HomeMy WebLinkAboutCLEMENS ST., 1505
.,
...-
B REM E R TON
B U I L DIN G
PERM I T
D E PAR T ME N T
=======================~===================================='====~====
Application Number 92AP04802
Permit Number 12995
Project Group
Application Date
Issue Date.
Assessor Acct #
Site Location
. Owner - Last Name
-- st reet
- City
- Phone
Tenant's Name
Agent v s Name ..;t'
Architect ~ s Nam~;1;0
[lBuilding do'
[X] Mechanic
[ ] PlumbiD
03/13/1992
03/13/1992
1505 CLEMENS
COVER
1505 CLEMENS
BREMERT
(20
First RICHARD
ading..d.".....l. ] S1
ve,.B1.trrding ["l"^B~rnih
Mq:b1.'l e Home [] Lail~... C
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HI
Zip 98310
Paving'
Underground
lition
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Work wil
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Nature.
for gas
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Construct.ion"
Type.
Residence [X]
Business [)
other [ ]
New [ ]
Repair []
Remodel ()
Addition (]
Status
Code
Inspections
Required
Foun:datibn [ ]
Framing []
Insulation [ ]
Plumbing []
Mechanical [X]
Wallbbard []
Final [X]
Recei ved By :~. . H' '. Approved By: (). ''''', j' , ! I.'""
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B .R E M E R T 0 N B U I 1.. D I N G D E P A R T M E N T
M E C H A N I C A L P E R M I T A P P L ! C A T I 0 N
==================~=============~==~=======~=========================
Application Number 92AP04802
Contractor
street
City
Phone
Representative
state !..icense #
City License #
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HOMESTEAD HEATING
4392 NW GUSTAFSON ROAD
BRE11ERTON
(206
98310
03/09/1992
urn~rs
Heq{ers
B.,5.1 ers
Qas Outle.ts
i~ool ers
iAi rCondi t i
,tReat. Pumps
iRe-Heat Boxes
i: Ai r Handl ing Un
:~.Fans
\?ange H
~ryers
n~cinera
Al'1;,erations
ank~
frftt~ration
e r f~t':,'ems "
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PLIC
TION
CITY OF BREMERTON BUILDING DEPARTMENT
PHONE: 478-5281
SiTE .S
'~'\~&rcLel)\J<C~
, i ;565 C.J lP~(N jl'S 61-
If.\ MAil ADDRESS
:ONTRAClOR "~~ MAll ADDRESS
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Class of work: ." 0 .t:l~"!" '+ 0 ADDITION 0 ALTERATION
[J rJtECHANICAL
~ ASSESSOR'S ACCT. /I
r&vrwf~ ~()
ZIP
3'77-/~g4
PHONE
'fI'~ d7
o REPAiR
COMMENTS
D PLUMBING
Plffi5~.
SWb' ~O
tbm~L{) U-
No.
~r~:4~
#11 Tv of Equipment
STOVES Gas '.oil Wood g~ J <;<
FIREPLACE I SEAT (J J{J in.j
FURNACE Gas (Nat._ LPG._) Oil_
'j'Jood add on_ Other_ Electric_
BTU
Type: Up flow_ Down flow_
Horizonta'- Wall_
CONVERSION BURNER: Gas_ (Nat._ LP_)
I Jnder 100,000_ Over 100,000_
File
. HEATER BTU_ Gas_ Elec._
ER Gas_ Oil_ Electric_
Other_,J;lP ~
;;;. GAS SYSTEM Max. 5 outlet Total_
,,'~r~VAPOR4tION COOLERS Roof_ Wall_
BTU_'"
',AC UNIT Electric_ Gas Elec. Combo_
BTlI . '7
HEAT PUMP Single Package_ SpliL-
Add 0"- BTU Ton_
MIXIN~ OR REH~l\T BOX CFM_ BTU_
AIR HANDLING U~IT CMF _ BTU_
FANS ExhausL- Supply_ Bath:...--_d" oW
RANGE HOOD Residential~'Comm.--3f;'
, ROOF DRAINS ' ~~:,;F", ..,. :J\1;~ ".'~."
. '" '~"''''''' ;""
CLOTHES DRYER Res.~Comm._;.
INCINERATOR
ALTERATION 10 DUCT SYSTEM
Heating/Coolin9-- Exhaust_
TANKS Oil_ Gas- Propane w/OK
from Fire Dept.----,:. Gallons
REFRIGERAT10N UNIT
.,.
'i), .
~:::i'>?, <..:.
^"::;:^'~.
PERMIT $
TOTAL FEE $1
.
~AL APPROVAL
RECEIPT NO.
No.
"TYpe 01 Fixture or Item
Fee
WATER CLOSET (TOILET)
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & DISPOSAL
DISHWASHER
LAUNDRY TRAY
CLOTHES WASHER
WATER HEATER
URINAL
DRINKING FOUNTAIN
FLOOR - SINK OR DRAIN
SLOP SINK
WATER PIPING & TREATING EQUIP.
WASTE INTERCEPTER (Grease)
VACUUM BREAKERS & BLACKFLOW DEVICE
LAWN SPRINKLER SYSTEM
SWIMMING POOL - Private_ Public_
GROUNDWORK
SUMP
ALTERATION
KIDNEY MACHINE
PERMIT $
TOTAL $
NOTICE
THIS PERMIT BECOMES NUll AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS SUS-
PENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK
IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPUCATION AND
KNOW THE SAME 10 BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND
ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPlED WITH WHETHER
SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME
10 GIVE AUTHORITY 10 VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER
STATE, OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF
CONST: UCTION,
-,\
"/I--9~
(DATE)
SIGNATURE OF OWNER (IF OWNER BUILDER)
(DATE)
PERMIT
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KITSAP COUNTY
OEP ART~Mi- OF COMMUNITY c)t;VELOPUE~T
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CITY OFBREMERTON ~ BUILDING DEPARTMENT
478-5275 -- 286 FOURTH STREET, BREMERTON, WA 98310
INSPECTION REPORT
PERMIT NO.
(2 f7~
. .
. . . . J
I have this ciay inspected this structure and these premises and have found the following violations
of City, County and/or State laws governing same: '
(J)
C IIf,If ~ '/"1 y~ Cd'- 'N S e ~ 0' S ~ v J ',J-.
I/". . (/;j-kJ I -.4, . . '. '. /_- I I>
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You are hereby notified that no more work shall be covered upon~these premises until the above
violations are corrected. When corrections have been made,' all or re-in ect'
Do Not Remove This Tag DATE /7 f 7;: -
INSPECTOR FOR BUILDING DEPT.
~Df
INSPECTION RECORD CARD
CITY OF BREMERTON BUIilllNG DEP ARTIdENT
12995
. PERMIT NUMBER
I
ADDRESS
OWNER
CONTRACTOR
1 505 r.T ,F.MF:NS
RICHARD COVER
HOMESTEAD HEATING
PHONE
PHONE
1 FOUNDA liON
1. PERMIT ON SITE
2. CHECK PLANS TO PERMIT
3. CHECK SETBACKS
4. PROPERTY STAKES
5. FOOTING WIDTH & DEPTH
6. SOIL BEARING O.K.
7. CHECK FOR FILL
8. REQUIRED STEEL IN PLACE
9. CHECK FIREPLACE FOOTING
10. ANCOR BOLTS
, , . FOUNDATION VENTS
12. CRAWL ACCESS
, COMMENTS:
FOUNDATION INSPECTION
APPROVED BY:
2A FRAMING
1. WIRING APPROVED
2.FOUNDATION VENTS
3. SHIELD UNDER POSTS
4. POSITIVE CONNECTIONS
5. SOIL TO WOOD CLEARANCE
6. BEAM SUPPORT
7. TR. MAT. NEXT TO CONC.
B. WASHERS ON ANCHOR BOLTS
Q_Rj;A.M~:LE.BOE.ER6IZE
20. FIREBLOCKING
STAIRS
DROP CEILINGS
TUBS OR SHOWERS
ROOF 8.. CEILING LINES
FURRED OUT AREAS
FIREPLACE AT CEILINGS
HOLES PLUGGED TOP & BOTTOM
LID IN VOIDS
21. WINDOWS
MEETS ENERGY CODE CLASS
PERMITS
1: Floor plan of the hous d h
2. Show the location of t~ an tW ere the furnace is located.
3 D. t' e me er.
. Irec Ion of pipe.
S~ze (BTU's) of furnace.
-. SIze and type of pipe.
6. How far the gas line is running
7. Size (BTU's) for water heater, ~ange, etc.
.~ ;ChCLtd Cm~r
10' Q)~
:j)j)CO 8ru '-s
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MECHANICAL
1. PERMIT ISSUED
2. FURNACE LOCATION
3. FURNACE CLEARANCE
4. '8' VENT SIZING'
5. 'B' VENT CLEARANCE
. 6. IBI VENT SUPPORT
7. COMBUSTION AlA
8. DUCT SIZING
9. DUCT SUPPORT &. JOINTS
1 a.GAS PIPING TEST
11. GAS PIPE SIZING
12. GAS PIPE SUPPORT
COMMENTS:
~'i:$ s
~ 'Il~z{4'1 %-~
M
HVAC APPROVED BY:
GAS PIPING APPROVED BY:
WDST
1. WOOD STOVE CLEARANCE
2. CHIMNEY CLEARANCE
3. HEARTH EXTENSION
4. CHIMNEY HEIGHT
"
WDST APPROVED BY:
~~.~~
#i/fz- ~
P ;'~E~~~~~~
2. UNDER TEST'
3. WATER PIPE SIZING
4. DWV SIZING
5. PROPER SUPPORT
COMMENTS:
UNDERGROUND APPROVED
BY:
6. PROPER FrrrlNGS
7. REQUIRED CLEANOUTS
8. PROPER GRADE
9. HWT PRES. RELIEF VALVE &. UNE
10. SEISMIC STRAP
ROUGH-IN APPROVED
BY:
3
WALLBOARD
6. ARE SEPARATION IN GARAGE
7. ATTIC ACCESS
8. DRAFT STOP IN ATTIC
9. PROPER CONST. OF FIRE.WALLS
10. DROP CEILING &. LIGHTING
1. LID OVER SIDES
2. NAILING
3. WfR AT TUB OR SHOWER
4.518 UNDER STAIRS
5. FURNACE ENCLOSURE
COMMENTS:
WALLBOARD APPROVED BY:
4
FINAL
1. HANDRAILS
2. GUARDRAILS
HEIGHT
INTERMEDIATE
3. EXHAUST FANS
4. WATERPROOFING IN SHOWERS
5. DISHWASHER AIRGAP
6. FIRE DOORS
LABLED AS REQUIRED
SELF CLOSING
7. FIRE DAMPERS INSTALLED
8. PENETRATIONS IN FIRE WALLS
9. HOT WATER TANK PRL
. .. 10. OUTSIDE GRADE
11. SOIL TO SIDING CLEARANCE
12. SMOKE DETECTORS
13. FIREPLACE HEARTH
14. SAFETY GLAZING
15. INSULATION
WINDOWS MEET ENERGY CODE
UNDERFLOOR &. ATTICE INSUL...
WATER PIPE &. HEAT DUCTS
16. WOODSTOVE APPROVED
17. WINDOWS & DOORS CAULKED'
'. : ~ ,',
FINAL PLMB. APPR. (comm.) ~ ~ 2 I - pOMMENTS:
FINAL MEeH. APPR. (~n~ ~_L_ ~_L21/1 L .
FINAL BUILDING APPR.
.... .
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:~h""""
,B REM E R TON
B UI L DIN G
D E PAR T MEN T
'PERMIT
~~===============~===============================================;===
Application Date
Issue Date
AssessqrAcct #
Site Location
Owner. - Last Name
- Street
- Cit.y
- Phone
Tenant's Name
Agent's Name
Ar.chitect's Nam
[ ] Building
[X] Mechanic
[ ] Plumbin
12/05/1991
12/05/1991
Application Number 91AP04494
Permit Number 12776
Project Group
Nature
Woods
1505 CLEMENS
COVER
1505 CLEMENS
BREMER'l'O
(206
First R.,ICHARD
MI
Zip 98310
ading ..~~_",~_.r] s
v e1),H':t't~a i ng 'r'~,""'ij,U rn
Mo,tpi1'e Hom~ [] Latxl.. C.L
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Paving
Underground
Demolition
Work wil'
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Coristructio,
Type
Inspections
Required
R . d [X'J F d t' r~]
_ e,S1 ence , .' oun a .1.,on .
Business [] Framing []
Other [ J # Insulation [ ]
New . [ ] PI umbing , [ ]
Repair [] status Mechanical [Xl
Remodel [J Code Wallboard []
Addition [] Final [X]
----~---~----~~-----~---~------~~----~---_._-~~-------------------.-----
.Receive,d By: ')," t~,' " ,APproved By: . " ./ c'
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B R f. MER T O,N
B U I L DIN G
D E PAR T MEN T
M E C H A ~~X C ALP E R M I TAP P LIe A T I 0 ~
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Contractor
street.
city
Phone
Representative
State License :#
Ci ty IJicense #
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Application Number 91AP04494
HOMESTEAD HEATING.
4392 NW GUSTAFSON ROA.D
BREMER TON
(206)
Zip 98310
03/09/1992 .
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ac~sf' ., ~
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Hes:b"€:rs
Bo,tlers
G2fs Out 1 ets
dloolers
jh r Condi ti
I!Hea t Pumps
!Re-Heat Boxes
~Air Handling Un'
II.Fans
;~ange Ho
DI.ryers
ItJ.cinera
Af"teratioY1S
T aD:k.,s .
frfgeration
e r "N;.ems
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. ......PE~MIT .:' AP,RLICA.TI.:Q,N.
"-""T'~~--'~-"'~'~-'-'W '-.' CITY OF BREMERTON BUILDING ,0 ARTMENT' "', ,.' '. , .' ..:. ....
. . PHONE: 478-5281 .' 6' . ,11../'
t~b5' G~mert s' S-\- I
MAIL ADDRESS
Class of work: D NEW' D ADDITION D ALTERATION
. D:MECHANICAL
CO~MENTS
No.
~p. of Equipment
STOVES .Gas /o.iI_ Wood_
FIREPLACE IN$ERT
FURNACE Gas (Nat._ LPG.-> o.iI_
Wood add on_ Other_ Electric_
BTU
Type: Up flow_ Down flow_
Horizontal_ Wall_
CONVERSION ~URNER: GaL- (Nat._ LP ->
~der 100,OO~_ o.ver 100,000_
~'T HEATERBTU~ Gas_ Elec._
BOILER Gas~'o.iI_ Electric_
Other~ HP___
GAS SYSTEM Max. 5 outlet Total_
EVAPORATION CPOLERS Roof_ Wall_
BTU_
AC UNIT Electric_ Gas Elec. Combo_
BTU_
HEAT PUMP Single Package_ Spli~
Add 00_ BTU To"-
MIXING OR REHEAT BOX CFM-,- BTU_
AIR HANDLING UNIT CMF _ BTU_
FANS Exhau~ Supply_ Bath_
RANGE HOOD Residential_ Comm._
ROOF DRAINS
CLOTHES DRYER Res._ Comm._
INCINERATOR
ALTERATION TO DUCT SYSTEM
Heating/Cooling_ Exhau~
TANKS o.iI_ GaL- Propane wlo.K
from Fire Dept._ Gallons
REFRIGERATION UNIT
Fee
1_ ,<:;;i)
4
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PERMIT $ 15';..0,'
2/~
10TAL FEE $
:INAL APPROVAL
,"
~ -'~.
~J1W~
.ASSESSOR'S ACCT. /I
ZIP
PHONE
LICENSE NO.
, D REPAIR
I
D PLUMBING
No.
~pe of Fixture or Item
Fee
WATER CLOSET (lOILET)
BATHTUB
LAVAlORY (WASH BASIN)
SHo.WER
KITCHEN SINK & DISPo.SAL
DISHWASHER.
LAUNDRY TRAY
CLOTHES WASHER
WATER HEATER
URINAL.
DRINKING Fo.UNTAIN
FLo.o.R -SINK o.R DRAIN
SLo.P SINK
WATER PIPING & TREATING EQUIP.
WASTE INTERCEPTER (Grease)
VACUUM BREAKERS & BLACKFLOW DEVICE
. LAWN SPRINKLER SYSTEM
SWIMMING Po.o.L - Private_ Public_
GRo.UNDWo.RK
SUMP
ALTERATlo.N
KIDNEY MACHINE
PERMIT $
TOTAL $
. ,
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED
IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS SUS-
PENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK
IS COMMENCED. .
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND
KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND
ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COM PLED WITH WHETHER
. SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME
TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER
STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF
(DATE)
SIGNATURE OF OWNER (IF OWNER BUILDER)
(DATE)
"'-"" "---
RECEIPT NO..
(White-ORIGINAL, Yellow-INSPECTOR, Pink-APPLICANT)
PERMIT
VICINITY MAP
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KITSAP COUNTY
DEPARTMENT OF COMMUNITY DeVELOPMENT
CITY OF BREMERTON - BUILDING DEPARTMENT
478.5275 - 286 FOURTH STREET, BREMERTON, WA 98310
INSPECTION REPORT
PERMIT NO. ! 2" ,1 7?
I have this day inspected this structure and these premises and have found the following violations
of City, County and/or State laws governing same:
(j) Fry~ r4[-'(: ~(/<;r A4t,/e
&pv.
hj41 h/!/I~7
rks5'
You are hereby notified that no more work shall be covered upon these remises until the above
violations are corrected. When corrections have been made, call or re-ins ecti
Do Not Remove This Tag DAT
~D'.
'INSPECTION RECORD CARD
CITY OF BREMERTON BUILDING DEPARTMENT
ADDRESS
OWNER
CONTRACTOR
1505 CLEMENS
RICHARD CLOVER
HOMESTEAD HEATING
12776
PERMIT NUMBER
PHONE
PHONE
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1 FOUNDATION
1. PERMIT ON SITE
2. CHECK PLANS TO PERMIT
3. CHECK SETBACKS
4. PROPERTY STAKES
5. FOOTING WIDTH & DEPTH
6. SOIL BEARING O.K.
7. CHECK FOR FILL
8. REQUIRED STEEL IN PLACE
9. CHECK FIREPLACE FOOTING
10. ANCOR BOLTS
11. FOUNDATION VENTS
12. CRAWL ACCESS
COMMENTS:
FOUNDATION INSPECTION
APPROVED BY:
no_, ~ .,-.."......_.............."...__,.....__ .-._-~'..-....'-\_I_.""................Il"""'.l!I~_.......~."II&t3.lt:i!'>hl1l:,.,.J!J!:~._......-.... ~ ~ .-.-.....-J..-..._...Itial'nI~.._ _
--.-..- -~-
2A
FRAMING
20. FIREBLOCKING
STAIRS
DROP CEILINGS
TUBS OR SHOWERS
ROOF & CEILING LINES
FURRED OUT AREAS
FIREPLACE AT CEILINGS
HOLES PLUGGED TOP & BOTTOM
LID IN VOIDS
21. WINDOWS
MEETS ENERGY CODE CLASS
SAFETY GLAZING .
REQUIRED FIRE EXITS
WINDOW SILL HEIGHT
22. CEILING HEIGHTS
23. SWAY BRACING
24. TRUSSES
PROPERLY INSTALLED
STAMPED
PROPERLY BRACED
25. ATTIC ACCESS
26. -RAFTER s.. JOIST SPAN
27. ROOFING, FLASHING, SHEATHING
28. SIDING
1. WIRING APPROVED
2.FOUNDATION VENTS
3. SHIELD UNDER POSTS
4. POSITIVE CONNECTIONS
5. SOIL TO WOOD CLEARANCE
6. BEAM SUPPORT
7. TA. MAT. NEXT TO CONC.
8. WASHERS ON ANCHOR BOLTS
9. BEAMS PROPER SIZE
10. FLOOR JOIST SPAN
11. NOTCHING & DRILLING
12. STAIRS
WIDTH
RISE & RUN
WINDERS
LANDINGS
HEADROOM
13. ATTIC VENTILATION {upper & lower}
14. CHIMNEY STRAPS SECURED
15. FIREPLACE COMBUSTION AIR
16. FANS VENTED TO OUTSIDE
17. WATER CLOSET CLEARANCE
18. SMOKE DETECTOR
19. SHEETROCK BACKING
UNDER STAIRS
ABOVE GARAGE DOOR HANGERS
COMMENTS:
FRAMING INSPECTION
APPROVED BY:
~'-----
-*'....;0.-
-- ~-
- -- -.-,
......""---.Il_.
L -<l. _ ."
'.,.
2B INSULA TIO'N
COMMENTS:
1. PROPER R-VALUE
2. VAPOR BARRIER
3. PROPER FASTENING
INSULATION INSPECTION
APPROVE'D BY:
MECHANICAL
1. PERMIT ISSUED
2. FURNACE LOCATI()N
3. FURNACE CLEARANCE
4. 18' VENT SIZING
5. 18' VENT CLEARANCE
6. '81 VENT SUPPORT
7. COM8USTION AIR
8. DUCT SIZING
9. DUCT SUPPORT & JOINTS
10.GAS PIPING TEST
11. GAS PIPE SIZING
12. GAS PIPE SUPPORT
COMMENTS:
M
HVAC APPROVED BY:
GAS PIPING APPROVED BY:
WDST
1. WOOD STOVE CLEARANCE
2. CHIMNEY CLEARANCE
3. HEARTH EXTENSION
4. CHIMNEY HEIGHT
WDST APPROVED BY:
.r........~~-..._...__..-~___ ~ -."..~~'f6;..",lI'I,..~;,.,~.~:.l..-:>llI<iII.....M~_.o.:.d~l!......:r=a~L'Il:~.......~=~~~'-_..,...'/....., A~l..-~-Li~r,t..~"iA.l.::...l.....I~~:a'l.~J.~-_.~ '.4..:1
-_. ...,-
P PLUMBING
1. PERMIT ISSUED
2. UNDER TEST
3. WATER PIPE SIZING
4. DWV SIZING
5. PROPER SUPPORT
COMMENTS:
6. PROPER FIlTINGS
7. REQUIRED CLEANOUTS
8. PROPER GRADE
9. HWT PRES. RELIEF VALVE & LINE
. 10. SEISMIC STRAP
UNDERGROUND APPROVED
BY:
ROUGH-IN APPROVED
BY:
~ ~~ ............,........... ~_""'c. ~,.j,."'. .., ~ , '...~__..,u~!IW,,,._....M
._....J~,.~ --.~__....._..........
~~tlI:.',.- ...._.... _....~-...." .................~~ ....><-o...........>..,;;,o.........-..,..,r~ --'......-.. _......~ ~
3
WALLBOARD
6. FIRE SEPARATION IN GARAGE
7. ATTIC ACCESS
8. DRAFT STOP IN ATTIC
9. PROPER CONST. OF FIRE WALLS
10. DROP CEILING & LIGHTING
1. LID OVER SIDES
2. NAILING
3. W/R ATTU8 OR SHOWER
4. 5/8 UNDER STAIRS
5. FURNACE ENCLOSURE
COMMENTS:
WALLBOARD APPROVED BY:
FINAL
1. HANDRAILS
2. GUABOBAlI,.,S.u.
HEIGHT
INTERMEDIATE
3. EXHAUST FANS
4. WATERPROOFING IN SHOWERS
5. DISHWASHER AIRGAP
6. FIRE DOORS
LA8LED AS REQUIRED
SELF CLOSING
7. FIRE DAMPERS INSTALLED
8. PENETRATIONS IN FIRE WALLS
FINAL PLMB. APPR, (comm,)
FINAL MEeH, APPR, (comm.
FINAL BUILDING APPR.
--.r1' ---
4
_ ___ ~j,j,_'~___'__"II:..""",~.. I _
~ ..,-"'_,......_.~_WI&tJo._.ll\toI..-~_O-'.,.,'.".~._~ ._-~..,,- "",,,,,.'*,"'_
9. HOT WATER TANK PRL
__JO...D.UISlDE.GRADE.------.
11. SOIL TO SIDING CLEARANCE
12. SMOKE DETECTORS
13. FIREPlACE HEARTH
14. SAFETY GLAZING
15. INSULATION
WINDOWS MEET ENERGY CODE
UNDERFLOOR & ATTICE INSUL.
WATER PIPE & HEAT DUCTS
16. WOODSTOVE APPROVED
17. WINDOWS & DOORS CAULKED
COMMENTS:
'. PERMIT
.
CITY OF BREMERTON BUILDING DEPARTMENT
PHONE: 478-5281
JOB ADDRESS
1505 CLEMENS
OWNER
RICHARD COBER
MAIL ADDRESS
1505 CLEMENS
ZIP
98310
PHONE
377-1289
CONTRACTOR
WOODSTOVE WAREHOUSE
MAIL ADDRESS
1121 BAY ST. PORT ORCHARD
PHONE
876-7244
LICENSE NO.
Class of work: D NEW
D ADDITION
a: ALTERATION
D REPAIR
D MECHANICAL D PLUMBING
CHIMNIi'Y (No fee information only) INSPECTION: Groundwork Gas Test
Masonary Lil'les Unlined Wasted Vents Water
Factory Mfg Type B Type L Htg. Ruffin Chimney
Location: Internal Outside Wall Stove or Insert Refrig.
No. Type of Equipment Fee 'No. Type of Fixture or Item Fee
STOVES Gas_ Oil_ Wood_ WATER CLOSET (TOILET)
FIREPLACE INSERT 4 1)0 BATHTUB
FURNACE Gas (Nat._ LPG. _) Oil_ LAVATORY (WASH BASIN)
Wood add on _' Other_ Electric_ SHOWER
BTU KITCHEN SINK & DISP.
Type: Up flow_ Down flow_ DISHWASHER
Horizontal_ Wall_ LAUNDRY TRAY
CONVERSION BURNER: Gas_(Nat._ LP~) CLOTHES WASHER
Under 100,000_ Over 100,000_ WATER HEATER
Oil_ URINAL
UNIT HEATERS BTU_ Gas_ Elec._ DRINKING FOUNTAIN
BOILER Gas_ Oil_ Electric_ FLOOR - SINK OR DRAIN
Other_ HP----,-- SLOP SINK
GAS SYSTEM Max. 5 outlet Total_ WATER PIPING & TREATING EQUIP.
EVAPORATION COOLERS Roof_Wall_ WASTE INTERCEPTER (Grease)
BTU_ VACUUM BREAKERS & BACKFLOW DEVICE
AC UNIT Electric_ Gas Elec. Combo LAWN SPRINKLER SYSTEM
BTU_ SWIMMING POOL - Private Public
HEAT PUMP Single Package_ SpliL- GROUNDWORK
Add on_ BTU Ton~ SUMP
MIXING OR REHEAT BOX CFM_ BTU_ ALTERATION
AIR HANDLING UNIT CFM~ BTU_ POST & BEAM
FANS Exhaus~ Supply_ Bath_
RANGE HOOD Residential_ Comm._ PERMIT $
CLOTHES DRYER Res._ Comm._ TOTAL $
Incinerator NOTICE
ALTERATION TO DUCT SYSTEM THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR-
Heating/Cooling_ Exhaus~ IZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
TANKS Oil_ Gas_ Propane wlOK SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
from Fire Dept._ Gallons_ . ' WORK IS COMMENCED.
REFRIGERATION UNIT. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND
KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND
~) ~~ ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHE-
PERMIT $ THER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRE-
TOTAL FEE $ 10 00 SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY
OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOR-
MANCE OF CONSTRUCTION.
FINAL APPROVAL
(SEE OTHER SIDE)
RECEIPT NO.
SIGNA TURE OF CONTR CTOif:; AI.e::::,::t:~::...NT
SIGNA TURE OF OWNER (IF OWNER BUILDER)
73'g:9S
PERMIT NO.
Jj~
2629
(White-OR IG I NA L, Yellow-I NSPECTOR, Pink-APPLI CANT)
......
'. PERMIT .._~Plt-IC~ !~ON
- . - .'. .-.. .-.-'. -~-- ........._._,--_._~--q..
CITY OF BREMERTON BUILDING DEPARTMENT
PHONE: 478-5281
~
PHONE
:377- /-<.. 0 9
LICENSE NO.y
?70..,.-7;2t.(<
d
MECHANICAL
D PLUMBING
"-
CHIMNEY (No fee information oniy) INSPECTION: Groundwork Gas Test
Masonary Lines Unlined Wasted Vents Water
Factory Mfg Type 8 Type L Htg. Ruffin Chimney
LocatIon: Inti!rnal Outside Wall Stove or Insert Refrig.
No. Type of Equipment Fee No. Type of Fixture or Item Fee
STOVES Gas_ Oil_ Wood_ WATER CLOSET (TOILET)
FIREPLACE INSERT ?I e;o BATHTUB
FURNACE Gas (Nat._ LPG. _) Oil_ LAVATORY (WASH BASIN)
Wood add on _ Other_ Electric_ SHOWER
BTU KITCHEN SINK & DIS?
Type: Up flow_ Down flow_ DISHWASHER
HOflzontal_ Wall_ LAUNDRY TRAY
CONVERSION BURNER: Gas_(Nat._ LP_) CLOTHES WASHER
Under 100,000_ Over 100,000_ WATER HEATER
Oi'- URINAL
UNIT HEATERS BTU_ Gas_ Elec._ DRINKING FOUNTAIN
BOILER Gas_ Oil_ ElectriC-.- FLOOR. SINK OR DRAIN
Other_ HP_ SLOP SINK
GAS SYSTEM Max, 5 outlet Total_ WATER PIPING & TREATING EQUIP.
EVAPORATION COOLERS Roof_ Wall_ WASTE INTERCEPTER (Grease) I
BTU---,- VACUUM BREAKERS & BACKFLOW DEVICE
AC UNIT Electnc_ Gas Elec. Combo LAWN SPRINKLER SYSTEM
BTU_ SWIMMING POOL. Private Public
HEAT PUMP Single Package_ SpliL- GROUNDWORK
Add on_ BTU Ton_ SUMP
MIXING OR REHEAT BOX CFM_ BTU_ AL TERA TION
AIR HANDLING UNIT CF~ BTU_ POST & BEAM
FANS ExhausL- Supply_ Bath_ I
RANGE HOOD Residentlal_ Comm._ PERMIT $
CLOTHES DRYER Res._ Comm~ TOTAL $
Incinerator NOTICE
ALTERATION TO DUCT SYSTEM THIS PERM1T BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION AUTHOR
Heilting/Coolins...- ExhauSL- IZED IS NOT COMMENCED WITHIN 120 DAYS. OR IF CONSTRUCTION OR WOf'lK!~
TANKS Oil_ Gas_ Propane wlOK SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AF-:-Ef
from Fire Dept._ Gallons_ WORK IS COMMENCED.
REFRIGERATION UNIT ! HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPliCATION M.:
KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AN[
( , r70 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH VVh E
(1\ PERMIT $ THER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NeT PRE
TOTAL FEE S /(9 00 SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF A~"
~ ~c:- -
INAL APPROVAL
OTHER S lATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE i"_r'.F:Jn
MANCE OF CONSTRUCTION.
SIGNA TURE OF CONTRACTOR OR 4UTHORIZED AGENT
fDA-:"=
SIGNATURE OF OWNER (IF OWNER 8UILDt:g'
/n.1 -,
(SEE OTHER SIDE)
RECEIPT 0.10.
PERMIT N(
t'l'Jhi\".ORIGINAL, Yellow.INSPECTOR. Pink.APPLlCANT)
.,.... : ~
INSPECTION RECO" CARD
CITY OF BREMERTON BUILDING DEPARTMENT
ADDRESS & DIRECTIONS
.
2629
PERMIT NUMBER
1505 CLEMENS
OWNER Rlc~ARn r.ORFR
CONTRAGroR WOODSTOVE WAREHOUSE
PHONE 377-1289
PHONE 876-7244
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:
COMMENTS:
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 DETEGroR --
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
. e
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 CORR O.K. CORR O.K.
1. HANDRAI.LS -- 9. OUTSIDE GARAGE --
2. GUARDRAILS -- 10. CLOTHES CHUTE --
A-HEIGHT -- 11. SEWER/HEALTH DEPT. --
B-INTERMEDIATE -- 12. COMMERCIAL BUILDING --
3. EXHAUST FANS -- A-MECHANICAL APPROVED --
A-KITCHEN VENTING -- B-PLUMBING APPROVED --
B-BATHROOMS -- 13. SMOKE DETECTORS --
C-LAUNDRYROOMS -- 14. FIREPLACE HEARTH --
D-DRYER -- 15. SAFETY GLAZING/
4. TILE AT TUB OR SHOWER -- DOUBLE GLAZED --
5. DISHWASHER 16. INSULATION CERTIFICATE --
PROPERLY INSTALLED -- 17. FREE-STANDING
6. FIRE DOORS -- FIREPLACE APPROVED --
A-SELF-CLOSING -- 18. WINDOWS & DOORS CAULKED --
B-SWEEP OR THRESHOLD -- WEATHER-STRIPPED --
7. ATTIC ACCESS --
8. HOT WATER TANK -- FINAL INSPECTION APPROVED
BY:
NOTES:
PLANNING:
.
-
.,
e
r-
N~ - 44889
LOO ['~ /
F; ;~~~;~_~;;;~;;_ R~pt No_ _______-Z/~~_L_____/._.-------------.!...-----
CITY OF BREMERTON BUILDING DEPARTMENT
F. E. IRISH, Building Inspector . ESsex 3-1411, Ext. 36
Own:r's Value I Bldg. Dept: Value I' DESCRIPTION:
$ /" U CJ () I - _ - _ Lot Block Additions
Address on Job -. .I-$.X? .~__.... .G~k~??.~!.. __ __ .... .;;'.'00 ____.,.........00 .... ......... _......_. Date . ._.,:1'. c?.:::. __:1____ .'7-. Y.::..m 00'" .m_
Building hmm__"_m X m__...h.__.._ and .m.m__mm stories __..__...n__m.mm. basement. Lot 'mm.__mm x .m.m.m__..
Front Yard 'n.nmhmn__'mh Rear Yard mm.._m__..__..h__ Side Yard .m.___m..nm..n__ Garage m..__.__nmm.m__n.m
OCCUPANCY. PERMIT REQ'UIRED BE,FORE O'CCUPYING BUILDING Zone mn_hnhnhn..m____m__n_m_n.
/" . , /"'7
Owner _./f:J:.~. ,-tf.;-{;,?.~.<..__ __ .(p..,of!, rlrd',,",~.L __........ __.. __. __ Address __ mn ___.m __. .n... n.. __ __ ___ __n.__... Phone . __ .mm. __. n'
Contractor _n__. n'nn.n __ __....00 0000 __ 00 __ 00 ._...._.. __.. __......00..00 00" Address ... .__. __. .n. 00 n __n..h.__ 00 00" _ 00 __. __. Phone 00 __00..... n' n'
This permit is issued for:
_.. .-d::L#-.--d!-:?-:.'!:?l',,?-?':.-;L _.. .,,,.. .._. ....-::::4""'- .~..~~~=?<~'::g!-._. .J!.. .At:'<:,;-.-:f..&-:!'..~d..:~-:;:,,:..d~~?:~.,-:-:...._...... ..._.. .... ._.. ._.. __...
(~.~~A., )
~ ~ (/ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~: ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~: ~ ~ ~ ~ ~ ~ ~ ~ ~: ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~: ~ ~ ~ ~ ~ ~ ~ ~ ~ ~~ ~ ~ ~~ ~ ~ ~
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
INSPECTION - Reinforcing steel must be inspected after placing andbe.fo,re covering. FORMS shan be inspected
and appro'ved before pouring. All plumbing, wiri:ng a,nd the fra,me of all buildings must be inspected and a,pproved
before covering. Wood preservative to be used on all wood against masonry. Ventilate foundation and a.ttic. Sepa"
rate permits requ'ired for plumbing, wiring a,nd heating. See City Engineer before working on streets or sidewalks.
-------~-------------~---------------------------------_.._---------_.._-------------_.._----------_.~...__._-.-..~..__.._---._-._._-~-_.-...__._-------_....._._--..--.---.-.....-....
-. - --- .--.- -- - -.- - - .-..- - - - - - - - -- -- -- - - -. - -...~ -. - - - - - - - -- - - - - - -- - - -- - - -. - - -..- ---- --..--- ... - -. - --- - - - - -- - - -. -- - ~ - ~ - --~ - ---. - -- -- -- -- -- -. -.. --... -.- - _.-- --.. -- -- -. -.-. --- - --.. --..---
----.-------...---------.---.-.------------..---------.-.-----.---....-----------...--..--.-..--.-.------.-----_._---._.-.__._---~_._-_._-_.._._._..-._-.._...._..._..-._-.--------.----
.---.-.....---.-----.-..----------------..----....---.--.------.--------.-------.--------.--.---------.---.-.-------...-----.--.---...------.-....----.----.-.--.-.--.--..--.--..------.---
. - -- - -- --- --- - -.. - - - -- -- - - -- -- -- -- - - -- --....- --. - --- -- -- - -.- - -- - -- -- -- -- -- - - -.. -...- - - -- --. - -- - -. -- - --. - - - - -- -- -- --- -- --. -.- - -- - --- - ...- -.. -. -. - - - - --- - -- - - - - - .-- -. .oo_- _.__ .___ _._.___..
- - - - -- -...- - - -- - - -- - - -- - --.- - - -- --- -- - -- ---- -.- -- -- ~ - - -- - --- -. -- --..- - -. - --- --- - --- -- -..- - - - - - - - - -- - - --- -- -- - -- - - - - - --- - - -- -- --- - --- --- - --- -- --- ---- -- -- - --- - --- - --- - --- - --- ------
---~-------------------------------.------------------.---------.------------------..---.----.----------.----------~--------_._----._---_.~._.._-------..--.__.._...---.----------
-.._----.--.....__._-..-.._---_._---_._----~-------_..__..---------------.--.-----------.-...-------------------._-_._-_._-.-_.._--~--------..----~------_..._--------_....--..-----------
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-- -- - --.. - - - -- - - -- - - -- - -.. - -- - - -- --- --- -.. - - - - --- - -- - - -- -.. -.. - - - - - - -~ - - -- - - --- - -- - --~- ...-~-.. - -..~ -..... --.. - -.. - - - - - - ~- - - - - - - -- - --~ -- - - - -... - - -- - ~ --. ~ --- --- - ---- - -- - - -..- -- -- -. - - ---. --- --
- - - - - - - --- - - -- - - - -.. --.. - -- - - -- - - -- - - L - - - -- ~ -- - - - -;. - - - ~-- - -:..;- - --- - --- - -- - - -- - - --- - ..--- - - - - - - - - - - - - - - - - - - - - -- - - - - - - -- - --- -- -- - - - - - - -- - - - - -.. - - - - -- - - -- - - -- - - - ._-.. -- - --- ---- ---- --
- ,. fG,r,/1#"vp( p' ~/L-- --
Owner s SIgna tu reo __ __.. __...... __" __.. __.. __.. __... __. __ _. __ __..... __.. _..." By... _' _. __.. __.. __.. __.. __..... 00'" __...__. __..__.. __. _ __......~... __...n...
His Authorized Agent
Building Inspector __ _,. .~j.. _,;f!:., \" 2-4-':~~~_....:..... _ _... __.. __ _ _ _' _ _ __ _". _, ___. __.. __...
/"1
By n._.... __ __4:~..... __.._. __. __....... _ __ __.... __ ___ n.' n.n. __.. __.. n. __n. __.__
~DF
."",~,,;::, '
.
~.
~.
e
N~
43428
/.;rt;;,~"':.l;.1l_ --O~,
, d ,.,,J ..
Fee $.__m_.. - - u_:. !:'':-4i;''~''-J::;::'nnm nmm_.. n _000000_ n 000
'1 ,j f
Receipt No. n_~'?~2f~~.~:~~._..._nm..mmmm_n_mm.
BUILDING
CITY OF BREMERTON
PERMIT
BUILDING DEPARTMENT
~//
F. E. IRISH, Building Inspector . ESsex 3-1411, Ext. 36
Owner's Value I Bldg. Dept.
Value DESCRIPTION:
$ ~/7S!,f).., 1'$
Lot
Block
Additions
Address on Job _L~_ :!<~_: ,:~_ __r:;: ~~::-?:'~ t:&~ "'-'. _~ _.00- _. __ _ _ __ u _u ___ _ ____ _... _ _ _ _ _ _ _ __ _ _ __ _ _ ___ ___ _. __ _ _ __ u _ Da te __/:~,__,_1..~_~'___~'..~ "1... __ _ _ __ _ _ __ _ _ ___ _ _u __
Building ________________ x __________m___ and ________________ stories ________________________ basement. Lot _____.________u x ________________
Front Yard ____00________00____00"_ Rear Yard ______h_.m_________u Side Yard ___.____________________ Garage ______._________________0_____
Occupancy 0 __ 0__ 00_ _ _ _u_ ___ _ __ n u_ _u_ hU ___ 0 __ _ _ _ _ _ _ _ __ _. 0_ _ _ __ _ _ __ _ _ _ __ _ _ __ __ _0 _ _ __ __ __ __ ___ _. __ u _, u_ 0 0 _n u Zone ._n_ .Uh_ __ _u _ _n. __ _ _ _0_ _ _n _ _n u_ _ u
Owner ___ ___ ___ ____ __._ __ __. _ __ _ _ _0 __ __ _ _ _ _ _ _ _. __ _ _ __ _ _ _ __ ___ _. __.. __.. _ _ __ _.. __ _. Address __ _ _ _.. _ _ _ .__.. _ _. __' _ __. _ _ _ _. __. _ ___ __ __ _ _ _ Phone ._.._ _ ___ _ _ __ _.__
Contractor !li.:k-V~- !~~ _ _(:"::~~'_:';'<,..t:.. _ _. n~:f",,'!~"~"O ~,_ _ _. _ _ _ _ _ _ _ _ _ _ _ _ _ __ Address _ _ _ _ _ __ _ _ _ _. _ _ _ _ _ _ _. _. _ __ _.._ _ _. _ _ _. _ _ _.__ __ Phone 0_ -'__ _ _ __ __ __ _ ___
This permit is issued for:
_._:'-0"'_"_; 0 __ _: :i'~: ;'0'"_-_ '- ~ - ~c}-:.; _ _ _ A_ <j~'""~ ~ d';,-, ",::':::i..I':" - - - - - - - __ - - - 0 - - - - - _. - - - - - - - - - - - - - - - _ 0 _ _ _ _ _ _ _ _ _. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 0 _ _ 0 _ _ _ _ _ _ _ 0 0 _ _ _ _. _ _ _ _ _ _ _ _ _ _ _ __.. _ o. - _ 0.. __ _ _ _ _ _ _.0 -..
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
INSPECTION - Re,jnforcing steel must be inspected a,fter pladng and be,fore covering. FORMS shaU be inspected
and approved before pouring. All plumbing, wiring and the fralme of aU buildings must be inspected and a!pproved
before covering. Wood prese'rvative to be used on an wood aga,inst masonry. Ventila,te fo'undation and attic. Sepa,.
ra,te permits requ'ired for plumbi'ng, wiri1ng a,nd heating. See City Engiineer before working on streets or sidewa,lks.
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Owner's Signa tureo - - __ _. __ _ _ _. 0 0 _.. _ _. _ __ u _. _. _ O' _ 0 0 _ 0 0 _ _ _. _ _ _ _. _. _ _, _. _ _ _ _ __ By);.o r~ o~'-f!j~p,.fjl!. <f- .-:~;':; (;--!Q~t d.lo ,~-?o"' :;:: :~:7:: },:=,'~'u::__
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