HomeMy WebLinkAboutCARR BLVD., 1543
...
...
E~(.~
BREMERTON PERMIT CENTER
286 4th Street~ Bremerton. WA 98337
Phone: (360) 478-5275 FAX: (360) 478-5.278
GRADING PERMIT
Applicant: LOUIS MENTOR 360-782-0155
4541 THE CEDARS BREMERTON WA 98312
Permit No: 02-0014
Status: ISSUED
Applied: 01/14/2002
Issued: 04/26/2002
Expires: JO/23/2002
Job Addr~ 1543 CARR BLVD
Location: 1543 CARR BLVD
Parcel No: 3719002-006-0105
Owner: LOUIS MENTOR 360-782-0155
4541 THE CEDARS BREMERTON WA 98312
Contractor: :5 e I-F
Lic :It: Exp:
Oesc: GRADING PERMIT (350 CUBIC YARDS) FOR FUTURE USE TO LEVEL PARCEL FOR FUTURE RESIDENTIAL
*****************************************************************************~~****~*********
Cubic Yards * Permit Fees: 89.50 Total Calculated Fee: 131.00
350.00 * Plan Check Fees: 37.00 Additional Fees: .00
* Other Fees: 4.50 Total Permit Fee: 131.00
*********************************************************************************************
This permit shall beCl:;lm,,,,, null and void if the bl.dldin;:J or !,Jork ..?.uthoYi.z.ed by this peymit is not corrll'MfnceKl \,Jithin
180 ds.ys fyoo the date of euch permit, or if this bui Iding or wer k authorize-d by' such permit i",' sllspc'nc-€:'d OY
abandoned at any tune aftey the I,,Joyk is commel1C€d for a peYioo of 180 deWS.
NOTICE: - It is the Y'iasponsibility of the permit. h,;,looy, not, the City C)f Bremerton 01". El.d 1djng Official t.:) see
to it that yequiyed iI1RipecU.on.3 an1 n1$,de.. Thor., permit holdF))" mllst noH,y the Buildin~;:j Official when yeady' for
Inspe',::.tions. FaUu'rf? of the peymit ho100y YO notify' the Bui 1djrIQ Official of Y"NU.:l )'""d imrJecti,l':lnS ma,y ye$lllt
in the si:cppas? elf thB \oloyk until sllch tim~ t.hat tr.e p-2ymi"l.:. holde)' can subst,antiate to the building official
that. the conceale'Cl ",ioyk me-et$ or exceeds code re<1l.liyeflW:Y1t.S, An>' dfimoliticl)1, te$t.il'g, 0'1' financi.11 buYden sr.a.U
be bol'l'l<e directly by the peymH holooy. Failun~ to sl.lbslanti<lte code j'equ"i.,.'?ment.s \-!' 11 indemnif'.!:.h,,' Li,t>'
aga,insl any and all n,"""0'onsibili,ty 01' liabil!.t,:r c:oY1nl?c.ted ('JHh th? CQr>",t'(Uctic'1i.
1 heyebY eel'tify that! h:'\ve n!ad and eX1.>Imined this pennit and kT1>::),,) the same to 00 tyue and coyyeet.. All
Pyovisions of lav,ls and oYdinances 90veyning this tyoe of \0Qrk will be cOl11pl:ied with whethli'Y spe,cifii?d heYl;!ir>
or not. The ."'~ ,.,.it ""- no' "eou.. to .,,~ .ut"'''ty to violate or =,,,,, the "ovi.icm of
an)' otl .'1' stat 0: loca <l.~J regu1atlng construeyon %!<l9-Q€rionnalice of constxuctl0n.
Sigrratl.lye: _._,~~_~ Oate=__.
Per. it Center--Approved BY'_W_~
fn;'lm the
corrl::ractoy's resistyatjcn 1a(;I, unoo'(
Oate=_...
Date: _~_la_:lld'
~ ~.A"r'f:'~'\'i .,' "
. 1.___ :., !~E}j,-~ ( r-~
:::::;:: i:; ~,~~=.~:::: \::::::::::::::::::::: :::::::::=::::.:::::=::::::::::::::::::: =:::::::::::::::::::::::::::0::::::: "":::: :::::::::::::::,,~:::::::: .,,=:::::::.:::::::::::::: ==::::::::::~::::::::::::::::::::::::::::::.:::::::::::::::~:::::;::::::::::.:::::.,,~::::::::: :::::~'" =::::: =: "'"
"~ BREMER TON PERMIT CENTER
.. ~i"r '" PERI"HT CO~mITIONS
Pe1Nmi\t ,>1'.jo: 02-100;':4 Pag!3: 1
====~========d====~==============~~===~==================~========:=======:===
Job Address:: :i. S'41._"I;C'P;'RR 8L VD
AseT Acct No: 3719002~006-0105
Location: 1543 CARR BLVD
.(
,
Applied: 01/14/2002
Approved: 04/26/2002
Issued: 04/26/2002
Applicant: LOUIS MENTOR
Owner: LOUIS MENTOR
ContY'8ctor:
Description:
GRADING PERMIT (350 CUBIC YARDS) FOR FUTURE USE
TO LEVEL PARCEL FOR FUTURE RESIDENTIAL USE
ConditiorlS:
1. PROVIDE SITE PI
LIMItS OF GRADING FOR REVIEW
PROVIDE TEMPORARY EROSION AND SEDIMENTATION CONTROL PLAN
THAT MEETS THE CITY OF BREMERTON REQUIREMENTS.
2. LAND USE CONDITIONS/COMMENTS:
NOT1CE OF DECISION - DETERMINATION OF NON-SIGNIFICANCE
(PL02-0005) ISSUED 3-27-02. MUST ADHERE TO ALL THE
~~~~~~u;~~N~~~~E~_.T~E=_'~I_~__..____ Date_______
.....-..
. 'J
'", - ~,~ .
,j.'.'
.~: ,- ,1-"'1.
~i , ,: '"~\l
." ~
{:.~ 0:-.) ( ..... .,.J
C -v ~- r- '--_kP.
~.."''''''
. .,t
,.~,1 ,~
w. ., l~.q
..EMERTON PERMIT CENTER
286 4th Street~ Bremerton~ WA 98337
Phone: (360) 478-5275 FAX:: (360) 4.78-5278
t'i6~;r"~~
Job ~ddress: 1543 CARR BLVD
Locat.ion: 1543..CAPR BLljD
Aser Acct No: 371~602-006-0105
Building Permit No: 02-0014
Ste.t..lls: ISSUED
Issued: 04/26/2002
Expires: 10/23/2002
R E QUI RED
INS PEe T ION S
Item: 01000 EROSION CONTROL
Item: 02800 SOILS COMPACTION
Item: 02700 FINAL--BLDG
Dept: PUBWORKS Division:
Dept: TESTING Division:
Dept: BLOG 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 Endustries
HEALTH: Bremerton/KitsBP Health District.
478--4921
478--5235
ALL INSPECTIONS PERFORMED BY THE CITY OF BREMER TON MUST BE SCHEDULED THROUGH THE
PERMIT CENTER.. (360) 478-5275.
h~ * *** *** *** ******* *** *********(/1** * u*", u****n**** *. kH . ., ,- H _t* * * n* ** *,,"
~7~~~; ~u ~!~ ~ ~_ ~~' s __________.___,,___~__"'_._-_-_- Da t e ~ _ .._________.______
;.11
\
\
'\\,
..
On..-bO J'-j 0
d {Sp
~'1_ .
APPLICA1'lT: DOWNER DCONTRACTOR DAUTHORIZED AGENT
Building Permit Application
City of Bremerton, W A 98337 Phone: (360) 478-5275 Fax: (360) 478~5278
VL 0;2 -():JcS
.
/I
: jiLC .\Jdrt;SS: 1S"'I3 CA--R-R... BL.U D
R. G:.t4. C f1.. -HJ JJ ~ 3 I ''t..
o U f--f..- t\..t 'EN 1-0 I?-
, 4)''1 I + I-l Ii: CFi: D A-il...5
, C::Onl:r:lC~or:
i T:1X .\ccounc :-.iumbe::: 53y- ~ C( -/7 z..r
! 3 ~JO; -6CJ 9--6D&-CJ /o.s-
: :\ddress:
g R.i:I'-t. ~ IL-H I\l G{ ~ S j '-
: :\ddress:
i
, ConU::lctor Lcense;:;::
; Explncion DaLe:
I
: Conc:lct Person:
i Concact Phone#:: ? <if L- 0 I SS-
Check the type of application for below:
D SF RESIDENTIAL NEW D COMMERCIAL NEW
D DCPLEX D COMMERCIAL REMODEL
D ;YL.\J.~uFACTURED HOME D COMMERCL;\L ADDITION
o RESIDENTIAL REMODEL 0 COMMERIC\L REPAlR
D RESIDENTIAL ADDITION D MULTI-FAlvlILY
o RESIDENTIAL REPA1R D TENANT IMPROVEMENT
D GARAGE
o ACCESSORY BLDG
o SIGN
o DEMO
r:g. GRADING (Cubic yards: J.m
o OTHER:
Scope of Work Proposed: F: l' 19.-- J:. 4 "'V't LId e.-ep It 1.. ) "'- f- ~ Vb,S 1.;1
+0 t--"--l-se ~IJ -+- My be..-t/fP- >~{.A,Jet--' Jf-e'l.l ~ cL)....
Square Footage:
Dwelling:
Gar:lge:
Decks:
IS THIS PROPERTY WITHIN 200 FEET OF A SHORELINE?
YES
NoL
Valuation
Permit fee
, ,Total Fees
Surch es
, Energy: SSO.OO
. ScaLe: S -+.50 /3'1 trd '
, I' ' 'h' '" Id-Ic.f'h~;;L-80 'll' h d ' li ' hll "b tim" d I
..pp lcanons tor W lch no permIt IS Issue WIt In 1 days to OWIng t e are or clpp canon 5 a expue y Itanon, clD ? aDS
clnd other dara mbmirted for review may thereafter be rerurned ro the applicant or destroyed by the building official. The buildin:;
I)fficial may extend ,he time for clction by the applicant for cl period not exceeding 180 days on request by the applicant 5howlng
that circumstances beyond the control of the applicant have prevented clction from being taken. No applicant shall be extendeJ
more than once. In order to renew action on an application after expiration, the applicant shall resubmit plans ::md pay a new plan
~( . 5-0
review fee.
APPLICAi.'iT'S SIGNATUR DATE: ~ 1- 0 L
fD)~@~D\Y1[g 0
ln1 JAN 14 2002 ,
BREMERTON
BUl101NG DEPARTMENT
,.i,~' ',',l,, '
l ~,
:i.: !11:~' ~'" ~~ *)l\:*. *;1\ 1'!: :n: ,~ (,' ln~:.>it w '1" * :.~ ,.:;X Ii P W' ~ ;1; ~y~: :~;;, ~\, )C.\~ n.: )~,nl' ',1: ';j' ',:( 'I>. ',<:. :' .< t :;: ,,'j' I:: W W 'J, .'l :1. c, ~: ~:"
, ~., ;:.~:C~:' If" i
'~ ~.~ ,)." """, -\l{ 'I"" ,...., 'f:'" w""' '~""~' 'F~' ~ ~,,,,,, ''''''I')V'~'' '" 'j,," ." ~.. IV'" ". '" ':f W ",' ~. ~ '1\ 'J<' ~". i' ," ," ~' ." '~, " '-. 'f' "", '.\"" r",.~, ,"' ,'"
" ."t' ,', "'..,.'1'- "Jk,'~' '.'~/",ll'" ,', 'J' '>.,") '{'~'-'f """~i:.'i' f, .", '''''_ ',..,,\\ fr'''}>''''-'''''' 1\'1,' ll',,' ", ~ 'l" f-'" .,.. ,A, .,. ";\ -. '1'. fu ,~, 'f"" 11 ", _.' ",/,$1'
11~::r::].p"I'" r\ll'lnlt'\Ar" ~ ('i',){~j,1\(1 ~'::'" (i't"",I"',11 r'l+ .: q;~\ ti(\ {.'",":",/'.,;i---,' /f',l.:.'. ~.' "".'.~: d"_.~
. L "" I.... ~, l - .-'1 i\ ,~' 'r.;',. ,t I,., ...~' '" . . '~., (- t "..... "'" _,' .. ,~ .: ~ ....J
0ayment Method: vrsA Notation: rlENT0R V!S~ Tnit ~ VW
_ _ '." ,_ K"'_ ...,. _ ._ ...,. '.... .... ....' ".... ,," -.'" .,y ,,,,,. _ .- ." .... ... ,._ ~ ,~",..,~ ,,,_ "'.. ...' ~,. "_ .... _~ "" .~. ,~ ,. .. .". ," ".'" ..... '~M '.. ;~_ _. ' . _'.' ~" 'r .~ 'v ""W _..
P e: r !l:i \. lic!;
'1,-1
....... -J
Tvp~~ GR~DTNG GRIAG!;~lG 0rr'~!17
P !,}, r C:,f~.f ~j{~*; :":? 1 Q(1)2 ,.c;".~:;: ,--, 0 't. {) :~,
~i~e r0$S: ,tS43 CA~~ B'_VD
. L r)(:;?. tit'! n -: t 5 i,13 C .Qd.~)!~t ~. t L:?:!
Th12> Pa>"ll1f'II'l
'~4 ('10
T ,....;.:. ,\) r;' ~;~!: .
~ }'r ;.\. 1 C-,;! :) ~"~ l ~:' ~
1 ',; J . (.1 ;'.".
:I,,? ~ , t~i)
:; ":-~'
" J~:1<:.
~~~~~~~%V~~'~W*k~~~~4A~~~~\:~*~:~~*~~~~~4k*~~V~,.~'~~K.~~~\~~~~~~~w~~*
t~ \~' ~ (;L: n ';'
n~;"~(' ;-. j '. t J. '.!~-:
GRA[fli0G QER~Tl' F?ES
f; ;;~.; _" ~} ; -, i.
J.~-32~~1004 (,;214)
..>ot ';' . ~~O
1":14?"'"':;:::~7 "l ':: (O>? ,:'i'~)
'~:: r ;:::! T F" (.:~ I;,; <.~ :.:}p ( ;...; I'J;'J (.; !:'
/J . E.l'.'
,/
--' --~-'----------....-....-...---------,--,
lU, '** ,,,,,.'Ji :I\*;;:-;;~;<<)!();( ll: 'hl; ;.~W* )i:)l(;,(A:'1I::<<>>: >>,,:~(;l(>>:*Y.c)I;)iO~ y,~)fi ~:<<*:IJ(l;: :I: >>::-;-: ll: ~j(lIi>"O:O;.1X lllll: lIOX)l;X/ *li:~'OX:.x X<'
RECEIPT
~*t~K..*I~.W~.**~.*~.**.*.*B*D*...*~*a.*~***.*.*.*.~*....*..zr**
RlCEJPl Number: O?000036 Amount: 37.00 01/14/02 13=26
~ayment Method: MASTER NolaLion: MASTER MENTOR lnit: TO
.,- ~.. ...... ... ,,~... .... ~... ,... - ..-.. 4..... ~ .' ~.. .,..... ~.... '4>" -, '""'"........... ... _ __ '_~ _ _ .... _ ..- ..... ~'" _... ._.., _ .... _ ~."-' "M '"'" ,....._ .... ........ ......._ ..... _ ..... __ .., _ _ M' .,.
Permit No: 02-001d Type: GRAOING GRADING PERMIT
~)it.? Addres~';; 1543 CAR~~ BLVD
Location: 1543 CARR BLVD
lotal Fees: 131,00
TILLS P.:'wrnent 37.00 rot.i:'ill~LL Pmts= 37.00
Balance: 94.00
.*.=~*.****z.*~****~I**...*.*****.....**.*.***~*..*....**..**~**
Account Code Det~GripU 011 Amount
H,'.345.8300 ((j.500) BUILDING PLAN CHECK FEES 37.00
- -- ,...,.............""..... .~....- ~ .... -- ....... .,. .~ -. - .~" -..... -.- - ... . - -,. .". - ........... -.., .... ,,~--.... .-......... ....... _ '.. -~_ ......'" .... _.... ... _'....- ,_ w-
~
.J-:'"
******~***************~*****************************************
RECEIPT
****************************************************************
RECEIP1" Number: 02000040 Amount: 212.00 01/15/02 10:23
Payment Method: MAS fER Notation: mentorl master Init: TO
Planning No.: PL02-0005 Type: PLANNING PLANNING ACTIVITY
Site Addr0ss: 1543 CARR BLVD
Location: 1543 CARR BLVD
Total Fees: 212.00
lhls Paymenl 212.00 Total ALL Pmts: 212.00
Balance: .00
**********~*~***************************************************
Account Code Description Amount
16-345.8103 (4583) GEPA FEES 212.00
I
,
I
j
IrJ
;'-"
N
~ \'
. I..)
t) /
~
'--
.'-.
Lf:
, \
~\
, ,
T;'..
,L,-
'-
v
'K
Vj
(
. (L
\.\/ '
~
'.
<"
,-.
- y
J.
"l& ., . \ 'Z.
r. I
" '"
\ \ \ \
'I (~\
\..\" . '\" {
. .. <'
~' . \<.\ \
\ (,
1"0
7
~
1
t
. ~..
. \~
~ 0\
C
V,-':l ,~.. \)
. \-""" u
"Ii: \~ \;'-
\v \. ,,/ .'
,"~ . l.)'
,I ,
~? \ e..V '
Q;
u
tl/1i
,1\1
o
V'
,-~ '-' ...:~._ ,c.r...,\
,.J~ "..,~. , \
'x;' .. \.
- \> ',0 J(\/ 0
/ '-
\' ;) >:.
;x; .. \.j
'X
(
s
~
!... () CA. ;::. /',.J\ e (c. .; <J ))
'-if 1...( ( + {e C.e i {. (I S
[:' ! L ~~ it., /,'JJ I.,)
Cj b'~., J \ "'t_
79 L-.O\ S-5-
fD)~(Q;~nw~~
lJ1) JAN 1 tl 2002. l0
BREMERTON
BUILDING DEPARTMENT
..
'f/lj i ~
,.0 I- - ~ - ..!-
~" Ils~!".l.j'T
I
j I ~
I ~ I~ ~
~ I I ItA...,
~L__-I
4~ : @
,..
~ ~l
~'\"'~_f:~~
~ III
l&-
I ,1
,
I I
~
~ 1
~ e> @ t
\J
"t .11'5.... 3
b-
I
@I
,0""'- I
\~1}f> {
\"'!>.<A~
4e..
8030
~~..,
,,(
,I
'::!
?
~
N
f-
.. €Efj:~
(l
t:S
e>
o
.41"........
,..
I: t9
,
I I~.I..
1 r 8---
~
....,J ~ 6~ ,'l
I
11'
tl'
'Z.'I!>1..4-...
@
\\ @
~
N
l<'\ '"
~ 8
~
~
~~~
,..~
~
~
1-
. 0
I 6' e
I
~ @>
~
,~
t' w:.. "
(@l)
II'
,
~e"'e.""", ......
I i @>
.
I
!.t..!$.oc.
D @
0
\f\ 37/9
Q
0
,
~
$ " BI0:3- e.
- '" <@?>
,
(1
"'
f::SIOJ." ~
_e_ o $
It. -
7.0' ~ "'-MT \f-
ro'
-
~ ~
g"-"
,
'"
'--
e III -)
,
.. '" "
" I
,.t. ~
,-,
,") t.- ~
N rJ
ED ~
~ \
~
I"". ,"
I
o
o -
11'-
e
~.",
~
f'
..
1-
~
!
."
€
[1.--
~
r-
ns
171 ~
t9
~
~
,~1
~
1.,,>>. 'l......
002
8
,<.,
(e:::)-')
~.tO
~
=
MJ]
@Z
~fJ!IlI~
rCl~~
c::)
c::) 2
"" 0
~ ffi~
'l'-I :.:2: Q
UJ C!:J
ffii:;
S
5
m
VICINITY MAP
~
~
o ~cg~DW~
BREMERTON
BUILDING DEPARTMENT
City of Bremerton ~[!13
Department of Community Development
NOTICE OF DECISION
DETERMINATION OF NON-SIGNIFICANCE
Environmental Application No.
Date Issued
Date Published
ACTION
PL 02-0005
March 27, 2002
March 27, 2002
PL 02-0005 GRADING PERMIT
APPLICANT:
Louis Mentor
4541 The Cedars
Bremerton WA 98312
LOCATION:
1543 Carr Blvd.
Bremerton WA 98312
APPLICATION: Grading Permit! SEPA
PROPOSAL: To stockpile approximately 350 cubic yards of fill for two months on 1543 Carr Blvd. The
fill will then be used to grade and level the parcel to build three single-family homes.
ACTION TAKEN BY: Chris Hugo, Land Use Official
SEPA THRESHOLD DECISION: DNS
PERMIT DECISION: APPROVAL
The City of Bremerton has taken action on this matter as described in this NOTICE.
THIS DECISION MAY BE APPEALED: to the Bremerton City Council within fourteen (14) days of the
date of this notice by the deadline for appeal below.
An appeal to the Cit~ Council must be filed in writing with the Bremerton Department of Community
Development, 286 4 h Street, Bremerton W A 98337 on prescribed forms or in compliance with BMC
21.02.935(g).
For further information contact: Dri Ralph at (360) 478-5845.
CONDITIONS OF APPROVAL: 1) Applicant is to employ the best management practices for erosion
control as outlined in the Bremerton Municipal Code Storm Water Management Manual. Erosion control
will include silt fencing, straw bales, covering stockpiles etc. 2) The proposed stockpile should remain no
longer than the proposed two months. 3) Stockpiling is prohibited on or over the existing septic system
drainage field on site.
Th~ Responsible Official of the City of Bremerton hereby makes the following Findings and Conclusions
based upon a review of the environmental checklist and attachments, other information on file with the
City of Bremerton, and the policies, plans and regulations designated by the City of Bremerton as a basis
for the exercise of substantive authority under the Washington State Environmental Policy Act (SEPA)
pursuant to RCW 43.21 C.060.
FINDINGS OF FACT:
1. The applicant proposes to stockpile 350 cubic yards of fill on the above-mentioned site for future use
to level the parcel for the building of single-family homes on the parcel.
2. Storage will continue for the period of two months.
3. The parcel on which fill will be stored is generally flat. Sand and gravel are the predominant soils
found on site.
4. The fill comes from a construction project on Auto Center Way. It contains no known contaminants.
5. Erosion will be prevented and limited via best management practices according to the Bremerton
Municipal Code Storm Water Management Manual. Erosion control will include silt fencing, straw
mulch, covering stockpiles etc. No further erosion control plan is required.
6. There are no anticipated impacts to air quality.
7. There are no foreseeable impacts to vegetation, or wildlife.
8. There are no anticipated environmental health or lighting impacts.
9. This project could have an impact on the residence that is currently on the parcel. The applicant
must follow erosion control guidelines to prevent any unnecessary intrusion.
10. There is a septic system in the current residence. This stockpiling should not occur over any part of
the existing drain field. Moreover, no trucks or other construction vehicles should disturb or impact
the drainage field while there are residences living on site.
CONCLUSIONS OF RESPONSIBLE OFFICIAL:
The Responsible Official concludes that the proposal does not have a probable significant impact on the
environment, and an Environmental Impact Statement (EIS) is not required under RCW 43.21 C.030(2)(c).
This decision was made after a review of comments received prior to the expiration of the comment
period, a completed environmental checklist, other information on file with the City of Bremerton, and
existing regulations. The information is available to the public upon request.
Responsible Official:
Lead Agency:
Christopher R. Hugo, Director, Department of Community Development
City of Bremerton, Department of Community Development
Date of Issue:
March 27, 2002
Date of Publication:
March 27, 2002
Appeal Deadline:
April 10, 2002
NOTE: Pursuant to RCW 43.21 C.075 and City of Bremerton Environmental Regulations BMC
Chapter 21.12, Decisions of the Responsible Official may be appealed. Appeals are filed with the
appropriate fees at the Planning and Building Department located at the Bremerton Permit Center.
Appeals must be filed within 14 days of the expiration of the comment deadline.
You may appeal this Determination to the Bremerton City Council no later than: April 1 0, 2002.
You should be prepared to make specific factual objections. Contact Dri Ralph (360) 478-5275 to ask
about the procedures for SEPA appeals.
t-'i Od' OOC)0
PERMIT CENTER
Building and Planning Department * 286 4th Street * Bremerton * W A * 98337
(360) 478-5275 * Fax (360) 478-5278
WAC 197-11-960 Environmental checklist.
ENVIRONMPHAL CHECKLIST
Purpose of checklist:
The State Environmental Policy Act (SEPA), chapter 43.21C RCW, requires all governmental agencies to
consider the c:nvironmental impacts of a proposal before making decisions. An. environmental impact statement (EIS)
must be prepared for all proposals with probable significant adverse impacts on the quality of the environment. The
purpose of this checklist is to provide information to help you and the agency identify impacts from your proposal (and
to reduce or avoid impacts from the proposal, if it can be done) and to help the agency decide whether an EIS is
required.
!nstntctions for applicants:
This environmental checklist asks you to describe some basic information about your proposaL Governmental
agencies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring
preparation of an EIS. Answer the questions briefly, with the most precise information known, or give the best
description you can.
You must answer each question accurately and carefully, to the best of your knowledge. In most cases, you
should be able to answer the questions from your own observations or project plans without the need to hire experts. If
you really do not know the answer, or if a question does not apply to your proposal, write "do not know" or "does not
apply." Complete answers to the questions now may avoid unnecessary delays later.
Some questions ask about governmental regulations. such as zoning, shoreline. and landmark designations.
Answer these questions if you can. If you have problems, the governmental agencies can assist you.
The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of time or
on different parcels ofland. Attach any additional intonnation that '.vill help describe your proposal or its environmental
effects. The agency to which you submit this checklist may ask you to explain your answers or provide additional
intormation reasonably related to determining if there may be significant adverse impact.
[he o(checklist for nonproject proposals:
Complete this checklist tor nonproject proposals. even though questions may be answered "does not apply." IN
ADDITION. complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D).
For nonproject actions, the references in the checklist to the words "project," "applicant," and "property or site"
should be read as "proposal," "proposer." and "affected geographic area," respectively.
1. Name of proposed project. if applicable:
I :> l' 3 C A- ;L (L
~~:~4U2~2~~
.~
BAEMERTON
iSUllDlNG DEPARTMENT
A. BACKGROU:'\'D
2. Name of applicant: L {' u ,'( IVI,3-I"; +-t /1-
3. Address and pl;1one nUlJl,ber of applicant and contact person: ._ '"I (/, _ b I s-J'
~ ') '-{ (+ l \-!.. Lc ~ ~ L> 3 (; c , ~ '-
B 1,"{ &-K ~/L +-t Ii) J (,.J I~
Ci&'J/L
4. Date checklist prepared: i - / I - C l....-
S. Agency requesting checklist: C-.....'.}...) <') R r-C,--,-,-e~ i/ / jJ ~t.
/ll'J
j)~r-' I-
WAC (4/15/98)
[CH. 197-11- W AC-P. 53-64J
TO BE COMPLETED BY APPLICANT
6. Proposed timing or schedule (including p~asing, if applicab!s): J' I- \
. Fe f"., -ILr ~tJLL/'t (;5 :j-..-Fc.-.K Ft Ii' l F- )
7. Do you have any plans for future additions, expansion, or further activity related to or connected with this
proposal? rfyes. explain.
1,4. ~-I ~ .3 h t ""<1 t' j
8. List any environmental information you know about that has been prepared, or will be prepared, directly related
to this proposal. IV i /1,) 12..-
9. Do you know whether applications are pending for governmental approvals of other proposals directly atfecting
the property covered by your proposal'? rfyes, explain.
NO
10. List any government approvals or permits that will be needed for your proposaL if known.
(0 j ye e-
11. Give briet~ complete description of your proposal, including the proposed uses and the size of the project and site.
There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do
not need to repeat those answers on this page. (Lead agencies may modify this form to include additional specific
information on project description.)
~2'l \ J \. ~}- .~ Q e 0 ~ ( \ ~ + ..5
+0\;. ,-,--~t l :, k () ~ e 5
WAC (5/15/98)
Page 2
[Chapter 197-1 I-WAC - P.5-64]
TO BE COMPLETED BY APPLICANT
5) Does the proposal lie within a IOO-year noodplain? If so, note location on the
site plan. /t,J ;)
6) Does the proposal involve any discharges of waste materials to surface waters'?
If so, describe the type of waste and anticipated volume of discharge.
fJ'D
b. Ground:
I) Will ground water be withdrawn, or will water be discharged to ground water?
Give general description, purpose, and approximate quantities ifmown.
AJ () ,
2) Describe waste material that will be discharged into the ground from septic tanks
or other sources, if any (for example: Domestic sewage; industrial, containing
the following chemicals. . . ; agricultural; etc.). Describe the general size of the
system, the number of such systems, the number of houses to be served (if
applicable), or the number of animals or humans the system( s) are expected to
serve. L) ;'1\
c. Water runotf(including stormwater):
I) Describe the source of runotf (including storm water) and method of collection
and disposal, if any (include quantities, if known). 'Nhere will this water now')
,.1- J.~"'~
Will this water now ipto other \~aters? If so, describe. _ c- . .-<.... "- ~ ,-\..J
IZ. '"'- "- <r ).- i:.,.... ,-,,--- ~ l \ l\. '>,-....l t' r-~i:-l!.. i I\. f--. 7 r-
y[ ... i..:....
2) Could waste materials enter ground or surface waters? If so, generally describe.
lU0
d. Proposed measures to reduce or control surface, ground, and runotf water impacts. if any:
(VA-
EVALUATION FOR
AGENCY USE ONLY
4. Plants
a. Check or circle types of vegetation found on the site:
WAC (5/15/98)
Page 5
[Chapter 197-11-WAC- P. 5-64]
TO BE COMPLETED BY APPLICANT
~idUOU' tr" ,Ide" mapl" "p,n, othe,
/vergreen tree: fIr, cedar, pine, other
shrubs
1/ grass
pasture
crop or gram
wet soil plants: cattaiL buttercup, bullrush, skunk cabbage, other
water plants: water lily, eelgrass, milfoil, other
other types of vegetation
b. V/hat kind and amount of vegetation will be removed or altered?
Gr~ > t, ..l. (.:.,... t-t~ c;;. S
c. List threatened or endangered species known to be on or near the site.
N () /J' 'Q:
d. Proposed landscaping, use of native plants, or other measures to preserve or enhance
vegetation on the site, if any:
5. Animals
a. Circle any birds and animals which have been observed on or near the site or are known to be
on or near the site: . il5 D
birds: hawk, heron, eagle, songbirds, other:
mammals: deer, bear, elk, beaver, other:
fish: bass, salmon, trout, herring, shellfIsh, other:
b. List any threatened or endangered species known to be on or near the site.
o j
I
C. Is the site part of a migration route? If so, explain.
/ '\
/U r.)
d. Proposed measures to preserve or enhance wildlife, if any: \
/0 Q
EVALUATION FOR
AGENCY USE ONLY
6. Energy and natural resources
WAC (5/15/98)
Paae 6
'='
[Chapter 197-ll-WAC - P.5-64]
TO BE COlYfPLETED BY APPLICANT
a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet
the completed project's energy needs? Describe whether it will be used for heating,
inanufac turing, etc. E. 1-<."--' t- (It e ,-,-,.j... \ ~ ~
b. Would your project affect the potential use of solar energy by adjacent properties?
If so, generally describe.
/J 6
c. What kinds of energy conservation features are included in the plans of this proposal?
List other proposed measures to reduce or control energy impacts. if any: Iv c ;.. i?
rJ {( . -v C -.:. J r
7. Environmental health
a. Are there any environmental health hazards, including exposure to toxic chemicals, risk
of fIre and explosion, spill, or hazardous waste, that could occur as a result of this proposal?
If so, describe.
f0J
1) Describe special emergency services that might be required.
f.j ) to '12-
2) Proposed measures to reduce or control environmental health hazards, if any:
/0' ~ tV ,~
b. Noise
1) What types of noise exist in the area which may affect your project (for example: traffic,
equipment, operation, other)? ;J '" ,..; ~
2) What types and levels of noise would be created by or associated with the project on a
short-term or a long-term basis (for example: traffic, construction, operation., other)? . ' , d.. I ~
Indicate what hours noise would come from the site.' ~ c'/,;; ,~-f, + ecA '........ . '-'--, J- \
JF ~./ It. /. I /
L.- ,.f "L s: r r-l.L.;..:r L t .'\.1
3) Proposed measures to reduce or control noise impacts, if any:
^, ,-
! ..) ~ IV "'2:..
EVALUATION FOR
AGENCY USE ONLY
8. Land and shoreline use
a. Vlhat is the current use of the site and adjacent properties?
WA.C(-/I-'98) (-' C':::.t.j Pc.., (...( ~L Page 7
. ))/ ~
[Chapter 197-1 I-WAC - P.5-64]
TO BE COMPLETED BY APPLICANT
b. Has the site been used for agriculture? If so, describe.
pO
c. Describe any structures on the site.
/ h.)~ ~
d. Will any structures be demolished? If so, what?
~. J -....C
e. What is the current zoning classification of the site?
SF)
f. \Vbat is the current comprehensive plan designation of the site? 5 F""].
g. If applicable, what is the current shoreline master program designation of the site?;0. A
h. Has any part of the site been classified as an "environmentally sensitive" area? Ifso, specify.
;0 A-
1. Approximately how many people would reside or work in the completed project?
(
J. Approximately how many people would the completed project displace? .__
;Jh~ IZ-
k. Proposed measures to avoid or reduce displacement unp' acts, if anv:. .
. -;l~
1. Proposed measures to ensure the proposal is compatible with existing and projected land
uses and plans, if any: {.; A-
EVALUATION FOR
AGENCY USE ONLY
9. Housing
a. Approximately how many units would be provided, if any? Indicate whether high, mid-
dle, or low-income housing..) L (j '-'0 - Ll \ d. J { e
WAC (5/15/98) Page 8 [Chapter 197-11-W AC - P.5-64]
TO BE COMPLETED BY APPLICANT
b. Approximately how many units, if any, would be eliminated? Indicate whether high,
middle, or low-income housing. / L" c--v
c. Proposed measures to reduce or control housing impacts, if any:
jJcl'ie.
10. Aesthetics
a. What is the tallest height of any proposed structure(s), not including ante~s; w~t~s
the principal exterior building material( s) proposed? L '-( r <-0 () c, .:!
b. What views in the immediate vicinity would be altered or obstructed?
IJ 1) N Q..
{
c. Proposed measures to reduce or control aesthetic impacts, if any:
. ~ ( --
;V ) /~ /2-
11. Light and glare
a. What type of light or glare will the proposal produce? What time of day would it mainly
occur? j::; lri-
b. Could light or glare from the finished project be a safety hazard or interfere with views?
)rtf-
~. What existing off-site sources of light or glare may affect your proposal?
It' It
d. Proposed measures to reduce or control light and glare impacts. if any:
jJA
WAC (51l5i98)
Page 9
[Chapter 197-11-WAC- P. 5-64]
TO BE COMPLETED BY APPLICANT
5. How would the proposal be likely to affect land and shoreline use, including whether it
would allow or encourage land or shoreline uses incompatible with existing plans?
/u A-
Proposed measures to avoid or reduce shoreline and land use impacts are:
j\) ;4-
6. How would the proposal be likely to increase demands on transportation or public
services and utilities? l) A-
Proposed measures to reduce or respond to s~ d~d( s) are:
7. Identify, if possible, whether the proposal may conflict with local, stare, or federal laws
or requirements for the protection of the environment.
/u ti
WAC (5!l5/98)
Page 13
[Chapter 197-1 I-WAC - P.5-64]
EVALUATION FOR
AGENCY USE ONLY
TO BE COMPLETED BY APPLICAi"IT
12. Location of the proposal. Give sufficient information for a person to understand the precise location of your
proposed project, including a street address, if any, and section, township, and range, if known. If a proposal
would occur over a range of area, provide the range or boundaries of the site( s). Provide a legal description, site
plan, vicinity map, 3l1d topographic map, if reasonably available. While you should submit any plans required by
the agency, you are not required to duplicate maps or detailed plans submitted with any permit applications
related to this checklist.
/S-Y:3 C.I\-IL lL IS. Lu 0 OIL (2:. Il-t. f2 r-~ N) GfA.
B. ENVIROi\'~IE""T AL ELEMENTS
I. Earth
EVALUATION FOR
AGENCY USE ONLY
a.
General description of the site (circle one): Flat, rolling, hilly, steeR s~pes,
mountamous, other... l"-t;> J- (7 5/ r!t:: + / :; / l)~' f- .> I:;, f ~
What is the steepest slope on the site (approximate percent slope)? , 2.. ~
b.
c.
What general types of soils are fo~d on the site (for example, clay; sand, gravel,
peat, ..5 ,~"'- L.\..- ');---..J- "-
muck)? If you know the classification of agricultural soils, specifY them and note
any prune
tanruand.
d. Are there surface indications or history of unstable soils in the immediate vicinity?
If so, describe. /J ()
e. Describe the p~ose, type, and approximate qua,n~ties of any filling or gradin10 t/....J) _ ("t' d C' Il S, f
proposed. Indicate source of fill. ;J 5'01 J. :> Q _4. i;J .... f- i..' e ~ f '~
5 ~ "-r-<:"" €
{/1-'- ~
c < ~ -!-.Ul..
W' A- '1
[ Could erosion occur as a result of clearing, construction, or use? If so. generally
describe. AS 6
g, About what percent of the site will be covered with impervious surfaces after project
construction (for example, asphalt or buildings)'> 3. ...) 7"
h. Proposed measures to reduce or control erosion, or other impacTS to the emh if
any: f1, A .
2. Air
WAC (5/15/98)
Page 3
EVALUATION FOR
[Chapter 197-II-W AC - P. 5-64]
TO BE COMPLETED BY APPLICANT
AGENCY USE Ot'.'L Y
a. What types of emissions to the air would result from the proposal (i.e., dust,
automobile, odors, industrial wood smoke) during construction and when the project
is completed? If any, generally deSCri,p e and give approximate guantities ifknown.
--\.1 r'L~-i t<->...Je.-'+(~{ Cc.Jfit5fr~c+-d-v'
5 4 .r t- J--\--<- I- '^"-
b. Are there any off-site sources of emissions or odor that may affect your proposal? If
so, generally describe. IV It.
c. Proposed measures to reduce or control emissions or other impacts to air, if any:
fJ.-1\ "
3. Water
a. Surface:
1) Is there any surface water body on or in the immediate vicinity of the site
(including year-round and seasonal streams, saltwater, lakes, ponds, wetlands)?
If yes, describe type anq provide names. If appropriate, state what stream or
river it Hows into. IV J UfZ-
2) Will the project require any work over, in, or adjacent to (within 200 feet) the
described waters? If yes, please describe and attach available plans.
fvi_ A,
3) Estimate the amount of fill and dredge material that would be placed in or
removed from surface water or wetlands and indicate the area of the site that
would be atfected. Indicate the source of fill material.
fJA .
-+) Will the proposal require surface water withdrawals or diversions? Give
general description, purpose, and approximate quantities ifknown.
!fA
EV ALVA TION FOR
AGENCY USE ONLY
WAC (5115/98)
Pao-e 4
'"
[Chapter 197-11-W AC - P.5-64]
[F{)lY!
DEPARTMENT OF COMMUNITY DEVELOPMENT
286'" Fourth Street. Bremerton W A 98337 (360)478-5845 FAX (360) 478-5278
March 26, 2002
Mr. Louis Mentor
4541 The Cedars
Bremerton WA 98312
RE: PL 02-0005 Grading PermiU DNS
Mr. Mentor:
We have completed the DNS process for your application. You can pick up your permit on
April 11 if there are no appeals.
The City of Bremerton has issued a Determination of Nonsignificance (DNS) on the above
referenced proposal. In accordance with WAC 197-11-355, the City of Bremerton is
required to send a copy of the DNS to agencies other than City of Bremerton Departments
that will be requiring permits for the proposal. If these agencies have comments regarding
the DNS, such comments must be submitted to the City of Bremerton, Building and Planning
Department within the (14) day appeal period required by the City of Bremerton Code. For
this application the deadline is 10 April 2002.
Thank you for your input. If you have further questions, please do not hesitate to contact me.
sin1erelY,
ulVlr~
Adnanne Ralph
Environmental Planner
Department of Community Development
Ecnl (1): Determination of Nonsignificance
( .
ScOpe of w
Address:
Owner:
Contracto :
BREMERTON BUILDING DEPARTMENT
Inspection Report
rj Gr
Permit Number:
o~ -O()tLt
Phone: 78' d - () I.SS
Phone:
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)
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
St~irs: rise & run; proper width Fire blocking wall to ceiling, furred walls every 10'
Fire blocking: stairs, soffits, lowered ceilings Fire blocking: tubs/showers
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
Wallli, roof sheathing Shear nailing
Buildinp dried in
FRAMING
COMMENTS:
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/FOUNDA TION INSULATION APPROVED:
WALL INSULATION APPROVED:
CEILING INSULATION APPROVED:
Appliance location and access, proper support Appliance clearance to combustibles 1-
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 Wood stoves & fireplaces: Tight-fitting doors
Wood stoves & fireplaces: proper health Manufacturer's specs on site
Chimney liner: when required Chimney: separate flues when required
MECHANICAL
COMMENTS:
GAS PIPING APPROVED:
FURNACE APPROVED:
OTHER APPLIANCES APPROVED:
OWV & water piping under test OWV: proper grade
OWV: proper sizing OWV: proper drainage fittings where required
OWV & water piping proper support OWV: 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
PLUMBING
COMMENTS:
PLUMBING GROUNDWORK APPROVED:
PLUMBING ROUGH-IN APPROVED:
Proper fastening nails - 7" o.c. horiz. Plane Nails 8/1 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. plan (5/8") Screws - 12" o.C. horiz. 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 Oraftstops where required
Usable space under stairs (5/8" required) Waterboard where required (not on ceiling)
Corridors
SHEETROCK
COMMENTS:
SHEETROCK APPROVED:
Energy code requirements met, exhaust fans 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
FINAL
COMMENTS:
r-Ud ^ I ^ nnnr\\ Ir-n.
. -"~. ... ,r"'iJ. ,\.r..'.",'..~... II '.... J..;;~;".... P._ .':t>"f ,_[T,.<.,:,'1j_-,,;. .f"~ ',' ....u.'\;!\'<;...,..;t..~\ t",-~,. -:,^ ",::.v~~>'V'f(~f,,,,..'--j-L:.y\;;\4;~;"'" ..~.. .... ; "~f "...~- . -..\.,'. f ..~~ ",'
-~, ",
...
('....
. '.~
BUILDING PERMIT
City of Bremerton, Washington 98310
Assessor's Tax Account No.: 2> 7 I q - 0 o~ ~ 66 {p -- 0 J
N2
8882
Phone: (206) 478-5281
Site Address:
1543 Carr Blvd.
C.H. Youngberg
Phone No.:
. Address: Box 719. Borst
479-1595
Owner's Name:
Applicant: .
EJ Owner
o
Architect
o
Contractor
o Tenant
Architect Firm:
Representative:
Phone:
Address:
Contractor:
Self
Representative:
Address:
Phone:
Contractor's License No.:
Exp. Date:
[!] Residence 0 Business 0 Other:
o Demolish '0 Duplex 0 Muiti-Family (No. units
o Grading (cu. yds 0 Bldg, Move
Nature of Work Proposed: Reroof 8 Squares 3 tab roofing and renair .ki f"rhpn f1 OOT q;:lO'
General repair and upgrade valuation added to permit per Dick 5/25/88
o
New
[!] Repair
..0 Sign
o Remodel/Addn
o Parking Lot
Sq. Ft:
Utilities: o Water o Waste o Sewer 0 Septic o New
Valuation of Materials/Labor: Plan Review Fee: Permit Fee:
[UBC Sec. 304(b)] $ $27 . 00
$1080.00 19'5'-1f
Receipt No.: Receipt No.: 78310
'$500.00
Date: Date: 4/11/88
o Existing
0, Storm
Surcharges:
State ij~;~ ~
Energy $10/$15 0
Zone Designation:
Minimum Req. Setbacks: Front:
Occupancy Classification (UBC):
No. Stories:
Side:
Rear:
Height:
Heat Source:
Comments/Conditions of Approval:
Richard R. Mumma, Building Official
~
INSPECTIONS REQUIRED: Foundation 0 Framing 0 Plumbing 0 Mechanical 0 Wallboard 0 FINAL [K]
OWNER OR BUILDER SHALL CALL 478-5281 FORALLREQUIRED INSPECTIONS AND RECEIVE APPROVAL PRIOR TO CONTINUING
WORK. SEPARATE PERMITS ARE REQUIRED (WHERE APPLICABLE) FOR PLUMBING AND MECHANICAL
All provisions of ,laws and ordinanc~~_~governing '!hiS type of 'work will be complied with whether specified herein of not. The granting of'a permit does not presume to give authority to violate or cancel the
provisions of any other state or,.loeai law regulating construction or the performance/Of ,construction, SEE AND READ NOTICE ON REVERSE. '. .~
Signature ///:;J;"pZ~~1/('/C./t,t4/ //~, Datel:/.;.--))- YY
r j' ./' V ' ___7 ,. ,/~/ 1../ /'7
Copies to: White-owner: YeIlOw-fJe;~ink-Assessor;'~oidenrod-BUil(j';~ Stat. Code I I
\'ti-
{
i
BUILDING
PERMIT
APPLICATION
Phone: (206) 478-5281
Address: 15 X'
- -"
Phone No.p!.;7,1j? ~.) ~1" ~
7/Y> 6~R~-rr k?B
, . /
Applicant:
D Architect
D Contractor
D Tenant
Architect Firm:
o
Representative:
Phone:
Address:
Contractor:
. W>1RY
/
Representative:
Phone:
Address:
Contractor's License No.:
o Other:
o Multi-Family (No. units
o Bldg. Move
Ff1) ~tJ
1-" t7 )'J
o
New
Exp. Date:
~. Repair
I
o Sign
D Remodel/Addn
D Parking Lot
D Residence
D Demolish
D Grading (cu. yds
Nature of Work Proposed:
o Business
o Duplex
~
~Ye/; ;;
Sq. Ft.:
Utilities:
o Water
D Waste o Sewer D Septic o New
Plan Review Fee: Permit Fee:
$ $.;;27 00
Receipt No.: Receipt No.:
Date: Date:
o Existing
D Storm
Valuation of Materials/Labor:
[UBC Sec. 304(b)]
Surcharges:
logo,oo
State 43-:-5-0)SJ
Energy $10/$15 tJ
Zone Designation:
Setbacks: Front:
Occupancy Classification (UBC):
Side:
Rear:
Height:
No. Stories:
Heat Source:
Comments/Conditions of Approval:
I understand that applications for which no permit is issued within 180 days following date
of application shall expire by limitation, plans and/or other data submitted may be returned
to applicant or destroyed by the Building Official. (Sec. 304(d)UBC). I certify that the
information on this application furnished by me is true and correct and that the applicable
requirements of the City of Bremerton will be met.
S~n~ure Da~
Copies to: White-owner: Yellow-file; Pink-Assessor: Goldenrod-Building
Stat. Code I
/ 0 -( q ~ 'if g-
/)~C0L ~ I
f
t[; OWL;-iufAj/ Cfh~V'C#6d;1J>1, ~ CJ2'f6 Y~lWr'
Ao~ a::t ;cJ'i3 ('al/, /gli/d . 5 an, 9tJt'jfcJ do ~
e.r-~ v~ dn/ ---ft~ h6CW!f? 0Yl P(ffV]J~ ' Oa~.).L(+t;
P--Q (A~umJ;CMJ uJ~ r( ffllh<<1-:J ~ r"~ l>>l'~ 30-4SJ1J
~.,~ o.v' ii, 'J? -f fo-vv oQ rrworK ~! 0//i-;c9. h IJvJ h,cr, ,
~ ~~+ar5 0-/lQ r;?I~hovJ. ~-{ 10((~~.
rAO f'Q evrFhr mcJ-i 6YJ I -P~() ~ -10 cmJ!} ~ cd- L{ 7 f - 76 Lf 0 q
'J>r~01( wtkfj.~
OO~@~aw~WJ
(1 (, -f'- (} (:i ! C Q c,,"
.-' J (.! '.,>' !....Juu
The Energy Starts Here
BREMERTON
[WILDING DEPARTMENT
Puget Sound Power & Light Company 1300 Sylvan Way P,O. Box 2189 Bremerton, WA 98310 (206) 377-3931
i ---'
)
-~.- .0'_ "-- -. .-' W--" '.,.....v.y..o
-_._~">""'V'''''''''''---~'''''Y'''''-~~~~~~~...,Q.J-'~~-t....~~~.............~~--.....''
\~
,
1
~
~
CITY OF BREMERTON - BUILDING DEPARTMENT
478-5281 - 817 PACIFIC AVENUE, BREMERTON, WA 98310
INSPECTION REPORT PERMIT NO. ?foq~
. \
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:
.h
( )) () (" i< () n
...J ,-,.- n . b n I
{ ^ c...,~ \:..~ l <.:::JJ..
De..lrn,\~
\
:.5 I i-c h ct..s e.".~ C!- e f d C.J...~
r\ (l Of:.....r r'Y"\ \ t ..D t E: 0... 2J e._
I I
Wor"K
r-e. V \S~
"
,.
You are hereby notified that no more work shall be covered upon these premises until the ab~ve viola-
jj~ aN~irreR~~;;~orThii;s T;gbe:::S~ ~/ ir-1nS;WJfLAAJ /1
'I (( v l/ ,NsPEcroR-FOEkBUILDING DEPT.
I
_/?J-3~
.;
CITY OF BREMERTON - BUILDING DEPARTMENT
478-5281 - 817 PACIFIC AVENUE, BREMERTON, WA 98310
INSPECTION REPORT. PERMITND. ?&/f~
\
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:
IAJork. () r)
d e_.'~Q/l' be.r1
~e .Ir t'"Y) \ -'c
3.' +C e~a..s, ~ ~J'~ tir~
6 fl P rY"t I *=- ~ t ~a...d '- J
WOrK
. '
re.,\J \s~
You are hereby notified that no more work shall be covered upon these premises until the ab ve viola-
tions are corrected. When corrections have been made, call for re-inspe t" n
Do Not Remove This Tag DATE q~~ if
CITY OF BREMERTON - BUILDING DEPARTMENT
478.5281 - 817 PACIFIC AVENUE, BREMERTON, WA 98310
INSPECTION REPORT.
PERMIT NO.
('2&0
I have this day inspected this structure and these premises and have found the following violations
of City, Countyand/or State laws governing same:
~h*'16r pc-
YeJUL~.!
-
( v-..
$" I 2.../e, ,
You are hereby notified that no more work shall be covered upon these pre
tions are corrected. When corrections have been made, call for re-inspecti
Do Not Remove This Tag DATE /Z' I)., ~f
INSPECTOR FOR BUILDING DEPT.
~NSPECTION RECORD CARD
CITY OF BREMERTON BUILDING DEPARTMENT
ADDRESS & DIRECTIONS
1543 Carr Blvd.
PERMIT NUMBER
8682
OWNER C. H. Youngberg
CONTRACTOR
Self
PHONE
PHONE
479-1595
COMMENTS:
1 FOUNDATION
CORR O.K.
1. PERMIT ON SITE --
2. CHECK PLANS TO PERMIT --
3. CHECK SETBACKS --
4. PROPERTY STAKES --
5. FOOTING SIZE CORRECT --
6. WALL SIZE CORRECT --
7. CHECK FOR FILL --
8. REQUIRED STEEL IN PLACE --
9. CHECK FIREPLACE FOOTING --
10. ANCHOR BOLTS --
11. FOUNDATION PLATE --
12. FOUNDATION VENTS --
13. CRAWL SPACE ACCESS --
FOUNDATION INSPECTION APPROVED
BY:
2 FRAMING COMMENTS:
CORR O.K.
1. WIRING APPROVED --
2. FOUNDATION VENTS --
3. SHIELD UNDER POSTS --
4. POSITIVE CONNECTIONS --
5. SOIL TO WOOD CLEARANCE --
6. POST CLEARANCE - 2" --
7. BEAM SUPPORT --
8. TR. MAT. NEXT TO CONC. --
9. WASHERS ON ANCHOR BOLTS --
10. BEAMS PROPER SIZE --
11. FLOOR JOISTS $PAN --
12. NOTCHING & DRILLING --
A-FLOOR JOISTS --
B-STUDS --
13. STAIRS --
A-WIDTH --
B-RISE & RUN --
C-WINDERS --
D-LANDINGS --
E-HEADROOM --
14. ATTIC VENTILATION --
15. CHIMNEY STRAPS SECURED --
16. FIREPLACE COMBUSTION AIR --
17. FANS VENTED OUTSIDE ---
18. A-BATHROOMS --
B-LAUNDRY ROOMS --
C-KITCHEN --
18. WATER CLOSET CLEARANCE --
19. SMOKE DETECTOR --
FRAMING INSPECTION APPROVED
BY:
CORR O.K.
20. FIREBLOCKING _ _
A-STAIRS _ _
B-DROP CEILINGS _ _
C-TUBS OR SHOWERS _ _
D-ROOF & CEILING LINES _ _
E-FURRED OUT AREAS _ _
F-FIREPLACE AT CEILING _ _
G-ELECTRICAL HOLES PLUGGED_ _
H-PLUMBING HOLES PLUGGED__
I-LID IN VOIDS
21. WINDOWS
A-SAFETY GLAZING
B-VENTILATION
C-REQUIRED FIRE EXITS
D-WINDOW SILL HEIGHT
22. CEILING HEIGHTS
A-BASEMENT
B-MAIN FLOOR
C-UPPER FLOOR
23. SWAY BRACING
24. TRUSSES
A-PROPERLY INSTALLED
B-STAMPED
25. ATTIC ACCESS
26. CEILING JOIST SPANS
27. RAFTER SPANS
28. ROOF SHEATHING
29. ROOFING APPLICATION
30. SIDING
31. CLOTHES CHUTE
32. SHEETROCK BACKING
A-UNDER STAIRS
B-ABOVE GARAGE
DOOR HANGERS
M MECHANICAL CORR O.K. CORR O.K.
1. FURNACE SIZING -- 1. WOOD STOVE CLEARANCE --
2. FURNACE LOCATION -- 2. CHIMNEY CLEARANCE --
3. FURNACE CLEARANCE -- 3. HEARTH EXTENSION --
4. 'B' VENT SIZING -- 4. CHIMNEY HEIGHT --
5. 'B' VENT CLEARANCE --
6. 'B' VENT SUPPORT --
7. COMBUSTION AIR --
8. DUCT SIZING -- FURNACE APPROVED BY:
9. DUCT CLEARANCE -- HEAT PUMP APPROVED BY:
10. DUCT SUPPORT --
11. DUCT JOINTS -- GAS PIPING APPROVED BY:
12. GAS PIPING TEST -- WOOD STOVE APPROVED BY:
13. GAS PIPING SIZING --
14. GAS PIPING SUPPORT -- OTHER:
15. OTHER --
P PLUMBING CORR O.K.
1. UNDER TEST --
2. GATE VALVE --
3. WATER PIPE SIZING --
4. DRAIN PIPE SIZING --
5. VENT PIPE SIZING --
6. PROPER SUPPORT --
7. PROPER FITTINGS -- UNDERGROUND APPROVED BY:
8. VENTING --
9. CLEANOUTS -- ROUGH-IN APPROVED BY:
10. PROPER GRADE --
11. HOT WATER TANK P. R. VALVE --
12. OTHER --
3
WALLBOARD
CORR O.K.
COMMENTS:
1. LID OVER SIDES _ _
2. NAILING _ _
3. W/R AT TUB OR SHOWER _ _
4.5/8 UNDER STAIRS __
5. FURNACE ENCLOSURE _ _
6. FIRE SEPARATION GARAGE _ _
7. ATTIC ACCESS _ _
8. DROP CEILING & LIGHTING _ _
9. BACKING AS NOTED ON FRAMING_ _
WALLBOARD INSPECTION APPROVED
BY:
4
FINAL
1. HANDRAILS
2. GUARDRAILS
A-HEIGHT
B-INTERMEDIATE
3. EXHAUST FANS
A-KITCHEN VENTING
B-BATHROOMS
C-LAUNDRYROOMS
D-DRYER
4. TILE AT TUB OR SHOWER
5. DISHWASHER
PROPERLY INSTALLED
6. FIRE DOORS
A-SELF-CLOSING
B-SWEEP OR THRESHOLD
7. ATTIC ACCESS
8. HOT WATER TANK
NOTES:
PLANNING:
~
ptJ.A.
~1~5t.-
CORR O.K. CORR O.K.
-- 9. OUTSIDE GARAGE --
-- 10. CLOTHES CHUTE --
-- 11. SEWER/HEALTH DEPT. --
-- 12. COMMERCIAL BUILDING --
-- A-MECHANICAL APPROVED --
-- B-PLUMBING APPROVED --
-- 13. SMOKE DETECTORS --
-- 14. FIREPLACE HEARTH --
-- 15. SAFETY GLAZING/
-- DOUBLE GLAZED --
16. INSULATION CERTIFICATE --
-- 17. FREE-STANDING
-- FIREPLACE APPROVED --
-- 18. WINDOWS & DOORS CAULKED --
-- WEATHER-STRIPPED --
--
-- FINAL INSPECTION APPROVED
BY:
~~
II..~... 611 f<-
/Ieee!
\>~~'V' (~sJP~~ Iv
~~n,- 4€.RU C)~&Jf?~ot
~ ~/f!2
CITY cot'\TIL
BIl.L :\:'-10
D'5I'I<' I
E. L. STliRDIVA;\r
DLJ!i'{c{ }
ROY T, MOSELY
Di.UTlC! 3
JI:'-I ADRIAN
DUfner.:
CLYDE L, PACHEK
e
('j l..y'" OJ 13rc 111 C rt 01 t
.
:2J9 FOURTH 51 REET
HRE!\IERTO~. \\O\SHINCiTON 9~.110
(:;06)4 ~ R. ''::5:2
Di..,;,io 5-
AL VILU-JOCK
Building Official
Building Department
\\AYOR ~IORR1F D..\\\'hINS
ART A"DERSO:-:
/):'5;rn:F 6
PHIL DROU;\
DL',:rtct -:
SPE:'-CFR HORNING
DC.flle,8
478-5281
RUSS JOH;\Sm;
~
DiSfric! Y
DA TE :
J1aIjQr.i.e..-Blossom
_Star -B.t... 1 Box 38J -0-
~f;ire..n.er:tQU, . }\1i'l. 9.8.310
Dear ~orip. R10ssnm
The Building Department wishes to advise you
conditions existing on the premises located at
are in violation of
EM: 17.20 Dangerous Bldg.
that the following
1543 Carr Blvd.
Rerro ,c/ 'I ~-
_ ve garaqe-ol. barrel
JIQIILSide () f hCll1se-n:"pai-:t:-flooJ; --RepJ:a-ee--.elec:\;;.;l;ic-s@AAGe-
upda....e 1 kh, d ~
. L' e ec- rerrove c me)' an replace-steps. clean yr:m"l -..Ie1IO.\le crlr frOl-:tl-back of lot.
Please abate this problem within the next 10
or sooner if possible, in the follmving manner: Inperative up date..
Elec. conplete -rerrDV~eand oil~ -cl~~a11d rp]JY)~"~1if'~_/
days,
@ ~0{.
The Building Official would be willing to meet with you to discuss
the abatement of this problem. Please contact me by letter or phone
on or before 4-26-83 to set up an appointment.
If we do not hear from you, or if the problem is not abated by the
date set forth above, a formal notice will be forthcoming.
Sincerely,
11 /~?/y
/ /,~
!/t /d? /(/
'AL 'VILcr.,\^lOCK ~
Building Official
)
Gote'l'!.'al' (0 thi' Oh'mn;c.fO and Hnml' nf ,hI' /Jl1vpf :;;:mlnn Nnvnl (,'J,ip''''nrA
'rl