied: 07/13/2000
Issued: 07/13/2000
Expires: 01/09/2001
Applicant: SAAVEDRA SANTIAGO A
107 S CAMBRIAN BREMER TON WA 98312
Owner: SAAVEDRA SANTIAGO A
107 S CAMBRIAN BREMER TON WA 98312
Contractor: SEL.F
Lie #: SELF Exp:
Subcontr:
Oesc: CLOTHES WASHER
\,
*********%************************~****************)~*****************************************
Valuation * Permit Fees: 27.00 Total Calculated Fee: 27.00
.00 * Plan Check Fees: .00 Additional Fees: .00
* Other Fees: .00 Total Permit Fee: 27.00
********************************************************************~************************
MECHANICAL/PL~~ING FIXTURES-- "PLBG-Clothes Washey..........: 1
****************************x***********************************************.~***************
This peymit shall become null and void if the building 01" woyk authoyiz:ed by this peymit is not COI11tTIenced wit.hin
180 days hom the date of $Uch peymit. or' if this building 01" woyk authoYiz:ed by such peymit is suspended 01"
abandoned l:\t aX1Y. time afteY the woyk is commenced foy a peYiod of 180 days.
NOTICE .- It is the YUl$Ponsibility of the peymit holdel". not the City of Byemeyton 01" Building Official to see "~"
to it +"hat y~ql1iYed inspections an~ made. The peymit holdey must notify the Building Of'ficial when ready foy
insp~tions. Failuye of the p~nmit holooy to notify the Building Official of yequi yed inspections may YE.>sult
in the stoPpage of the wOYk until $Uch time that the peymit. holder ~~n,SLIb$tantiate to the building official
that the concealed woyk meets 01" exceeds code yeql1iYef11ents. Any demolition. t(t'6ti,119. 01" financial bt.lyden shall
be ooyne diyectly by the peymit holdey. Failuye to substarrtiat,e code n.qUin;mlents will indemnify the City
against any and all yesponsibUity 01" liability connected with the constyuction.
I hli.weby cf!yt.ify' that I have yead and examined this peymit and know the same to be tyue and coyyect. All
pyovisi,ons of laws and oydinances goveming this type of woyk wi 11 be complied with whethey specified herein
oy not. Ihe 9yanting 'of 1,y'peymit.1does not.. pn?$ume to give authoYity to violate 01" cancel the pyovisi01lS of
any othey stat y local Aaw Yeg~lati119 constyuction 0'1' the peyfoymance of constyuction.
I //__.0_. .J'
,
Signature:
Date:
1- /> - f) Q
I
I ceytify tha r am eXelYiP~ YOI'll the Yeql..tin~ments of the state contnactot"s l'egi,etyation law, uncle!"
Section 3. Chaptey 126. laws of 1967.
Si9natun~:. _.t_'QM
*~************************* /;1j
Permit Center--Approved 8y:~.-{/.JL~.:. ___
Date:_________
Date: _~ 7 - ( 3-=..0 0
BREMERTON PERMIT CENTER
286 4th Street~ Bremerton~ WA 98337
Phone: (360) 478-5275 FAX: (360) 478-5278
Job Address: 107 S CAMBRIAN AVE
Location:
Assr Acct No: 3732002-037-0002
Building Permit No: 00-0344
Status: ISSUED
Issued: 07/13/2000
Expires: 01/09/20Q~'
R E QUI RED
INS P E C T ION S
Item: 01550 PLUMBING
Dept: SLDG
Division:
*********************************************************************************
TESTING: Must be recognized by the Washington Association of Building Officials
SPECINSP: Must be registered with the state of WA
ST OF WA= State of WA Dept. of Labor and Industries 478-4921
HEALTH: Bremsrton/Kitsap Health District 478-5235
ALL INSPECTIONS PERFORMED BY THE CITY OF BREMERTON MUST BE SCHEDULED THROUGH THE
PERMIT CENTER, (360) 478-5275.
************ * ******~**** . ****************************************************
Permit HOlde'~ jy:
Signature: ,~ Date:__~~~~~________
nllEIVIEIi.'rOl~ IIUILDING j)EI)All'fMENl'
PlumbinglMechunlcallnspection Ueport ' (f)
scopeofw<<:rk:f(~~ -hYI ,~ PennltNumber'
Address: (07 '-- __--4~~Owl1cr: If (/~
Contractor: O~ Phone: 1-19 - 4J-d<S
. ,
GAS I)IPING
U n~_c:r ~l (I Ol'.~~<.>!-lJ-.!1~I..!.~~e!J) Prol~~~i_~i.r.ag~ SU!)'pOr[
1 r m_i!!~'~'~~J.~~~I.<:: whcl! unJcrli~~U1(1 Co~_~~~I!wrarE_I_~~~..!u..lcrgrouJI(I or wilhih 6" of carll.
GrouJI(I-juinl ulliom prohibilcd in certain loc;l.liom nushillKS 1101 allowed ill collceak.l areas
COMMENTS:
GAS PIPING APPROVED:
FURNACE
M all uf'-~II rery -.! l.w!i -9_~_~'~~_I_~_i IC l!!9.I~~I!.!-;l_~!.0~1J.III_~~1
Cbranu: to COIIILUSlihks VC:~'-~!$= dcuancc 10 coJnhu~libb
-----------
Vc_I~i.:.i..~~~2ponJ collncclions Vcnllerlllillalioll
ColllbllSlioll air Cl!iuu.......:r.: liner alldJor separale {lu~ as required
Gas slull-off widlin 3' Pi_~_l ekval<xl off ~oor i!!Ji.;Jrage
---,----
Ducu: she & 5IIpl'orr/insulued when rcqllir<<l ll.c:tmn air
COMMENTS:
rUllNACE APPROVED:
MISC. APPLIANCES
M:'....~f!.':~'-~c:.r~.!'l'.ccil]~.!.iolls ()I~~i_~e --- -- }~~_t.i~~I..!-:.lcc.cs~.'-ll'rorl
Ckuallcc lO U>lIIhllSlihks Vcnlinli: dc.tunoc 10 COlllhllSlibks
----------------- -- f- --- --- --.------.------
V CI!.....~.~~iylt~.:~.P l'()r'i.~-, II ":~~-'!~ Vent lerlllin:.Ilion
----~-----
COIIILIISlioll air ~_~0_~~..:.!i_ncr an,Uoc :>Cl'au_lc flues as rC<l',ircd
Gas shul-off widlill 3' W(}(~I S.love & fi~~aoes.:..r..':.~ hC;Jrll,
Wood ,toves: EPA <l2E!ovcJ Ga, log,; n_~cIY ,hul-off
Wood SIOVC1ll & ~~~CCll: t.i~l fiuiu!; doon Gas shul-off within 3'
COMMENTS:
MISC. AJ>PUANCES APPROVED:
WATER DEATER
rvf;l~~~,-,!!~(~~~_fia.'-~"~I_~~_C L()al}_~"'~_~~_'..!..!':'l'r.orl
Ckuanoc to comhuslibb VCI!!_i..'Ij): ~r;u_~~ IO~-'I!!>.IISIi.~1cs
Veut si:zj'.!fL~~T.l'~rr/ COl~l<<li~~1S VCIIl tcrlllin;atioll
----------
Combuslion <lir CI.lim_~~~K1Jor ~_UIC {luC1II U fC<luired
Gas shut-off witllin 3' Pit'!! c~~..!..~~rr n~0~n.ge
Gue valve on coM ~lei- supl'.ly Relicf valve draine.llo ol1l,i.lc
.-.--.---- -
Copper ~~IV;Jni~L~~lIlCCtiolll U,!io~on w;alC~~
Seismic ,tup
ALL WOltK UM)I~l TIllS IIEltl\II1.' A1-.-110
COMMENTS:
WATER HEATER A!>PllOVED:
~
r/
*.***.~~****I**.***.*...****4*~**I*********..*...***.*******..**
RECEIP,
.#.****~*m*...*.*****.*.*****~**.**..*.*..**.**.**..*****...*_*_
Rr CEIPT Nl.lrnb(~r: OOOnOS'9<l Amount: 27.00 07/U/OO 15:06
Payment Method: CK No~ation: SAAVEDRA CK Init: VW
-'~ .... ,.- ,.... ,.~ ._' "" ,.',... ~., """ <~. ~,,".. ~,..,. -. ,,"'..... ,~" -.. .- .~'. ."" ,..' _w ..~ -<_ .,.,. '''< _... ~.... _ __ ,... "" _. ',~. "'. _'..... ..... ~,... ~., .., ..... ..... ........ 'h""'" ,J... ...., ." ....... .... ..... ,..,. _ ,... W' ,.,.. ...... "'V ''",.
00-0344 Type: M/P
3732002-037-0002
107 5 CAMBRIAN AVE
Total Fees: 27.00
Total ALL Pmts: 27.00
Balance: .00
.*'*.*~*w...*****~*.**.**~*.****z********~..***.*..**.***._*..**
Account Code Description Amount
16-322.1003 (2213) PLUMBING PERMIT fEES 27.00
h':rmi t No:
Pitreel No:
~,ite Address:
i1F.CH/PlBG PERlin
rhi.s fJd:./ment
;:~? 00
,. w ."", ,~ .... ~.. _. h.. "".......... ",.' '-'~ ,,, ..... v, ..... '..~ <.. "'-,...... "''', ",. '" ';" .,,, .,~ .'.. '~". ,,~, .... ~< .......~ "'....,. '""_ .._ .... '" ...... ti~ .,~. ,,.., ................._ ..... ". ,,_ '"OK "" '.... _.,~.. <'" "ti .......... .,... ~._ ..._~_.
VICINITY MAP
---.
0
---c
YJ
~
-" I
~ e--,
)
-
'E0 ~
~ ~
J
r-I
.......MECfIA.NlCA.L....
.... ......PLUN4lHNG
[J.
I
Type of Fuel:
Occupancy:
Electric
Residen tial
Site Address:
Oil
Gas
Commercial
II No. TYPE OF EQUIPMENT No. TYPE OF FIXTURE il
I
1L-\0i G E WATER CLOSET
W'OOD/PELLET STOVE/GAS FIREPLACE BATHTUB
GAS FUIU\iACE btu: LA VA TORY' (bath sink) I'r.':" r,:::l(n\ rP n
CONVERSION BUIL'\fER btu: SHOWER \U J It: l~J lb U
LiNIT HEATER btu: KITCHEN SINK lr l
-I '{
BOILER btu: DISHWASHER JUL ..L ~
GAS PIPING I LACNDRY TR.i\Y r:)I:'H:: l\ Jl !: r ,
EV,\PORATION COOLERS btu: I CLOTHES WASHER 1.11 ,........-.1.
OJ !!I nltH~ DEP
AC UNIT btu: WATER HEATER - I
HEAT PUMP bm: URINAL
REHE.-\ T BOX btu: DRINI<lNG FOUNT-\IN
AIR HANDLING UNIT btu: FLOOR SINK OR DIL-\IN
EXI-L".UST FANS SLOP SINK
IL","'JGE HOOD (residential) I WATER PIPING & ALTERA.110N
I
IL-\NGE HOOD (commercial) GREASE TRAP /INTERCEPTOR I
CLUIHES DRYER I-lOSE BIBBS I
, I
INCINERATOR , LA \'V'N SP RIN KLER SYSTE'vl I
I DUCT .-\LTERATION S\v1~[MING POOL I
TAN KS type: BLDG. SEWER: (mobile/moved hOllse) I
REFRIGERATION UNIT ROOF DRAINS ~
OTHER: OTHER: /'
NrECHA1"-JICAL FEES: 00
PLUNillIl' J FEES: ;;fI'
CITYS 1 CR lliG E:
OTA FE ~S:
n -
Owner:
4 l2-S
APPLICANT'S SIGNATURE:
/.... \ l\ ~ T.--'"
\ -.... 1
i Contractor:
, Address:
i
i
i ,
I
I Phone ,
!
Contractor's License Number/Expiration Date:
I
I
~~IDJ
iUuiJ
drON
lC\RTMENT
~DATE: T .--is ~V()
"