HomeMy WebLinkAboutCLARE AVE., 2866
~LL
BUILDING PERMIT
INSPECTION
CARD
.p.RgI.,;~r__rI.1J$..~ARQ.EIlQ.M_rf.l~.Wt;!lT.tlfgB
Building Plumbing 0 A arm/Sprinkler
DURIN .. INSPECTIONS THE BUILDING PERMIT & APPROVED PLANS SHALL BE ON SITE
Permit # !! !! Q ~ - D D ~Z5 [P@~U @~ @OUrn
For Inspections Call (360) 473- 5870 Approved Date Notes
1st., r r , 1 Erosion Control In Place
.., FOldVDATIOlV
DO NOT POUR CO~CRETE
PRIOR TO APPROVAL
Foundation Footing (Check Setbacks)
Foundation Walls
Plumbing Ground Work
In Slab Mechanical
Footin Insulation
Rough In
Duct / Vent
Support / Test / Meter set
Under Floor Framing
2nd PLUlI-:1BING
JlfECHANICAI_
GAS PIPE
I'd
3 FRAi~JIN(i
II' I sf & 2 lid I
, . are approvef.
Shear & Hold Down Connections
L&I Electrical Approved
Ventilation Requirements
Framino
1
l
~
th
4 INSULATiON
~th
~ SHEETROCK
6th
FINAL BUILDING
All of the above must be 11NAL ELECTR1C1L Dept, o.lLabor & [m/t,,'try
approved
prior to tinal
415-4000
o
I'
,
o
o
ILL FiN,IL lNSPE CV/\tJPLLTED OccllpallLJ' App/'tll'(/l
Sil/ule Fllmilv Residence VI/fl'
00 :\!OT OCCUpy BUlLDI:\!G WITIlOl.IT BnLOING DEPART\IE:'\T .-\PPIWVAL
PROTECT TIfIS C4RD FROM TUE WEA Tl/ ER
OCL
V't
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3-;)6.5-000-178-0102,
Co pvri:l hi Kilsa p Cou ntv 2004"
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614'Division Street,
Port Orchard, WA 91
Voice: 360.337.7053
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CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER 8806 00385
DATE ISSUED: 06/01/2006
345 - 6th Street, Bremerton, WA 98337
(360) 473-5275 Fax: (360) 473-5278
ASSESSOR NUMBER:
APPLICANT NAME:
OWNER NAME:
CONTRACTOR:
LENDER NAME:
3965-000-178-0102
BUSBY DEBUSSCHERE ROBERT &
BUSBY DEBUSSCHERE ROBERT &
HANDYMAN NETWORK
ZONING:
PHONE:
PHONE:
PHONE:
R10
(360) 377-0980
(360) 377-0980
(253) 858-1038
SITE ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
2868 CLARE AVE
2916 NW BUCKLIN HILL RD UNIT 135, SILVERDALE, WA 9
2916 NW BUCKLIN HILL RD UNIT 135, SILVERDALE, WA 9
3309 56TH ST NW SUITE 106, GIG HARBOR, WA 98335
PHONE: 0-
SUBMITTED:
06101/2006
APPROVED:
EXPIRATION:
11/28/2006
STATUS: ISSUED
VALUATION:
$1,910.00
Building Permit. No Mechanical/Plumbing
Building Permit
State Surcharge
$69.25 2211
$4.50 0236
$73.75
DRYWALL & INSULATION IN BACK PORTION OF KITCHEN IN SINGLE FAMILY
RESIDENCE
TOTAL FEES:
Building Code Edition:
Occupancy Group:
Type of Construction:
Flood Zone:
Setbacks:
Sanitation Method:
Number of Bedrooms:
IBC: 2003
(Front) (Side) (Rear) (Other)
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
H/D: 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 described and authorized by this permit has not commenced within 180 days from the date of issuance, or if the work is suspended or
abandoned at any time after the work is commenced for a'period of 180 days. It is the responsibility of the permit holder to see that the required inspections are made. Failure to obtain
required inspections may result in stoppage of the work until such time that the permit holder can susbstantiate to the City of Bremerton 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 provisions of
any State or local law regulating construction or the performance of the construction. If listing the owner as general contractor, I certify that I am exempt from the requirements of the
State Contractor's Registration Law under Section 3, Chapter 126, Laws of 1967. 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. (DCD-01)
DCD: 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).DCD: 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.
DCD: Validity of permit. The issuance or granting of a permit shall not be construed to be a
permit for, or an approval of, any violation of any of the provisions of the Washington State
Building code or of any other ordinance of the City of Bremerton. Permits presuming to give
authority to violate or cancel the provisions of the Washington State Building code or other
ordinances of the City of Bremerton shall not be valid. The issuance of a permit based on
construction documents and other data shall not prevent the building official from requiring
the correction of errors in the construction documents and other data. The building official is
2. (DCD-02)
Page 1 of 2
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER BB06 00385
DATE ISSUED: 06/01/2006
345. 6th Street, Bremerton, WA 98337
(360) 473.5275 Fax: (360) 473-5278
ASSESSOR NUMBER:
APPLICANT NAME:
OWNER NAME:
CONTRACTOR:
LENDER NAME:
3965-000-178-0102
BUSBY DEBUSSCHERE ROBERT &
BUSBY DEBUSSCHERE ROBERT &
HANDYMAN NETWORK
ZONING:
PHONE:
PHONE:
PHONE:
PHONE:
R10
(360) 377-0980
(360) 377-0980
(253) 858-1038
0-
SITE ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
2868 CLARE AVE
2916 NW BUCKLIN HILL RD UNIT 135, SILVERDALE, WA 9
2916 NW BUCKLIN HILL RD UNIT 135, SILVERDALE, WA 9
3309 56TH ST NW SUITE 106, GIG HARBOR, WA 98335
SUBMITTED:
06/01/2006
APPROVED:
EXPIRATION:
11/28/2006
STATUS: ISSUED
also authorized to prevent occupancy or use of a structure where in violation of the
Washington State Building code or of any other ordinances of the City of Bremerton.
DCD: Smoke detectors required in all sleeping areas, adjacent hallways and floor levels.
DCD: Windows in sleeping areas must meet emergency egress requirements.
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.
3. (DCD-15)
4. (DCD-16)
Insulation
Sheetrock Nailing
Final Inspection - Building
Page 2 of 2
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
"
~~.
PERMIT NUMBER BB06 00385
DATE ISSUED: 06/0112006
345 . 6th Street, Bremerton, WA 98337
(360) 473-5275 Fax: (360) 473-5278
ASSESSOR NUMBER:
APPLICANT NAME:
OWNER NAME:
CONTRACTOR:
LENDER NAME:
3965-000-178-0102
BUSBY DEBUSSCHERE ROBERT &
BUSBY DEBUSSCHERE ROBERT &
HANDYMAN NETWORK
SUBMITTED:
06101/2006
VALUATION:
$1,910.00
Building Permit
State Surcharge
$69.25 2211
$4.50 0236
$73.75
TOTAL FEES:
Inspection Requests
DCD: Building Inspections
L&I: Department of Labor and Industries
ZONING: R10 \
PHONE: (360) 377-09~0
PHONE: (360) 377-09~0
:::::V'D(~'\'C]
SITE ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
2868 CLARE AVE
2916 NW BUCKLIN HILL RD UNIT 135, SILVERDALE, WA 9
2916 NW BUCKLIN HILL RD UNIT 135, SILVERDALE, WA 9
3309 56TH ST NW SUITE 106, GIG HARBOR, WA 98335
EXPIRATION:
11/28/2006
STATUS: ISSUED
Building peM,it . No Mechanical/Plumbing
DRYWALL & INSULATION IN BACK PORTION OF KITCHEN IN SINGLE FAMILY
RESIDENCE
Building Code Edition:
Occupancy Group:
Type of Construction:
Flood Zone:
Setbacks:
Sanitation Method:
Number of Bedrooms:
IBC: 2003
(Front) (Side) (Rear) (Other)
Square Footage:
Bid Price from Applicant
1 TOTAL
(360) 473-5870
(360) 415-4000
Fire Inspections
H/D: 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 described and authorized by this permit has not commenced within 180 days from the date of issuance, or if the work is suspended or
abandoned at any time after the work is commenced for a period of 180 days. It is the responsibility of the permit holder to see that the required inspections are made. Failure to obtain
required inspections may result in stoppage of the work until such time that the permit holder can susbstantiate to the City of Bremerton 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
responsibiiity 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 provisions of
any State or local law regulatin~-construction or the performance of the construction. If listing the owner as general contractor, I certify that I am exempt from the requirements of the
State Contractor's Registration' Law under Section 3, Chapter 126, La f 1967. All revisions to an approved plan require DCD review and approval prior to performing work. All building
and tenant occupancy permits~reJ reqUir\d to pass final inspection or permit expiration and obtain a certificrte of occupancy prior to use or occupancy.
~~~~:::::~:;::::~!~;&~~:~'7d~~:d"do:;D(n~
^" ?'" ,EfY- ~ ~ ~
/ '" (CONDITIONS./ \
City of Bremerton's approval of this application pertains-only-to.the_City~s-regulatory jurisdiction, and thus compliance with C'
regulations does not necessarily ensure compliance'Vvith_federal or state laws.
--------.
1. (DCD-01) DCD: 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).DCD: For more information, please contact Clean Air Agency fiJ
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.
2. (DCD-02) DCD: Validity of permit. The issuance or granting of a permit shall not be construed to be a
permit for, or an approval of, any violation of any of the provisions of the Washington State
Building code or of any other ordinance of the City of Bremerton. Permits presuming to give
authority to violate or cancel the provisions of the Washington State Building code or other
ordinances of the City of Bremerton shall not be valid. The issuance of a permit based on
construction documents and other data shall not prevent the building official from requiring
the correction of errors in the construction documents and other data. The building official is
Page 1 of 2
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER 8806 00385
DATE ISSUED: 06/01/2006
345 - 6th Street, Bremerton, WA 98337
(360) 473-5275 Fax: (360) 473-5278
ASSESSOR NUMBER:
APPLICANT NAME:
OWNER NAME:
CONTRACTOR:
LENDER NAME:
3965-000-178-0102 ZONING:
BUSBY DEBUSSCHERE ROBERT & PHONE:
BUSBY DEBUSSCHERE ROBERT & PHONE:
R10
(360) 377-0980
(360) 377-0980
(253) 858-1038
0-
SITE ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
2868 CLARE AVE
2916 NW BUCKLIN HILL RD UNIT 135, SILVERDALE, WA 9
2916 NW BUCKLIN HILL RD UNIT 135, SILVERDALE, WA 9
3309 56TH ST NW SUITE 106, GIG HARBOR, WA 98335
HANDYMAN NETWORK
PHONE:
PHONE:
SUBMITTED:
06/01/2006
APPROVED:
EXPIRATION:
11/28/2006
STATUS: ISSUED
also authorized to prevent occupancy or use of a structure where in violation of the
Washington State Building code or of any other ordinances of the City of Bremerton.
DCD: Smoke detectors required in all sleeping areas, adjacent hallways and floor levels.
DCD: Windows in sleeping areas must meet emergency egress requirements.
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.
3. (DCD-15)
4. (DCD-16)
.-)
I
)
(
Insulation
Sheetrock Nailing
Final Inspection - Building
Page 2 of 2
(3f300 0 0 3 <6?
~l}#-- I
PERMIT CEN~ t. (0
Building Permit Application
Dept. of Community Development * 345 - 6th Street. Suite 600 * Bremerton * WA * 98337-1873
(360) 473-5275 * Fax (360) 473-5278
:::::i~:::::lln'r::::i:::::::::::::::::::::::~::::::ft........ ::::::lint.ri~t9.r:::::::::::::::::::::::::::::~:::::::~:::::::::~::......... :~::Iv.il9.m;iI.:::lgivt.::::~::::~:::~~:::j:j:j:j:::~:~:::~:::~:::~:::~:~:~:::::~:::~:~:::~:~:::::::::::::::
qf?:>/(J
MtE
What is the application for? (Please check one)
D NEW SINGLE-FAMILY RESIDENCE
D NEW DUPLEX
D NEW MANUFACTURED HOME
D RESIDENTIAL REMODEL
D RESIDENTIAL ADDITION
D RESIDENTIAL REPAIR
D NEW COMMERCIAL
D COMMERCIAL REMODEL
D COMMERCIAL ADDITION
D COMMERCIAL REPAIR'
D NEW MULTI-FAMILY ffi1 g @ [g 0 \lf7 R@
D TENANT IMPROVEMENT \!J L5
D NEW GARAGE/CAR PO JUN 0 1 2006 D
D NEW ACCESSORY BUILDING
D NEW SIGN COBMREMERTON-DEPT OF
MUN/TY DEVELOPM
D STRUCTURE DEMOLITION ENT
D GRADING (Cubic Yards:
D OTHER:
IS THIS PROPERTY WITHIN 200 FEET OF A SHORELINE? YES D NO D
Scope of work proposed: f)I' ll.1::( J h- 41/Z~bt ~ 'i!\.mc,C (C~'f7,'f4)
f6rt(~ ~~'fc:#11 r ~, , . ,- . .
Square Footage:
Dwelling: it tJ 0
Garage: a(J(j
Decks':
/
Surchargo/
(()1_d5 +70 r; ~.75
A I.. . . . c.iJL~ .;;; 0 DC;. d f I' . hi' b' I( .t t. did I th d t
pp Icatlon for which no permit IS Issued within 180 days follOWing the ate 0 app Icatlon s al expire y 1l'J;11 a lon, an pans an 0 er a a
sUbmi~ted for review ~ay thereafte~ be returned to the applicant or destroyed by the building official. The bC1iaiRg~ay exte~:.!ime _'
for action by the applicant for a perrod not exceeding 180 days on request by the applicant, showing the circumstances l5eyondihe-control-ofttie
applicant have prevented action from being taken. No applicant shall be extended more than once. In order to renew action on an application
after expiration, the applicant s re bmit pia and pay a new plan review fee.
Valuation
Plan Review Fee
.1;J--
Permit Fee
Total Fees
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
Receipt Number: ~ii
345 - 6th Street, Suite 600, Bremerton, WA 98337-1873
(360) 473-5275 Fax: (360) 473-5278
BB06 00385
BB06 00385
Building Permit
State Surcharge
1/2211
1/0236
$69.25
$4.50
Total:
$69.25
$4.50
$73.75
$0.00
$0.00
Total:
$ 73.75
$73.75
CHECK
2009
.~
'-
Page 1 of 1
(
IU"IIUU~:k~:
AFTER RECORD[NG MAIL TO:
N;uoc ROBERT BUSBY-DEBUSSCHERE
Ad.dn:as2 B 6 6 CI.J>.R c: A VE:NUE
aI)', Stale, Zip BREMERTON W,ll. 98310
1BE GRANTOR FORSr-wm, HUSBAND AND WIPE
rbr.ad in co..sidmlion of TEN DOLLA.RS AND O'!'HER VALUJUlLE CONSIDERATION
in Iwld paid, ~nvCY5111d waITIlUs toROBERT BUSBY-DEBUSSOIERE AND CHERYL DEBUSSOlllRE,
HUSBAND AND WIFE
lbc followinJ d=rilxd real estaU:, silllalocl in the CoWlly of Kitnp . Stale of W~lOn:
TAX PARCEL NO.: 3965-000-178-0102
ABBREVIATED LEGAL: PORTION OF LOTS 178 &. 179, CORRECTED PLAT OF PIRST AnDN.
TO SHBRlDAN PARK, VOLUME/PAG8 8/23
FULL LEGAL: AS SET PORTH IN EXHIBIT "A" ATTACHED HERETO WHICH BY THIS
REFiRENCE IS MADE A PART HBREOF.
SUBJECT TO: AS SET FORTH IN EXHIBIT "I\." ATTACHED HERETO WHICH BY THIS
REFERENCE IS MADE A PART HEREO!'.
Daled: March 23. 2001
j~.~fi~......................................,~..M.~~................
EXCISE~$_~~'~ 28 2001
~Y~~SAPCOUNTYT ........ ......m ...... ...
STATE OF wa~gt:on
COUNTY OF 1"'.>4 Jif?
on thi. ~ day of ~/L,t'A ,2001, I certify that I know or have
satisfactory evidence that JOSEPH M. FORSMANN AND LINDA M. PORSMANN. the
persons who appeared before me, and sald per.ons aCknowledged that they signed
this instrument and acknowledged it to be their free and voluntary act for the
uses ~nd purposes mention thia instrument.
LP~IO
l
FILE NO. E-l'OJ46
ESCROW NO:S-14G07-JH
&XllIJI IT A
7.
Easement, includ~n9
by inatrumenc;
Recorded:
Recording No. ,
In Favor of:
For:
Affects.
B.
Easement, including
by instrument;
Recordec1:
Recording No.:
In favor of:
For:
Affeccs:
its terms, covenants and provis~ons as disclosed
September 29, 1948
476900
City of Bremerton
sewer and water lines
portion of .said premises and other property
its terms, covenants and provisions as disclosed
July 27, 1950
515535
City of Bremerton
sewer and water lines, telephone and power
cables
portion of said premises and other property
I'JJJII~.'~~~k2:
'.:E~
I
IDIIlIT A
PILE NO. i-l40246
ESCROW NO:S-l4607-JH
LEGAL DESCRIPTION:
LOT(S) 179, CORRECTED PLAT OF FIRST ADDI'fION TO SHERIDAN PARK, ACCORDING TO
THE PLAT RECORDED IN VOLUME 8 OF PLATS, PAGElS: 23, 24 AND 25, RECORDS OF
KITSAP COUNTY, WASHINGTON;
TOGETHER WITH A PORTION OF LOT 178 CORRECTED PLAT OF THE FIRST ADDITION TO
SHERIDAN PARK, ACCORDING TO PLAT RECORDED IN VOLUME 8 OF PLATS, PAGES 23, 24
AND 25, IN KITSAP COUNTY, WASHINGTON, OESCRIBED AS FOLLOWS:
BEGI NNING AT A POINT WHICH I S THE NORTHWEST CORNER OF SAID LOT 178; THENCE
SOlfl'H ON THE WESTERN BOlJNDAA.Y LINE OF SAID LOT TO THE SOIn'H BOIJNOARY LINE OF
SAID LOT; THENCE ASTERLY ON THE SOUTH BOUNDARY LINE OF SAID LOT, A DISTANCE
OF 16 FEET; THENCE NORTHERLY TO THE TRUE POINT OF BEGINNING.
SUBJECT TO:
I. Reservation of easement for publiC utilities sewer and water line,
telephone and power cables which may now be under the surface of any
of the area vacated, reserved by the City of Bremerton 1n Ordinance
No. 2303 recorded under Auditor's File No. 693297.
2. Easement affecting a portion of said premises and for the purposes
hereinafter stated, as granted by instrument recorded on JULY 19,
1950, in the office of the recording officer ot Kitsap County,
Washingtcn, under rec~rding number 514948;
In favor of, PUGET SOUND POWER Al-lD LIGHT COMPANY
For: Underground and/or overhead transmisslon and
electrlc lines and appurtenanC9s thereto;
Affects: portion of sald premlses
3. Easement affecting a portion of said premlses and Cor the purposes
hereinafter itated, aa granted by instrument recorded 1n the office of
the recording officer of Kitsap County, Washington under Auditor's
File No. 477801;
In favor of: PUGET SOUND POWER AND LIGHT COMPANY AND/OR
PUCET SOUND ENERGY
For: Underground and/or overhead transmission and
electric linea and appurtenances thereto;
Affecti: said premises and other property
4.
Easement as dedicated
Par:
on the tace ot the plat of said addition;
slopes, also the right to drain all streets
over and across any lot or lots where water
might take a natural course after the street
or streets are graded.
aaid premises and other property
Affects:
5. Reservation of fissionable materials, etc., to the Vnited States of
America as shown of the face of the plat.
6.
Covenants, conditions
instrument;
Recorded:
Recordlng No
and restrictions contained in the following
December 14, 19'8
481153
J::f1JUF-
\UlIWllllllmU1llI ~~ ~~!1~8~2:
~lll1l1l1 ~S1..llKI\"Ifl_Co'~ _ ..
AFTER RECORDING MAIL TO:
JOSEPH M. FORSMANN
2688 CURE AVE
BREKERTON, WA 98310
m~I'Ullmllmll
$lUG
3005563
PlI9t' I of 3
53/97197 SNap
mup Co, \oIR
Vllod for Record at Requellt of
Pacifie Northwest Title
&crow Number: 31023291
2,?J')~GIIZ- Statutory Warranty Deed
Grantos(s): LORRAINE J. SHIBLD
Grantee{s): JOSEPH M. FORSMANN. LINDA M. FORSMANN
Abbrevi.atedLegal: LOT 179, PORTION OF LOT 178, CORRECTED PUT OF FIRST ADDITION
TO SHERIDAN PARK
Additionallegal(s) on page: 2
Assessors Tax Parcel Number(s): 3965-000-178-0102
THE GRANTOR LORRAINE J. SHIELD, WHO ALSO APPEARS OF RECORD AS LO~INE
SHIELD, AS HER SEPARATE ESTATE
for and in consideration of TEN DOu.ARS AND OTHER GOOD AND VALUABLE CONSIDERATIoN
inl1andpaid,conveysandwarrant&toJOSEPH K. FORSMANN AND LINDA K. FORSMANN, HUSBAND
AND WIFE
the following described real estate, silu<ited in the County of KITSAP , State of Washington:
See Attached Exhibit A
'fE-
E>;CISE#1!i5:::L~l~, uA'
DY I((TSAP COU:fTY ~ 11i;~
7 1997
See Attached Exhibit B
Datod this ~ day of
,/) .
By .-..-'
LORRAINE J.
By
By
By
STATE OF WASHINGTON
County of KITSA?
}
} 55:
I certify that [ know or have satisfactory evidence that LORRAINE J. SHIELD
i B the peuon who appeared before me, and said person acknowledged that she
signed this instrument;;d aclu1ow1edge it to be her free and volW;U;Yact for the uses and purposes
mentioned in this instrument.
Dated: March 6~ 1997
,to .-"-11"".
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AN KAY KI
Notary Public in d for the Slate of\o1ASHINGTON
Residing at TACOMA
My appointment expires: FEBRUARY 28TH, ZOOl
Pap 1
U'B-10
1IIIIIIrln
3005563
Pil9" 2 of 3
93167/97 SNSP
Kl tSijl Co, WI
Exhibit A
LOT 179, COJIJUl:CTED PLAT OF FIRST ADDITION TO SHERIDAN PARK, ACCORDING TO
PlAT RECORDED IN VOUlKK B OF PLATS. PAGKS 23. 24 AND 25. IN KIT SAP COUNTY,
VASHINGTON;
TOGE'IlIER VIm A PORTION OF LOT 178 COJUtECTlm PlAT OF THE FIllST ADDITION TO
SHERIDAN PARK, ACCORDING TO PlAT llECORDED IN VOUJKK 8 OF PlATS. PAGES 23 - 25.
INCLUSIVE, IN KITSAP COUNTY, WASHINGTON, DESCRIBED AS FOUDWS:
BEGINRlNG AT A !'OINT WICH IS THE NORnNEST CORNKll. OF SAID UlT 178; THlI:NCE
SOUl1t ON THE WESTERN BOtlNDARY LINE OF SAID LOT TO THE SOUTH BOUNDARY LINE OF
SAID LOT; 11IENCE EASTERLY ON THE SOln'H BOUNDAH.Y LlllX OF SAlD LOT. A DISTANCE
OF 16 FEET; nIEl'ICE NOR.'IHDLY TO THI! TRUE POINT OF ~EG1NNING.
-).~. Cb'
JJIMllmII 'I.'D
3005563
Pilgf' :? of 3
83/67197 ez.BBP
Klts.lp Co, /.fl
Exhibit B
* Easement, and the terms and conditions the4eof, affecting a portion of
said premises and for the purposes hereinafter stated, as disclosed by
instrument recorded on AUGUST 16, 1948, under KITSAP County Auditor's
File No. 476900.
In favor of: CITY OF BREKERTON
For: MAINTAINING, REPAIRING AND OPERATING THE
SEWER AND WATER LINES
NOTE: The descdpdon contained therein is insufficient to
specifically locate said easement.
* Easement for electric transllllssion and distribution line, together
with necessary &ppurtenances, as granted by instrUlJlent recorded on
OCTOBER 14, 1948, in the office of the recording officer of KITSAP
County, Washington under recording number 477801.
To: PUGET SOUND PO\fEl{ & LIGHT COMPANY, A
MASS. CORP.
NOTE: The description contained therein is insufficient to
specifically locate said easement.
* Easement, and the terms and conditions thereof, affecting a portion of
said premises And for the purposes hereinafter stated, as disclosed by
instrument recorded on JULY 27, 1950 KITSAP County Auditor's File No.
515535
In favor of: CITY OF BREMERTON
For: PUllLIC UTILITIES INCLUDING SEWER AND
WATER LINES
Affects: A PORTION OF SAID PREKISES
* Reservations contained on the face of the plat
* Right of the public to make necessary slopes for cuts or fills upon
said premises in the reasonable original grading of streets, avenues,
alleys, roads, and to drain streets over and across any lot where
water might take a natural course after the street or streets are
g~~;~, as dedicated in the plat.
U) -:;:F
ORDER NO. 3;;20 )(P J5'--1
,- \
PACIFIC NORTHWEST TITLE
9927I\lil'kclhOrT\' 1{","1 N.I\'
r. 0 Ilt.x 1(,07
Sih'cl dnlt.'. \\lfI"hiuglc't1\ I)~.l R.l
PM) (,n."I,11
F,x: (!(jO) 1i'J2.<<(,')
N
IMPORTANT: This is not a Plat of Survey. It is furnished as a convenience to locate the land indicated
hereon with reference to streets and other land. No liability is assumed by reason of reliance hereon
Portion of Corrected Plat of First Add. To Sheridan Park
(Volume 8 I Pages 23-25)
(Section 11 & 12, Township 24 North, Range 1 East, W.M.)
149-00
148-00
H 1- 00
I ( i
146-00
116
145 -00
/0
144-00
" t
10-00
If J
;' f J
/50
15f-Ol
;;1 :../i
152 ISJ
JJ
119
152-00
153 -00
Ift/
.. . " - I
, ,r
I
178-0f
/19
39
~
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<:
4.J
~
~
175-02
~
C'c
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-,
<0
182-01
/81
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:From: "michelle kinsley" <michellek@headhunt.ie>
;Subject: RE: PR Executive - Job Opportunity - Dublin... Top 100 Company -
:Salary _ 50,000 to 65,00 Euro -
iDate: Wed, 19 Jul2006 10:18:15 +0100
iTo: <ckrdbd@donobi.net>.
- -
~__,~.j_~~_'~"~""'__""'__""""_"'~_"""__~""'_ '" '..r_ ___''~'.,. ,. ~''''~__,''_ _<_~~.....,~_~ _~. ,_,__ _"~'<'''___ _""""'_","""._,~__ ','_
Hello,
Thank you for your interest in the PR Executive position. Your wife does
sound qualified, however I am wondering what her salary expectation would be
as this position offers a salary of mid 40's in Euro plus the typical
package of BUPA Pension, Bonus scheme, Illness cover and educational
Assistance.
Regards
Michelle Kinsley
-----Original Message-----
From: ckrdbd@donobLnet [mailto:ckrdbd@donobLnet]
Sent: 18 July 2006 16:44
To: michellek@headhunt.ie
Subject: Re: PR Executive - Job Opportunity - Dublin - Top 100 Company-
Salary 50,000 to 65,00 Euro
18 July 2006
Hello:
While I would not be suited to this particular position, my
wife certainly would. She has the experience in handling
in-house public relations as well as the required degree.
We both currently live in the Seattle, WA area; she is an
EU national and would certainly be open to such an
opportunity. If you think she might be suitable for the
position, please let us know.
Kind regards,
R. Debusschere
On Tue, 18 Jul 2006 10:14:37 +0100
"Sylvia Harrison" <sylviah@headhunt.ie> wrote:
>
> Good Morning
>
> A major high tech company is expanding and hiring a PR
> Exeuctive to:
>
- "~.:--
- ':~,
. '_I~ ~
Tax Statement
Page 1 of 1
I I I Elected
Home Departments Officials
I County
Services
I ! I Parks &
Resources Environmental Electionsj Ucenses Recreation
View: BecelRl{~L~llfile.
[Click here to Print]
Barbara Stephenson
MAKE REMITTANCES PAYABLE TO:
Kitsap County Treasurer
PO Box 34303 Seattle, Washington 98124
WASHIHGfOt\
For Informational Purposes Only
Process Number 1490135
axpayer Name:
BUSBY DEBUSSCHERE ROBERT & DEBUSSCHERE
CHERYL
I Tax Property Description
SHERIDAN PARK 1ST ADDN
BLK-OOO LOT-178 0-01 PT OF LOT 178 OAF BEG AT A PT WHICH IS THE
NW COR OF LOT 178 RUN TH S ON THE W BDRY LN OF SO LOT TO THE
S BDRY LN OF SO LOT TH EL Y ON THE S BDRY.LN OF SO LOT A DIST OF
16FT TH NL Y TO THE TPOB ALSO ALL OF LOT 179
Account Number
3965-000-178-0102
Land:
Improvements:
TOTAL VALUE:
VALUE INFORMATION FOR TAX
2005
$27,280
$92,620
$119,900
$0
2006~
$34,230
$113,580
$147,810
$0
Frozen Base:
Exemptions (if any):
otal Qualifying Exemptions'
$0
TOTAL TAXABLE VALUE:(Land + Improvements minus Qualifying Exemptions)
$119,900 $147,810
[Click here to Pay by Credit Card]
[Click here to Pay by E-Check]
2006 WEB TAX STATEMENT
Printed:08/17/2006
BUSBY DEBUSSCHERE ROBERT &
DEBUSSCHERECHERYL
2916 NW BUCKLIN HILL RD UNIT 135
SILVERDALE, WA 98383
I GENERAL TAX DISTRIBUTION
I 2005 I 2006
STATE I STATE
GENERAL $355.03 GENERAL
REGIONAL $50311 REGIONAL
LIBRARY LIBRARY
I LOCAL SCHOOL $520.191 LOCAL SCHOOL
COUNTY $156.901 COUNTY
CITY $458.511 CITY
PUD $11.061 PUD
2005 Total $1,552.0012006 Total:
I
I
$384.18
$53.45
$551.32 .
$167.19
$494.56
$11.78
$1,662.48
Current Taxes
I\SSESSMENT 2005 2006
Noxious Weed $1.00 $1.00
I\smt Total $1.00 $1.00
2006 General Property Tax +
Assessments = $1,663.48
$0
Delinquent Section
Year Taxes Int/Pen to 8/2006
Total Delinquent Amt Due:
Total Collection Cost:
Total
$.00
$.00
Voted Rate --37.4 % Voter Approved
General Levy Rate per $1000 11.2473
TOTAL AMOUNT DUE:
$831.74
Levy Code 0060
First half taxes paid after April 30th will incur interest plus
penalty computed on the FULL year amount (RCW
84.56.020). .
Account Number: 3965-000-178-0102
(1490135)
................................................................................................................................................-.......................~........................................................................................................................................................
If you did not make a first half payment or pay
the delinquent taxes listed, if any, call 2
(360) 337-7135 for delinquent tax, interest and
penalty due. Delinquent payments received
without interest and penalty will be returned.
See Treasurer Information link.
TOTAL I
Half I
$831.74
$.00
I
$831.74\
BUSBY DEBUSSCHERE ROBERT &
DEBUSSCHERECHERYL
2916 NW BUCKLIN HILL RD UNIT 135
SILVERDALE, WA 98383
Make Remittance Payable To
Kitsap County Treasurer - PO Box 34303 - Seattle, WA 98124
http://kcwppub2.co.kitsap.wa.us/pls/ilisw/lis.generate _web_state...
1 7 -Aug-06
. Kitsap County Assessor's Property Report
Page 1 of 1
I I I Elected I County
Home Departments Officials Services
I I i I Parks &
Resources Environmental Elections/Licenses Recre21tion
Property
Report
Tax Account No. Process No. Situs Address
~~~~-000-178- 111490135 IF868 CLARE AVE
PrQ1L~J:ty 1111- Single family residence
Cla,~s:
r':';:-~Prrnt:t~NiP~gln"1
Parcel Information
~~~ ~..,~,~~~~,~~~~"\~~~-;'.$;.~.-ut-~~"1~l~~.$i.af-.<JiPl1~~fiI~l~,;;~Jr.""";;"~::fil
1# of
Buildings:
I Acres:
Izoning:
I Account
Status:
Tax Code 10060
Area:
. p- .
Jurisdiction: IBREMERTON
~~~~TWP- 111 24N 1 E
Neighborhood: 171 00542
11
1.32
ICity
IA - Active
!U4"A:~~1;~~JiEi.~~$~~~.tI:'~--SS~"':_~<<;:&&f.7~i-s_c~--",:;;tZ-'i:~~:W.~b~Slt~~~'P.2m-;'4W~~""it,;>~:;::;~wa,i!"~a\:t....-\i-~Ji':J~':::11,,~"t.,:"-nf.,~~.'I:..1:,-V
Taxpayer Information
Name:
BUSBY DEBUSSCHERE ROBERT & DEBUSSCHERE
CHERYL
Mailing
Address:
12916 NW BUCKLIN HILL RD UNIT 135
ISILVERDALE IlwA 1198383
II
}"ax pesc
Sales History
Related Accts
III
Value His~orv
~lQ~~_9.ryQtI~rJJ1S
~... .cc
~
http://kcwppub2.co.kitsap.wa.us/pls/ilisw/lis.online-'isJnfo_pkg.ac. .. 17 -Aug-06
. Kitsap County Assessor's Building Data
Page 1 of 2
I I I Elected I County
Home Departments Officials Services
I I j I Parks &
Resources Environmental Elections/Licenses Recreation
Building
Data
Tax Account No.
13965-000-178-
0102
,~.. p~t~l~Jli?lp?te;rl
Process No.
111490135
Situs Address
IF868 CLARE AVE
~~ol[4~ioii;,J,K:~~~~,A"~.:;~1-,,,,'f<t."'ir;t,1tr~':':~",,"{::<':;'Jt;,t;"N;~:'{!,l1~l:!t(<~,J');/<,:;~:;':"*,~.:t.w+~";:~~R<"~z,~1f,{':;tqg'~", ,:~~.}fP.tL, :~W...tk'#-0.: /;kii- ".,of ,,,,'f'< 4~~f4&-;;;j!l>"V", :>,< )f,<-J'" J,\:~'i#:I'!Lfw,~A''''; {:"'4~,~
Details
Year Built
Quality &
Type
Roof
Material
ExtWall
Type
Bldg 1 of 1
11942
IFair Rambler
Icomp sh to 235#
IWOOd siding
~~~;;t,1~~""'\o,'~t.'1S.~~~'5(;."~'-'-IJtll'!!;:..ul~~~,~iU;....\;It",~",, "&t.~:tM!~:Z-''iv.r,a;;~',t;,t,,11~~$ik':::M;,,:r,'1'.'?;',, ti.>"WP;'..J;;:it3-'z;. >::cy,r<,~,,,,t:l.>-.if .Jw;;;,;(/t,<"';:'~1hj~{,>J~,r~l-:(."j;,i~~~~~1{-,j-,\::,,>.\\'.~j:
Sg
Footage
Floor
Basement:*
Lower Level:
Above
Ground:
Total:
Porch/Deck:
Detached
Garage:
Attached
Garage:
Area
Living
Area
110
110
111232
111232
I * Could be basement or lower
level garage
I
I
I
10
10
11232
11232
1224
1720
I
~~1!i1Il~f':ff>",'t;..~''f>v, :,-a.'\(0"&."t',,VitolW~";l',~~;iJli:w.mf.":m~"y,',;'~ ",A~'S1f)t?I<Jk'''-<'''ih ~'::j.j.<<t~~ ~f,/,;kd* V4;';:,I"'A~#~lh, >'//<.f:;r--' ..%t> +_:;'6, fu,r'';.J"'.--t' ,;;t. ; <
Attributes
Bedroom 13 1 Fireplace I
(s) (s)**
Half Bath(s) 10 I Sewer Iv
Full Bath(s) 11 Iwater Iv
Heat IForced hot air I
http://kcwppub2.co.kitsap.wa.us/pls/i1isw/online JisJnfo _pkg.buildi... 17 -Aug-06
- Kitsap County Assessor's Building Data
Page 2 of 2
Source
~~ll-~A.".-w~"fu},jj<"'"~~~.."}rua~~~m.'(~."\'~'9ii~,~,r~..;,\}..~..bl~~#;:"M-A:....{~'l):;':.');i~,i-'" .14~;'~,;, ,~,$, l',,~Mt.:t:.$~'~>'
Land (Cant)
Land (Cant)
Other
ImprovementslReSidential Detached Garage, LANDSCPG
Imp. (Cant) I
Land Desc. ISite: platted, improved
I
I
* Could be basement or lower level garage.
** May include wood, gas, or pellet stove.
Mobile Home Details
l3t6)~~"~ "M~,\.ilJil~8~i~;~1
http://kcwppub2.co.kitsap.wa.us/pls/ilisw/online-'is Jnfo _pkg.buildi... 17 -Aug-06
Kifsap County Assessor's Valuerrax History
Page 1 of 1
I I I Elected I County
Home Departments Officials Services
I I I I Parks &
Resources Environmental Elections! Licenses Recreation
Value
History
Tax Account No.
13965-000-178-
0102
" ~, ',~"-, < j""" ,....
Rrfnnthl~pag~;
,:;:. '\, ~',<' "/k .~;t" <, ,.;:'~ -;;,'
Process No.
111490135
Situs Address
112868 CLARE AVE
\Wk"t.,,~"""<ll:i~{,~-'Hn~tm.t'Ji:P-"fi\~~'l,;,j!~iR~~i:W'1L':(~,ik<Nr_>1taim,1"'-':.."t$f';:;'1!-~~'!-.HiI~..m~~:",.. ,.IZ~S<JllA'i:m ~;./r{l1M",;,,;~t,'li:;.-l3l:;t~ .,~,.t .,.'~" -&: S','0,~..;it,I:L:'ik 'r' ,Mif:;J-'tiit,gg.ii,; 1W~f~H.j1t.~' -;n:?,~ 'rrJ,s.Yi~,:":: ~'!r';n~.'<.
Tax
Year
Land Improvement
Value Value
Total
Value
Taxable Annual
Assessed
Value Taxes
Annual Annw
FFP SSW~
Assessment AssesE
2007144,400 I
2006134,230 I
2005127,280 I
2004124,800 I
2003129,320 1
130,670 1175,070 1175,070 I 0.00 1
113,580 1147,8101147,81011,662.481
92,620 1119,900 1119,900 11,552.00 1 .
83,560 1108,360 1108,360 11,492.981
74,400 1103,7201103,72011,489.981
0.00 I
0.00 I
0.00 I
0.00 I
0.00 I
Tax Statement
t.'" ,-'C-._,O.",v, " :-' ,,;>;< "'C",'
';[: 'tl~sEHhiswii71aQ:W:
< .-:... " ~6~"';;' - ;n> -""M' . kb:. %-:.F:'" '_~> \. ,~
http://kcwppub2.co.kitsap.wa.us/pls/i1isw/online JisJnfo _pkg. tax_h... 17 -Aug-06
.BREMERTON PERMIT CENTER
2864th street. 8remerton, I,JA 98337
Phone: (360) 478-5275 FAX: (360) 478-5278'
BUILDING PERMIT
Appl iCiiint : . Fm~SMANN' :JOSEPH 479.....7B~8
2(166 CL.ARE AVE BRFMERrON WA 9H31.0
Per m i t No: 97,.,0501.
Stat\.Hil~ ISSUED
Applied: 08/08/1997
Issued: 08/0B/1997
Expires: 02/D4/1998
Job Addr: ~?B66 CLARE: AVE
L,Clc:at:i, pn:
Parcel No:
Owne~'I": FORSMANN JOS(::PH
2B66 ct.. ARE: AVENUE BRFMERTl)N WA 98~11 D .
Contractcl'r: SELF
LJc #:: SELF Exp:
Subc::cmt r :
. DElee: SHEETr~Ot:I\. PLUMB I NG FIXTURES J 1",101' WA'rER H I::: A TER
*********************************************************************************************
Valwiti.oTl. * Perml.t Fees: 76.80 Total C;:llcu:lated Fee: B6.~JO
SOD .DO * Plan Check Ff~f.1f.n ,,00' AddU; :lorial Fees: ,,00
* ot; hf.1r F F.:)e)t~ : 9 "SO T of; i:t], Per m H F Be : 86 .~IO
.:IHHHHf**H:\i(,*******'**il('**:l(.*******~,** ~H~*~"~ ****,)t*~'******~'**')('***********')(:'~*'l+,)t****** *.~********~,******
MECHANICAL/PLUMBING. FIXTllRES-- MECH-Gas Pipi (19 (out lets). .. .: 1 PLBG-Water Closet........;...: 1
PLBG-Bathtub.................; Pl.BG-Lavatory................: 1 PLBG-Water Heater............: 1
E \L~ O-.N 'S \, ~. .
**********************.*********************************.************************************ .
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.
NonCE - It is the responsibility of the permit holder. liot the City of Bremert.on or Building Official to see
to it that requiredtnspections .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;.imtil 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 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 reQulattn~~",con8tructlon or the performance of construction. .
Signature: -~-,I;::----=::::~---------"--"--- Date: _"ZALi7._________
I certify that 1 .am exempt from the requirements of the state contractor's registration law, under
Section 3, Chapter 126, laws of 1967.' '. _ /..'-~"\^'''+'i:~~:
. si9nature:____.~~_~~~::~_-_____-_____~ '. Date:~__~~~~-:2:_-__-_-__--
. ***:,(..)t***.~**;:..)l;********:,(,. ., '. . .. .
.pjll>'I" lI'I ~.~ r~ii.mhr''r'''...",.,..Ar'll''\Y'I''\\}/I.'.rl ~v:. ~, l"ltltiil'! . Ylcr:/ q )
."
~
I"~ i ~
~',"'"J~~ .~..,;,.\*'-
.', " "~: t ,,'
,-.. ~"'.' . .,'i'~, ei"
::!'l:)b Addr' ef.~f,(~:: :;:~H66 CL.AI:~E AVJ::::
I....OCi:tt :i. Cln ::
Af,(H-H' Acet NCl::
BREMERTON PERMIT CENTER
t 286 4th street If Bremerton, /4A 98337
Pl:!one: (360) 478-5275 FAX: (360) 478-5278
Building Permit No; 97~0501
Stl!ttu~:~:: IS~::;UED
Issued= OB/08/1997
Expires= 02/04/1998
I:~ E: (;~ U IF< E D
INS PEe T ION S
Item= 01.400 MECHANICAL
It €(!m I: 01600 PL"UMB I N(:~ fWI..)(:~I"'I"''' I N
Item= 01800 INSULATION
Item= 01900 SHEETROCK NAILING
Item= 027CO FINAL~-BlDG
D(('~pt:: BL"DG
Dept:: SI...,DG
D€:~pt:: BL..DG
D€(~pt:: 1::~L..DEi
D0~pt I: BI....D(~
D:l.v:l.~:~:i.on::
D:1. v if.:~:1. on::
D:I.v:1. $:1. on ::
Di v:1. f.~:i, on::
D:1. v:1. *s:1. on ::
*********************************************************************************
TESTING; .Must be recognized by the Washington Association of Building Officials
SPECINSP= Must be registered with the State of WA
ST OF WA1 State of WA Dept. of Labor and I.nduBtries
II':"'AI "'1"11" ~'~ ,.., "'''''''l'''' T' /1"" ,I. '", " II'"'' '1'1" L'l ,..).' ....1,,'(, 4 c...t..
'" ~::, ,. "" '." r.:,r f;,.me;. I ,U l \~, \, f,~dP ,,, I:..d" \, I ",I, fl,> \. .1, ,,' ,
4'7B"'''49:;:~ 1-
4 '7 B "''' b ;::~ :::1 !;:)
~
ALL INSPECTIONS PERFORMED BY THE CITY OF BREMERTON MUST BE SCHEDULED THROUGH THE
I~I=I~M'I'''I'' (~I=N'l"I=I~ (~~(')) ~'7"O-~?7'~
.." '\ I . oJ ".1 "" '\. ~ \..~ (;) , "1 f;,) ,.J ~n. ....) II
*******~*************************************************************************
P€:l't'm:i.t 1'''ICllde~'(' Pfi.~~ . r- .. :
S;l,(::natur'~::~:: .' /~ '.
. ...l ..,,, ",,, "",..:":''',.,.... . ".","""""":."..".."..:"'"......".." '''".....,,,...,,,,.....,,,,.,,..,,,.......,,.'':.,....,, "......" "......"...".. ,,,.....,,.,,..,,...."..,,,
, .
I..)-:..t' '1.." ' ?~.' ~ 7 .
" (,,J. I \;" II / -'i'
.._O..".,J,'~*.'''~'N...'...,'...~j..''''''''.'.'n.N''""''''''',ft'~''''n''''''''''~
"--.
~
;::..:..:..;.....BW. ~-.;:ft:I:'N" .:G.' .;...:pED....,.\~:..n.r..~:~;.,...,.I.D...r :'.....
:::.;:.~.~r?(;;:. . > =; .:". ~1dI. ~." ". . ..':"; :'., ..EJ.ft.lY".;.lr\i~C..Ei&;~L.t: :. .;~: '1.,;~;:.::':~.. .
.' n286':;iili)'Sct;tBrenJ.~~i1:.WA.; 983iri.' .pticiri~(206J47g:5275'::FAX:.(iri6j::'47i5278
APPLICANT: DOWNER D CONTRACTOR 0 OTHER:
SITE ADDRESS: 2 (j G r;. {'LA ref. /l'uc
OWNER: JbS~f'H {;~g,;t1A (\J t..J
CONTRACTOR: <;; eL r:
COUNTY ASSESSOR PARCEL II:
ADDRESS: 8j"6'~ CLJ4/?{: .A r/E
ADDRESS: C/(/:,41E&70r{ Wi 92?.?J C)
CONTRACTOR LICENSE 11
EXPIRATION DATE:
CONTACT PERSON:
CONTACT PHONE 11
Y1Gf -ifl.e.9
o SFR D DUPLEX
D SIGN D DEMO
o NEW D REPAIR
o MULTI-FAMILY D BUSINESS D OTHE~:
o MOVE BLDG. D MOBILE D GRADING(yds):
D REMODEL D ADDITION 0 OTHER:
INTENDEE> USE:
ZONING CLASSIFICATION:
~H fEr p~/: \.> DAT/J/(c;C) M
NATURE OF WORK PROPOSED:
<7
COUNCIL DlSTRICT:
Eit/'TR Y ,,4? E,.q
SQUARE FOOTAGE: Dwelling: Garage: Decks:
or epa men se n ty
: . ALU IOr.t . npLAN 'RF.VlEWFEE n PERMIT'EEE' ...."...,.,. ..... ". uRHXRGf:S n..n.... i:TOTALFEESt:
n. V . .'. "AT';" . ,::/: .... . .. ....
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$ $ $ ENERGY: $50. 00 $
STATE: $4. 50
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Applications for which no permit is issued within 180 days following the date 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 extend the time for action by the applicant for a
period not exceeding 180 days on request by the applicant showing that circumstances beyond the control 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.
I hereby certify that the above information is correct to the best of my knowledge.
APPLICANT'S SIGNATURE: L ~ DATE: g/B /q7"~
/
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:>:::::, ',: , ,.:iPJE~TAPPLICATION'::
:U"CityofBreIhertCln;Washingt~ii :98337 HPhone:(360} 47~5275FAX:{360)A78""5278 "
o " 'H<MECHANICAL'
o
, ,'PL~IBING
I
APPLICANT: jgJ OWNER D CONTRACfOR D OTHER:
COMMENTS:
C:::L ARE
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ADDRESS:
zi5'C:~ Lt..AR'~ ,AvE
bREt,{ E~ TdAlWi:/:. ?g 5: / <::J
ADDRESS:
CONTRACfOR LICENSE #
EXPIRATION DATE:
OWNER PHONE #
47q- 7?~q
CONTRACTOR PHONE #
:NO/:j::,TYPEOFEQUIPME'NT::H " , :; FEE ,. . NO> ,,;:'IYPEORFIXTURE.: :;:u;::: : FEE:
RANGE \ WATER CLOSET
WOOD/PELLET STOVE/GAS FIREPL\CE BATHTUB
GAS FURNACE btus: I LAVATORY
CONVERSION BURNER btu's:'j SHOWER
UNIT HEATER btu s: KITCHEN SINK
BOILER btu s: DISHWASHER
) GAS PIPING LAUNDRY TRAY
EVAPORATION COOLERS btus: CLOTHES WASHER
AC UNIT btu 's:/ WATER HEATER
HEAT PUMP btus: tons: URINAL
REHEAT BOX btus: DRINKING FOUNTAIN
AIR HANDLING UNIT bttt's: FLOOR SINK OR DRAIN
J EXHAUST FAl"lS SLOP SINK
RANGE HOOD (residential) I WATER PIPIING & ALTERATION
RANGE HOOD (c'omrnercial) GREASE TRAP/INTERCEPTOR
CLOTHES DRYER HOSE BIBBS
INCINERATOR LAWN SPRINKLER SYSTEM
DUCT ALTERATION SWIMMING POOL
TANKS type: BLDG. SEWER (mobile I moved house)
REFRIGERATION UNIT ROOF DRAINS
OTHER: OTHER:'
MECHANICAL PERMIT FEE $15.00 PLUMBING PERMIT FEE (15.00 or 4.50)
APPLICANT'S SIGNATURE:
MECHANICAL FEES:
PLUMBING FEES:
CITY SURCHARGE:
TOTAL FEES:
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DATE:
ff .,/~ /17 '
I
pmapp.dor revised 4/-23/97
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Fee $__//.._~~!l_______.___._.________________________________________ Receipt No. j_.r~__f__'?_____.______________________________
BUILDING PERM IT
CITY OF BREMERTON BUILDING DEPARTMENT
Owner's Value I Bldg. Dept.
$ .LI /f' ,;r'
Value I DESCRIPTION:
Lot Block
Additions
F. E. IRISH, Building Inspector . ESsex 3-1411, Ext. 36
Address on Job _i?_Xf.:_i)mafd4~_________m_________mm__n_m__m____n______m_____m__m Date _ ____m./.'" __,,;;;I:_0._.r;.___m____
Building ____m__mm_ x ____m__m_m and m_____m_____ stories _____m________________ basement. Lo ______m_____ x _l____m____
Front Yard m_______________n_m Rear Yard _________________m_m Side Yard _____________________m Garage m_m__m__m__________m
g~:~ra~_~~4~:d::~~~)::::::::::::::::::::::::::::::::::-Add-;~-~~-::-_-_-_-_-_::-_:-_:-_-_-_:-_-_::_~~~~_:::::::::::::-Ph;~~-:-_:-_:-_:-_:::::-_:::
COD tractor _ __ ___ ___ xfi..-M..-d.I.._~_ __ __ __ __ _ _ __ _ __ __ _ _ _ _ _ _ _ _ _ _ __ _ __ _ _ __ _ _ __ Address n _ _ _ __ _n __ _ _ __ _ _ __ __ _ _ __ _ _ __ _ _ __ _ _ _ _ ____ _ _ Phone _ _ ___ _ _ __ _ _ _ __ ___
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This permit is issued for:
, -,
::::::::::::::::::::::::::::~;1~:~~:~~2::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
All work to conform to all applicable building ordinances and amendments. Please note the following
special instructions and requirements.
DETACH HERE AND POST THIS SECTION ON JOB
INS,PECTION - Reinforcing steel must be inspected after pladng and before covering. FORMS shall be inspected
and appro'ved before pouring. All plumbing, wiring and the fra,me of all buildings must be inspected and alppro~ed
before covering. Wood preservative to be used on all wood a,gainst masonry. Ve'ntila,te fo,undation and attic. Se'pa-
ra,te permits requ'ired for plumbing, wiring and heating. See City Engineer before wo,rking on streets o'r sidewalks.
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- - - _ - _ _ __ _ _ _ _ _ _ _ _ _ _ __ _ _ __ _ __ _ _ ___ _ _ __ _ _ _ _ _ _ _ _ __ _ _ _ _ __ _ ___ _ _ _ _ _ _ __ - - __ - - - n _ _ __ _ _ __ _ __ _ _ _ _ _ _ _ _ _ _ n _ _ _ _ _ _ __ _ _ __ _ _ _ _ _ _ __ _ _ ___ _ ___ _ _ h _ _ __ _ _ __ _ __ _ _ __ _ _ _ _ __ __ _ _ __ _ _ __ n __ __ __ __ _ _ _ _ _ I"~,
Owner's Signature___n______________ ___ ____ ____ ___ _____ _________ ________ ____ __ By _____________ _ ___ __________________________________________ _______________ ___
~ His Authorized Agent
Building Inspector __ _____n_ ---~-?~ --- -~-;_f_----------------------------------------n-----------
,-...
~ OF By _____________________________6__D::,,___,____________________________________________
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RETAINING 1rfALL OR
FENCE APPLICAnON
To be located on front CX?
Alley ( ')
Checke d by ;? -;./ ;<;
- E:'&1gr. Dept.
Date: /~!~.d/t ~
.-.
/o~-:2.(-G(
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Corner Lot ( )
(jWUER c;;i!J~~dcz.._______
ADD1:m;~)S .. =< J>' j 1'- ~ ~, .
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