HomeMy WebLinkAboutCONSTITUTION AVE. N., 643
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Applicant: ANOERSmN LAND DEVELOPMENT CORP
563 6TH CT FOX ISLAND WA 98333
BREMERTON I::JIERM I T Il:::E:NTER (''')
286 4th Street~ Bremerton~ WA 98337 I
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Phone: (360) 478-5275 FAX:: (360) 478-5278 \v-e:--
BUILDINf:i PERMIT evv.f /'
99....{)?':: ],
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Ot,,/O;?/1999
,J6/;:~~;::/ 1999
1~U19/1.999
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Job Addr~ 643 N CONSTITUTION AVE
L"ocat :l on ~
Parcel No~ 3715000-016-0002
Owner~ MOEN~ CARLEEN 208-2125
643 N CONSTITUTION AVE BREMERTON WA 98312
Cont r act or:: ANDE:r~SClN L.,AND DE::VELOPMEN"r COHP ~~08"''';:~ 1. ~:5 L.:I. G if.: ANDEf~I..J)O;;~::l:n:~ Exp: 04""04l".,;~:OO()
S6:~~ 6TH CT F'OX ISLAND WA 9(~m3~:1
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ValuatIon.x Perm:i.t Fees~ ;::~03"BO Total CalcLJ.Jated I::'ee~ .' 20n,,~:lO
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. Oth€rr F'l!::f:)s: 4.:S0 Total Permit F'ee:: ~" ~:~on,,3()
x' * * :)j&* ** * ~~ * ,)( , . 'j(' * ~O(. ,x .j(. +(, +(,*.x.* ,)(.)( * ,x ~.** +(, 'li:' ,)( * *,lH('** ,x ,)(,.)(, *,)( j(..)i; * * *~. .)(..)( * '11: * * ** *.f!: ~* ,x *.)( * * ,)(, 'j(. ,x~.:l(. 'K' 'K*,~' * .)(, ,)(:)(..)(..)( * ,)(..~* ~Ht
This permit ,lha)'l become mill and void if the building or work authorized by this permit is not cCIITlmenced within
180 days fro~e date of sLlch permit, or if this building or work authorized by such permit is 8uspended."or
abandoned at any time after the work is commenced for a period of 180 di~YSi
NOTICE .. It is the responsibility of thl:l permit holder, not the City ()f Bremerton or Building OfFicial to see!
to it that required inspections are made. The permit holder must notify the Bu:i.lding Official when ready for
l.T'lspections. FaIl of the permit holder trJ notify the Bui.lding Offic'. J. of required inspections may result
in the stoppage the ~JOrk until such time that the permit holder can ,1.Jbstantiate to the building of"icial
that the concml 'd work meets or exceeds code requirements. illlY dem .. ':nn, testing, or finf.lncii~l buniFn shall
be borne diHIC' y by the perm~t Ider. Failure to ({ubst I,' tS nilquirements will indemnif')' the CIty
(J,gainst any ar, all responsib'.'" or liabilJ.(~nected ith the constructirm.
"
I hereby certify t at I have read and examined this permit and know the same to b(~ true and correct. All
provisions of laws and ordinances governing this type of wDrk will be complied with whether specified hereir
or not. The granting of a permit does not presume to give authority to violatEl or canct~l the proviaioM :A
any other state or local law regulating construction or the performance of construction.
Signature: _.. "c:~~~---.;;::.:::::::,.".;._.. 1)ate:"._._.f;L...7_,.".-:=::~~.
I certify t t I am exempt from the requirements of the state contractor's registration law, under
Sect ion 3, hapter 126, laws of 1967"
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BREMER'T'DN PERM:r. "T"' CEN"T-ER ~ ,
286 4rh Street. 8remerton. fJA 98337 , ( j
Phone: (3'(500) 478--5275 FAX: (::~60) 478'-5278 \ r <L-
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0~?;::~50 Dr~ I VE:WAY
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TESTING: Must ~e recogni.zed by the Washington Associ.at:l.on of Bu:l.lding Officials
~::;PE::CIN!::;P:: MU*::l'l:: b'(~ Y'e!::I:l.f:.~tered w:i,th the ~::;tate of WA
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pprm'lt No" 99""'O':,;~,n, ~')i;"j(',"':: J
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Applicant: ANDERSON LAND DEVELOPMENT CORP
Owner: MOEN~ DARlEEN
Cont '1" act or':: ANDE:j:~SON L,AND DI::::I.{5J)i.i81~F:N"1" COF<P
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Def(H::r :1. pt :1. on ::
NEW MOBILE HOME (52 X 27 FLEETWOOD)
Cond :i, t :I.on~~ ::
1. FLOOR ELEVATION OF MANUFACTURED HOME SHALL BE A MAXIMUM OF
12 INCHES ABOVE FINISHED GRADE.
2. E N GIN E E R I N G
A" RIGHT-OF-WAY PERMIT REQUIRED FOR DRIVEWAY APPROACH"
B. UTILITY FEES FOR PULLING WATER METER ($40) AND FOR
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'Permi 1'; No:
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MOBILE HOME PER(1IT
f";i'9-'0281 'T>'pe= MOB'iLl?
371 ~)OOO-() 16'-O()O~:
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~~4a N CONS''frnrfION AVE \ ,/
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2.<:JS "ao /,To;ta~. A~.L Pmts~ 'lOB ":<V"-"".,
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Account Cod~~ Oeser' ;lpt i on Amount
16-<322 " 1 O():,) {~~:2:t 5 ) MEeHAN I CAt. PEHM I T FEES 1. 8 .130
16'-'3~~2., lOO~3 (~;,~?l:j) PL.UMBING PERMIT FEES 35..00
l6-8~:~2.1. 007 (:;i~2:l7) MOBILE HOME: SET-UP FEES :t 50 .00
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ANDERSON LAND DEVELOPMENT CORPORATION
P.O Box 419 - Fox Island, Wac 98333
Phone (253) 549-4392 - Fax (253) 549-2243
5co~ 01- W~~
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BREMERTON
BUILDING DEPARTMENT
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ANDERSON LAND DEVELOPMENT CORPORATION
P.O Box 419 - Fox Island, Wa. 98333
Phone (253) 549-4392 - Fax (253) 549-2243
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PERMIT CENTER
Residential Site Plan Review Questionnaire
Permit applications are reviewed by our staff to make a preliminary determination of the presence or
absence of unique areas on the property. To help us make this determination, please supply the
followin information with a scaled and dimensioned site plan.
Ap licant Name:
Y101, ~CL Mt/, C~,
Description of Proposal:
r/p.iI t., a r/ ~ ~~
Str t Address (or cross streets if no adc!ress has been assigned):
... . b t"3 JI/ an) h Tvrft ~ Ctl ,-.....
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Critical Area Questions:
--
1. Is there any standing or running water on the surface of the site at ANY time during the year?
If YES, please describe conditions: V
YES NO
2. Has any portion of the site been identitied as a wetland? YES yo NO
If yes please describe:
..-
3. Is the site characterized as: Forest Cleared V Developed
4. Is the slope of the property: flat ./ gentle slope steep slope
.
15 it or more
Steep (15%+)
3 ft or less
Flat (0% to 3%)
100 ft.
1-
The applicant hereby certifies that all of the above statements and the information contained in any
other transmittals made herewith are true, and the applicant acknowledges that any action taken by
the City of Bremerton based in whole or in part on this application tl).ay be reversed if it develops
that any such statement or other information contained herein is false.
~~~~
Signature of Applicant
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I(enneth D. Reed, P .E.
Registered Civil Engineer
8976 Simmons Rd
Redding, Ca. 96001
Voice/Fax 530-243-3296
March 1 J 1999
To: .
HUD/FHA
Seattle Federal Office Building
Valuation Branch 10HDV
909 First Avenue, Suite 200
Seattle, Washington 98104-1000
Subject:
Magnum Foundation System
To Whom it May Concern
The manufactured home foundation system produced by Magnum Foundation Systems is
acceptable as a lateral force resisting system for wind and earthquake forces. This foundation
system can withstand pressures produced by 80-mph winds with an Exposure and Gust Factor
Coefficient of C as defined by the 1997 Uniform Building Code (UBC). This foundation system is
also capable of withstanding the earthquake forces prescribed by the UBC for Seismic Zone 4.
This foundation system also meets the design requirements of the HUD Manual @ed Permanent
Foundations Guide for Manufactured HousinQ of a permanent foundation. Section 100-3 of the
PFGMH covers this as an alternate foundation system that falls outside of the PFGMH itself.
If you have any questions or .need more information, please call me. Thank you.
. /// /; /1
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4 ~//tTA/')/~ (1'- .::,,0'
Kenneth D. Reed, P.E. \
Registered Civil Engineer
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MAGNUM PJER DIMENSIONS Al!Q!E
INCLUDE 4" FOUNDATION PADS
NOTE: ~
PEIR HElOfITS THAT EXCEED 35" ~
MUST BE CROSS AND
LONGITUDINALLY BRACED
SEE ORA WING OF MAGNUM
BRACING AND CLAMPING.
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PRECAST, REINFORCED,
LIGHTWEIGHT ,CONCRETE PAD
BSK ugrn"" Ne) O\l.ooe.~2
MAGNUM FOUNDATION 5Y5TEM5. COTTAGE GROVE. OR 97424
PH: (541) 942-3465/ (541) 942-8279 / FI.X: (541) 767-0279/ (541) 942-6404
INSTALLATION INSTRUCTIONS
I. INSTALL MAGNUM FOUNDATION
PADS AND PIBRS TO SPACING
TABLE PER TInS SHEET.
2. FOUNDATION FOR CHASSIS BEAM
SUPPORT SHALL BE LOCATED AND
SIZED FOR THE LOADS, AS SHOWN
BY MANUFACl1JREDHOME
INST ALLA 110N INSTRUCTIONS
3. LEVEL TIlE SOIL, AND PLACE
REINFORCED PRECAST CONCRETE PAD
BELOW MANUFACTURED HOME, AS PER
LAY our THIS SHEET. SAND OR 3/4"
MINUS MAYBE USED TO FILL IN VOIDS
UNDER PADS, WHERE GROUND IS UNEVE
4. SINGLE AND DOUBLE UNITS:
PREFERRED PAD ORIENTATION, WJ-lERE
EVER POssmLE, IS THAT THE LONG
DIMENSION OF llIE PADS BE IN THE
TRANSVERSE DIRECTION. ui> TO 1/2 .MJ\
BE ROTATED SO THAT llIE LONG
DIMENSION OF THE PADS AltE PARALI.I
TO TIlE MAIN FRAME, DUE TO SITE OR
SET.UP COi:fDITIONS. SEE DIAGRAM # I.
5. SET MAGNUM PIER TO ITS LOWEST
SETTING, PLACE IT ON CONCRETE 'PAD
AND ATTACH IT TO PAD WIlli 3/4" BOLT:
6. RAISE TOP SECTION OF PIER UNTIL IT
TOUCHES BOTTOM CHASSIS BEAM, llIEN
. LOWER UNTIL HOLES LINE UP FOR
ADmSTINO BOLT, AND INSTALL 518" BOL
THROUGH PIERS, THEN TIGJ-ITEN.
7. TURN LARGE NlJT UNDER HEAD UNTIL
PLA TE CONTACTS BEAM, AND INSTALL 2 '
CLAMP PLATES AND TlmrrEN FIRMLY.
8. FOR FINAL FINE ADJUSTMENT AND LOAr .
TRANSFER TO PAD AND PIERS, "ruRN
LAROE NlJT UNDER HEAD.
T~.
MAGNUMPlER
SizES
A. '12" TO 1'"
B, 14" TO 21"
C. 17111" TO 25111"
D, 24" TO 38"
E. 31' TO S2"
1 A
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L-__.._._2~
EARTHQUAKE RESIST N
FOUNDATION
BEAM SIZE NOTES
....
~- SPACiNG SHOWN ON lHIS PLAN ARE
FOR HOMES WITH 10" & 12" BEAMS.
ANY 6" TO 9" CHASSIS BEAM IS NOT TO
CANI1LEVER MORE THAN S' ON EACH
END OF UNIT, AND SPACING OF
MAGNUM FOUNDATION PADS AND
PIERS CANNOT EXCEED 16'.0"
HOME LENGT~S NOTES
DOUBLE WIDE:
Winds 80 M.P.H. EXPOSURE C
UP TO 44' SPADSANDPIERS.
4S'T066' 12 PADS AND PIERS.
OVER 66' 16 PADS AND PIERS.
SINGLE WIDE:
80 M.P.H. EXPOSURE C
UP TO 44' 4 PADS AND PIERS.
4S' TO 66' 6 PADS AND PIERS.
OVER 66' 8 PADS AND PIERS.
TIE DOWN FOUR CORNERS
4' FROM ENDS OF HOME
TIE DOWNS: DOUBLE WIDE:
I' FROM ENDS 110 M.P.H. EXPOSURE C
22' MAX SPAN. 4,000 iI PULLOUT
APPROVED ANCHORING SYSTEM
CONTACT MAGNUM FOUNDATION
SYSTEM FOR SPECIAL
PRINfS AND CALCULA nON
For 40# to SO# SNOW LOAD ROOFS
110 M.P.H. WIND LOAD EXPOSURE C
AND FLOODPLAlN
GENERAL NOTES
DESIGN LOADS:
ROOF LOAD-30 PSF
FLOOR LOAD 40 PSF
DOUBLE WIDtj
WIND 80 MooP.H. EXPOSURE C
SEISMIC ZONE 4
SINGLE WIDE
WIND 80 M.P.H. EXPOSURE C
SEISMIC ZONE 4 WITH
THE DESIGN LOADS SHALL BE
CONSISTENT WITH ROOF LIVE
LOAD, WIND LOAD AND SEISMIC
ZONE AS ESTABLISHED FOR
PERMANENT BUILDINGS WITH IN
A SPECIFIC LOCAL AREA
lHIS FOUNDA nON IS DESIGNED
TO BE CONSTRUCTED ON SITES
APPROVED BY ANY CITY, STATE,
COUNTY OR STATE HAVING
JURISDICTION, WITHOUT ANY
EXISTING SOIL PROBLEMS. PADS
ARE DESIGNED FOR 1,000 PSF
TOTAL LOAD PRESSURE AND
SHALL BE COMPATIBLE WITH
LOCAL SOIL CONDmONS.
IN AREAS WHERE SETTLEMENT
MAY OCCUR MANUFACTURED
HOMES SHOULD BE RELEVELED
WHEN IT ADVERSELY AFFECTS
UIE MANUFACTURED HOME.
TYPICAL BEAM CONNECTIONS
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~CING SYSTEM
TEMS
SPECIFICATIONS
WELD ACCORDING TO A. W.S.
SPEClFICATlONS
A. W.S. SOLID WIRE ER705-6
PLATESA.S.T.M. M 1020
PIPE SCHEDULE 40
BOLTS SAE. GRADE 5
PADS 3oooP.S./. 21 DAYS
LlGHI' WEIGH/' RED IFORCED
CONL'RETE.
MAGNUM FOUNDATION SUPPORT
ASSEMBLIEs SHALL BB COATED
WiTH FOREST TECHNICAL
. COATINGS CHASsiS PAINT IS-B-203
OR EQUIVALENT
TESTING
asK. ASSOCiATES
PIERS WERE TESTED TO 45,000 /I VERTICAL
RATED LOAD IS,OOO II
PADS WE...~ TESTED WITH PIER
MOUNTED TO 20,000 II VERTICAL
LOAD AND RATED AT 6,500 1#
LATERALLOADIS4,OOOll (RATED)
MAGNUM FOUNDATION SYSTEMS
CERTIFICATION:
lHIS WIlL CERT/PV 11IAT THE SUBJECT,
MAGNUM FOUNDATION SYSTEMS, IS
CAPABLE OF WiTHSTANDING ALL RATED
DESIGN LOADS. lHIS CERTIFICATION IS
PREDICATED UPON THE PROPER
INSTALLATION AND TIOHIl!NING
OF THE UNIT.
MOBIlEIiOME fARTHOUAKE [\RACING SYSTEM
CERTlFICA lION
THIS SYSTEM IS CERTIFIED AS BEING LISTED &
APPROVED BY A DEPARTMENT APPROVED LISTING OR
TESTING AGENCY PURSUANT TO THE CAe. nTlE 1.5
ClIAPTER ". CERTIFICATION DOES NOT AUTHORIZE
OR APPROVE ANY OMISf,ION OF DEVI" liON FROM
REaUiREMENTS OF APPliCABlE STATE LAWS OR
Rf:GUlA nONS FROM Rf:QUlREMENlS OF APPIICA8U:
STArr LAWS OR REGULATIONS.
STATE OF CALIFORNIA
DEPARTMENT OF HOUSING & COMMUNITY
DEVElOPMENT
OIVISION OF CODES & STANDARDS
::~~;/~
EXPIRES tP'J'/r"j/?f
PATENT PENDING
\
DEPARTMENT OF PUBLIC WORKS
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CITY OF BREMERTON, WASHINGTON
PER M I T
TYPG B
Mon Jun 21, 1999
Permit # 3550
Permit Fee:
$65.00
.A-cq-~
4-.?2-+4-
APPLICANT: ANDERSON LAND DEVELOPMENT CORP * Certificate Of Insurance Is On Fil
:L53
Owner: DARLENE MOENAddress: 563 6TH CT. FOX IS. 98333Ph: 549-4392 ,
1b #L fJ-rtd e Y'5 0 ^- ;?- S 3 - ~ 8' - ,;L1;;L5 /1117";.
Work Addresses:
643 NO. CONSTITUTION
DRIVEWAY APPROACH ON
NO CURB & GUTTER, OR
9TH ST
SIDEWALK
A PERMIT IS HEREBY ISSUED for the performance of the following:
DRIVEWAY 11~;J/f!I)I'fCH
IfSPII/ft!-r
This work requires blockage of a street or alley and may cut off access to
property for emergency vehicles
This permit is valid for 90 calendar days commencing with the date of this
permit unless specifically called out under limitations below. This permit
must be posted on the job site in a location accessible to City Employees.
The Engineering Department must have 24 hours notice of the need for
equired inspection. An inspection must be made prior to any work
_ommencing and after completion of the job. Phone 478-5270.
Limitations: SEE ATTACHED COMMENTS AND CONDITIONS. RESIDENTIAL DRIVEWAY
LIMITED TO MAXIMUM OF 20'WIDTH.
WORK SCHEDULE
Commence Work: 06/22/1999 8:00AM
Complete Work: 12/22/1999 4:00PM
INSPECTION RECORD
Date of Inspection:
Date of Approval:
Comment: TYPE B PERMIT
. ..
~~f Applicant)
~~cM~'
(I uer - M. BABBITT)
,
. " , II !r.\i
'0'"'
CITY OF BREMERTON ENGINEERING DEPARTMENT
RIGHT OF WAY PERMITNO.3550
1. Call for underground locates: 800-424-5555
2. Traffic Control shall be per Washington State M.U.T.C.D. and City of Bremerton
Standards. Notify CENCOM (478-5330), Kitsap Transit, Paratransit, Bremerton
School District ( during school year), and Brem-Air Disposal of work schedule prior.
to start of work, if blocking driving lanes. Sidewalk closed signs shall be used at each
end of the work area during construction.
3. The street shall be cleaned each evening. Catch basins and ditches shall be protected
from dirt and debris per City of Bremerton Standards. No dirt or debris shall be left
on a sidewalk. No dirt shall be left on grasS or landscaping for such a length of time
that it will result in damaged or dead plants.
4. The Contractor shall notify the adjacent property owners and the City of Bremerton
Engineering Department 24 hours prior to start of Work and the start of Paving.
5. This Permit and a copy of the Approved Plans shall be kept on the work site
during construction.
6. Received from the City of Bremerton: Dr/~ etA.lay n~/rt9a~ - n..CJ cv/'b .fI;~~.e4'"
/11ft. Trench and Surface RestoratIon Standards . ,9/' sI''tIIe.l</-Lk
#/}l-Curb & Gutter, Sidewalk, and Driveway Standards
.AI;1i-Traffic Control Standards
7. Any landscaping, pavement, sidewalk, sign, mail box, or retaining wall disturbed
during construction shall be restored to its original or better condition per City of
Bremerton Standards.
8. The Contractor shall maintain a parallel distance of 5 feet away from other City
owned underground utilities.
RECEIVEDBY~ ~
DATE:4~
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rEXIST. EDGE OF ASPHALT
SAWCUT AS REQUIRED
,l B R!W
~!:~-f:
CULVERT PAVE TO
PROP. LINE
~
5' MIN, , R~!W ,
t ~t>-i-
, \~'1o,
_-",,270 , _ ,~ MAX 670 GRADE
..,::~:,,:_.:-l{;'~,:;o. ' BRAKE (TYP,)
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EXISTING
ROADWAY
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B"':"'B
lB
* 10' - 20' RESIDENTIAL
24' - 30' COMMERCIAL
GENERAL NOTES
DRIVEWAY
MAX. GRADE OF 15%.
GRADE BREAKS NO GREATER THAN 670.
. SIDESLOPES SHALL BE 4H: 1V OR FLATTER WITHIN RIGHT-OF-WAY.
DRIVEWAY APRON
SHALL BE 2" ASPHALT PAVEMENT OR 6" CONCRETE OVER 4"
CRUSHED ROCK (3/4" MINUS).
GRADE SHALL BE :1:270. ,
PROVIDE A CLEAN, STRAIGHT, 2" VERTICAL EDGE ALONG EXISTING ASPHALT
PAVEMENT, FOR PAVING DRIVEWAY APRON.
DRIVEWAY CULVERT
12" DIAM. MIN. LARGE DIAM. DRIVEWAY CULVERT MAY BE REQUIRED BY
CITY ENGINEER.
WHERE NO ROADWAY DITCH EXISTS, THE CITY ENGINEER MAY APPROVE
DRIVEWAYS WITHOUT CULVERTS.
MIN. 12" COVER OVER CULVERT.
CULVERT PIPE MATERIAL SHALL BE CONCRETE OR CMP. ALL
PIPE JOINTS SHALL BE RUBBER GASKETTED.
CULVERT PIPE BEDDING AND BACKFILL SHALL BE 3/4" MINUS CRUSHED ROCK.
DRIVEWAY CULVERT ENDS SHALL EXTEND A MIN. OF l' BEYOND THE TOE OF
THE SLOPE AND HAVE A 4H:1V BEVEL MATCHING THE DRIVEWAY SIDE
SLOPE. ROCK AT EACH END OF THE CULVERT ~' 4" MIN. SIZE QUARRY SPALLS.
SCALE CITY OF BREMERTON
HORIzt.l.T.S. DEPARTMENT OF PUBLIC WORKS
& UTILlTlES
PLOT 1: 1 ENGINEERING DIVISION
DRAWING NO. DRAWN BY: SMJ
B-311A DATE 8-97
DRIVEWAY ,
FOR STREET ~THOUT
CURB AND GUTTER
SHEET
1 OF 1
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BREMERTDN PERMIT CENTER
, ' 286 4th Street~ BremertDri~ WA 98:337,
'Phone: (360). 478....5275 FAX:: (360) 478-5278
, , ' BUILDING PERMIT
J' t; A j ,J , ,,' ~ 4 '''1 N ("()N(.""I" '1"1"1 )', 'r I")N AVf.'" '
"O.l , ( t.l'r. ("J ,: "". ';:1..,. J, I, .::,
"I...:oCiat :1. on ~
Par ee 1 'No ~ ~\'71 ~~()OO""'016""O()Q2
~lPpl leant :'ANDE]~SON LAND DI::VEL"OPMENT CORP
PO BOX A19FQX ISLANDWA 9a~338
Clwnen MOEN. IJAI~LEEN ;~08'''';?l ~i~~i
64a N CONSTIH.lTION AVE BRFMFRTON WA 9831t?,
~~sa""'~:~08''''';'~ 1 25,
;: 'f I ~JA>>'
'LA-"
Permit No: 99-0430
Sti:ttuS: rSSUl~:D
Arn~lied: 08/16/1999
I HstH:-H::I; OBI 16/1..9(79
Expires: 02/12/2000
Cont ri'ict err : SUIJ""JVAN H"j"G &- COOL,ING INC.
PO BOX 221 8FLFAIR WA 985~(~B
405-0723 lie I: SULLI~K:063QT Exp: 11/29/99
Subt:ontr:
, ,
O('~f,iC: GAS' PIPING f:'OR MQBIL1:. r'IOME (99""{l281. )
*******~************************************************************************~************
Valuation * Permit Fees: 5.00 Total Calculated Fee: 5.00
.00 * Plan Check Fee~l: .00 Addi.t:i.onal r:'t"6sL .00
* Otht3f Fees: ,,00 Tota.l Perm:lt F'ee: !S"OO
*********************************************************************************************
MECHANIC,AL/PLUMBING FIXTllRES-- MECH-Gas Pipinr:! (outlets)....: 1
********~************************************************************************************
This permit shall become null and void if the buildin~ or work authorized by this permit is not commenced within
180 days from the date of such permi t, or if this building or work authoi"i zed by such permit is suspended or '
abandoned' at any time after the work is commenced for a period of 180 days.
NOTICE -, It is the responsibility of the permit holder, not the City of Bremerton or Building Official to see
to it that required inspections are made. The permit hCllder must notify the Building Official when ready for
inspections. Failure of the permit holder to notify the Building Official of required inspections may ,result
in the stoppage of the work until such time that the permit holder can substantiate to the building official
that the concealed work meets or exceeds code requirements. Any demolition, testing, or financial burden s~all
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 specHied herein
or not. The granting of a permit does not presume to give authority to violate or cancel the provIsions of
:;:~::~a~~::::~~::~:c::_:~_per:;:::~:'::;;::g====--. .
J cerll fy 't:7 .", exempt from the requ 1 r...nta of the atat e contract or' a reg! at rat! on law, under .
Section 3. Chapter 126 , laws of 1%7. '
51 gnat ute: _________-__________, __L~L___~.~-.-,..-,-..__.____ Oat e: .8--=.J..1o.,,:..-=_._1.._j_
: ***~'*~'*\l('***'~****~:*******~'1Hf I Ii J , ) ,
I"\:n 11.1<,1, V t,t,::! II, tn """.Hppr tJVt:ll.l t:lY; .L/"J.Ll...,,..{.,,,,. """.".". ,'''''''", ' Ufit t;,,'J;'.... ",..,,,.,,,,, "",,,,,,,, ""'"""""" , "",
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BREM~RTON ,PERMIT CENTER
286 4th Street If Bremerton" bJA 98337
Phone: (360) 478-527.5 FAX:: (:;160) 478-,5278
'Job Addre~~~~ ~ 64:::1 N CON!:rr I 'rUTl ON. AVE::
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Assr A~~t No: 3715000-016-0002
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p'f.~r m:l t No:: 99'''''04~:lO ~
St I:l,t U*ll:: ISSUED
lSBued= 08/16/1999
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Item: 01400 MECHANICAL
IN!::;. P E:. C "I", ION S
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PMyment Method= CASH. Notation: ANDERSON CASH Irlit~ VW
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99""0430 'I"YPl':):: M/P
a? 1 hOOO'" 0 16""OOO~~1
tAa N CUNsr J fliT t ON I~Vf::
Total feee: S.OQ
'l'otl:*l AI'!. Pm\;~~~: s.oo
n~lance: .00
*****~~***XX*******~X~******X***~*****X***~**M****~**~***********
Accuunt Code DC8crJptionAmount
t 6'''-::$~:;1? " t ()()~:l (:2215) t1ECI"'!AN J: CAt.. PF:J~M IT r::[FS b ,.00
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~:a.liE~lB!f:rON' Mt:IHCIPt\L UTILITIES P A , D
~ I. 302'1 Olympu8 Ddve . R E eEl V E 0
Q'~ . ['remertonj \\'aahinlton 92310-4799 JUL 181999
~ : M I 4.-78-53 is AUG 03 1999
~ -.: I I,'. \ . \ Y!.illfi.:JllUi~llC.B.__6..~K YO' l
or <,_ '~ ~ OF 13 . lOt; fNGjrjEE~:S
~ ~~ I Vo,k a,.or .0, --- Tap No. -Bra=. w:~c"P.t . ~-o_";~1.~'\
tJ J."11 l1he undersigned prop~rt;4~, Oiwner hel'eby ,8op lies
iJ ~J ~ i. Sex'V'l.oe . Addresl'.l ; __._~,3.. { rvv"';z..~ .
'"3 ~ t : ~~~~:l De8criPtion~__.==--BloOk'~_____
~ $.....il
"'" SERVICE REQUIREMENT: f] Water t< Wll8tewater [J tOl:'fttl-/at.er
.,( q: SERVICE ARliA: [] Ha.rine Drive water. [] Sewer l.h$t..r:l
l. ~ te..II., X City ~] No't'th Penl' Wate.l' (J Tracyton Watel'
P: .U. [1 County [) POl't of Breme.d:on [l --------,--
\I) . ~ _._ __ ....------ -.. ---- -.... -,.,---- ..---.-- ---- --- --- -----.. -- ---.------.--.- --- ------..--
c:i ~~. SERVICE CH)'RGT~S: et:CiJ/'JNfX:r n~ ~tW,,6. S',E7-
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Storm Wet4!l'" .... 'Ii' . . . .. . " ~ t ~ '" .. " .. . . .. . .~. . ... .. t , 'r'
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storm Water .tof units
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a $..___ .
~8teUl Devets.:emsH)'t. Charu_l\:
Water __.___...____,____________ .
Wastewater .._..._______._---..:.___._____ .
Storlll Water ___._________._._..__..______ .
'rellpors!")'" Serv ice ._._._______.. .
Road permi t [] C:l. t)' [I Count.y ...
Street Restoration [J Asphalt [] Concrete'
Tappirut Fee .,. -to I . ~ " '" , ... ~ . . ill , S .. .. t . ~ . . .. of . . , to ~ ..
Deposi t ___......_______._______.__ .
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Utility charges are the responsibility to tbe owner regardless Qf
14h~the:r the property i8 ooc'..lpied by the owneit' ort.enant, 1Jnpaid
charge ~h~ll hecollle /I. lien on tbe J,r.;:.pertf 8&.l'v1oed.
By this 'lIireallliE!llt, the under'iliJned 'ClImer &ck!MJwledllos tha.t. the otlner
assumes the ~18k and the City dieclaim8 responsibility fQr all ol~i~8
for damage 01' injury to pet'lIon or prl:'part.)'. result.ing fr.om t.lJoII
follo"ling:
a. Installation, lIaintenance and operation of a.ll phllllblnll.
or e,ppl iancea conneoted to the loI'ate,' meter or W'Qst1&water
(Buildinit permi t inspeotimcfj lit'S 11m1 tad :1n lfoope aud. do
guara.nt.ee plumbin. design or workmanship.)
b. Changes in pI'eSSUrej flow or celllpor"J.I'Y shut-off of. IHH'vic.u dUll;
to aye teDl l!lain tenance. glD~r.en.cJf or non-payment of oh:r.rles,
.__ l?I.J2.:!.'./J..ic.......H...~QJJ 17>,?. " '!I . rt:"y: ,.:2.\3-J!:r~~f?r
Name___A-~o.u.. .t.~/J. j)'1Lt..i.JJ!!!.llJ.&JIL~ Phone Number \;J:5:J) .;.y?- S4~Z-
Billing MetrellS __..t!C2......dci.X_~______.____ --- .-
.. City ..LaX-..LS.~--,._. -=-__ 8t&.te ~._ZIP 1?H'~
VOwnel"s Signature ~_----=,-__"::](Date _.............- rz _____. 19._
(\Agent1fj Sigrlature..-;:~~/~~:"'- _-'. _:::Z\Date ,-7/7-;./1.(r- . 19.__
Aocept.ed on behal!~~~:~111"niciPal Uti litiee: (L f, 'k'
By: ___.__...---";"~, " ,________.______ Date ~ct:l'2:....., 19/-?-
Original . YellQ~ Copies: Utilities Aocounting I ,~ .
Pink CoPy: Utilities Enlineerin. Go,ldenr'oa Copy; C1JlilCOIlUn
ir.lS{f6..""'1fO~.. JlN,2cuO.) 7-/J~9r; .:....L~Af.I,,_. C',I~ ';:a,.otVl't"n:, ~df 5-e~c../lr!/"
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BREMERTON PERMIT C_NTER
286 4th Street.r Bremer ton 11 tiJA. 9833.7
~
Phone: (360) 478-52;75 FAX: (3r) 478,-5278
BUILDING PERMIT
CONSTITUTION AVE Permit No=
Sti:ltuS::
Appl led::
I ~ssued:
Exp:l.res:
;::~(lB"<? 1.?5
".~
~v
99'''''O?B4
I ~~SUE:O
06/04/ 1. (~J99
06104/1999
1.;UOl/1. 9S'9
Job P,ddr: 64~~ N
L,ocat :l on ~
Parc!:~ 1 No:: ::'1'71. 5000.",0) 6""()OO~~
Applicant: ANDERSON LAND DEVELOPMENT CORP
~:i63 t,'\"I"1 CT FOX I StAND I^,I~ 9f33::~(1
Owner: MOEN, CARLEEN 208-2125
643 N CONSTITUTION AVE BREMERTON WA 98312
Cemt r act Dr: (1NDEI~SON L,AND DEVEL,ClPMI::::Nf Ctmp 20a..,<:? 1. 25 LIe :I~: ANDEf~LJ)()~?::1:,H3 E::xp: 04""0:?"':::~Cl()O
563 6TH CT FOX ISLAND WA 98883
Csse: DEMO 600 SQUARF FOOT SFR
********************~(************************************************************************
ValuatIon * Permit Fees: 18.00 l~tal Calculated Fee: 22~50
,m) * Plan Check Fees: Additional FeeSI ,00
* Other Fessl 4.50 Total Permit Fee: 22.50
*********************************************************************************************
This permit shall become null and void j.f the building or wlJrk 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 thf~ work Is commenced fm' a period of 180 days.
NOTICE .. It is the responsibility of the permit holder, not the City of Bremerton or Building Offieial to see
to it that required inspections are made" The permit holder must notify the Buildtng Official when ready for
inspections. Failure r.lf the permit holder to notify the Building Official of required inspections may result
in the stoppage of the work until such time that the permit holder can substantiate to the building official
that the concealed Nork meets or exceeds code requirements. Any demolition, testing, or financial burden ahall
be borne directly by the permit holder. Failure; to gubstantiatt~ code rElquin1ments will indemnify the City
against any and all responsibility or liability connected with the construction.
I hereby certify that i have read and examined thit'l permit and know the same to be true and correct.. All
provisions of lal~s and ordinances governing this type of vlOrk will be complied with i'lhether spedfied herein
or not. The granting of a permit does not presume to give authority to violate or cancel the prtlVisions of
any other state or 'local law regulating construction or th(~ performance of construct ion,
Si gnature: ....2:r"~_~~.".,.,__.,:_____.:~,-.-Date: __,.,./lL,LLJ/iJ,__"._.....__".,__
I certify t~-; I am exempt from the requirements of the state ~Ol:ltr~~tor:~eg(~~a~i~lfl law, under
Section 3, Chapter 126, lal~8 of 1967. /
Signature:' . .~'. ':""",~;"" -Date: .
..., - ~~,,,,,~_,,,,,,,. ..~,..._,.,.......,.,. ,~......._'...~-_..... ,...- ""'-- __iQ'I""",,,,~..... "... _ __....,.........__. '.....,.~..._...__..._ - __ _1I;:U"'_!\I"__'''"'.~tl;''''''___!'''''_ ........"._ ...._""'.,._ ~..,_"",
***************************
Per m I t; Cent er. -Appr oved By' .-." -~.. ........... o. t.. , ....tp 'f ""tI~ "t.
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Job AddreBs~
location~
Assr Acet No~
BREMERTON PERMIT ~ENTER
286 4th street 5 Bremer'ton" f,J 9833.7
Phone: (360) 478-5275 FAX: (3~O) 478-5278 ~ A A
,~~.
Building Permit No:
643 N (~NSTITUTION AVE Status:
I I!.~ 8 w;.)(::! ::
E:xp:1. '('es::
---
:::l71S000.."O 16""'OOO;::~
99-0284
ISSUED
06/04/1999
12/01/1999
i,
HE:(;~U I 1:~E:D
INS PEe T ION S
Item: 02700 FINAl--BlDG
D(':~')pt:: OL,DG
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*********************************************************************************
TESTING: Must be recognized by the Washington Association of BIJilding Officials
SPE:C-INSP:: f1ust bf':) r*;'l9:t~~~teY'C-:;ld w:i.th th~::'l state of: WA
BlDG~ City of Bremerton Building Department 478-527~
PLANNING: City of Bremerton Planning Department 478-5275
PUBWDRKS: city of Bremerton Utilities Department 478-5818
FIRE~ City of 8remerton Fire Mar8hal~s Office 478-5380
ENG: City of Bremerton Engineering Department 478-S270
HEAlTH~ Bremerton/K:ttsap Health Department 478-5235
ST ~= WA= State of WA Dept. of Labor & Industries 478-4921
*X~********************************************************************~********
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8REMERTON PERMIT CENTE~
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Pf"~Y'm'i 'l" No:: 99""'(,)~:"FM Pi:l"nq,,~'f' 1
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Jcb Addressu 648 N CONSTITUTION AVE
Aser Acct Nou 3715000-016-0002
. Location:
Applied: 06/04/1999
Approved: 06/04/1999
Issued: 06/04/1999
Applicant: ANDERSON LAND DEVELOPMENT CORP
Owner: MOEN~ DARLEEN
Cont r act or:: ANDEI:~SON L"AND DI::::VI::L,OPMI::::NT COI:~P
Description:
DEMO 600 SQUARE FOOT SFR
"'"
Conditions:
1" ONCE DEMOLITION WORK HAS BEGUN~ IT MUST BE COMPLETFD AND
READY FOR INSPECTION WITHIN 60 DAYS.
2. ALL. PORTIONS OF THE FOUNDATION SHALL BE REMOVED AND
DISPOSED OF ,AT AN APPROVED LEGAL DUMP SITE AND THE SITE
GRADED TO MATCH EXISTING CONTOURS. FILL IN EXCESS OF 49
CUBIC YARDS REQUIRES SEPARATE GRADING PERMIT.
S. CONTACT PUGET SOUND AIR POLLUTION CONTROL AGENCY AT
1-800~552-3565 FOR ASBESTOS REMOVAL INFORMATION. ASBESTOS
MUST BE REMOVED BEFORE DEMOLITION COMMENCES.
P .,.\ Y' m .,' 'I" 1",1(")] ("j t:", Y' ~ (:, ~ ' ~ ,4..
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BUILDING PERMIT APPLICATION
Phone: (360) 478-5275 FAX: (360)478-5278
. :,' .','
. 286 4th Street Bremettont WA 98337
APPLICANT: DOWNER. D CONTRACl'OR D OiliER:
~ITl ADDRE~S: b ~ .J/: r6/1 ~7i/(47;"r
OWNER: Jljae.n. .tfJ..r I~~___
CUNTRACTOR: A"",d~4L ~ J:kVj ccq?
CUNTRACTOR LICENSE #~kt.LJCJ?J T.[J..
CONTACT PERSON:
ASSESSOR PARCEL #: ~7/~~:? (!JIb 1?{)10"z-
ADDRESS: {$'~ J: (O-v'J ('7; 1uJt:.n,.. . &-
ADDRESS:Pt>&oz.. L//1 /OJ-./sl-. U. 9/3:'30
EXPIRATION DATE: &(./ 2~
CONTACT PHONE # 2~~cr---- "2..12-)
D SFR D DUPLEX
D .SIGN ~DEMO
D NEW 0 REPAIR
D SEWER
INTENDED USE: M/J?.2J
D MULTI-FAMILY 0 BUSINESS D OTHER:
D MOVE BLDG. 0 MOBILE D GRADING(yds):
D REM()DEL
D ADDITION D OTHER:
o SEPTIC
S~,
,
NATURE OF WORK PROPOSED:
~QlJARE FOOTAGE: Dwelling:
Garage:
F, D t tV Of
Decks:
<or eJJllr, men ."e my
VALUATION PLAN REVIEW FEE.. '..' ". PERMIT t.EE . SUltCHARC1::s . TOTAL FEES
$ $ $ ENERGY: $50.00 $
STATE: $4.50
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 Ollee. 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 thfl;t the above illftrmatioll is correct to the best of my knowledge.
APPLICANT'S SIGNATURE: ~~~___-
DATE: r //
hl'dl'l'.Jfll rC\'id ~/H/97
...
-
Work Order No.
Tap No.,
8REMERTON 0fTY TIQ9JRER4 t! 11
P A 10
JUN 1 - 1999
AGREEMENT , ' . '
-"---rTrW~ "Q~/-005f:.J5S'S-
Bremerton, WA. , 19
BREMERTON MUNICIPAL UTILITIES
3027 Olympus Drive
Bremerton, Washington 98310-4799
478-5318
~TILITY SERVICE
'_,The undersigned
Service Address:
Legal Description:
Plat
prop~rty owner hereby applies for Utility service at:
o i/3 .A/ (;,..1/577 7t/77tPJ; /
Block
~ot
Kitsap County
~;;~i~;-;;Q~i;;~;~~~--[]-;~~~;-\[~;~~~~~~~~;--[]-~~~;~~~~~;------------
SERVI,9E AREA: [] Marine Drive ~t:er [] Sewer District ,jl
lI],Ci ty' [] North Perry Water [] Tracy ton Water
I[] County [] Port of Bremerton []
SERVICE CHARGES:
S W/< Cllfl
~
)) 'f/JJ 0 ,
f/c.K/Y/ /1
BARS_t
Connection/In~~tion_Fe~:
Water: Domestic...............Size $
Fire ... ....... ...... ..'Size *
Wastewate~ ..... .:S:EI.;(,,)~i:... . .Ct.;-f: . ~ . . . . .. $
S to rm Wa t e r ......................... '. . . . $
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, ')i( .Jl. '1;1.. - 'i (n I !'i:Jf-/ (
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Front.._ Foqtage _Fee,:
Wa t e r ............ '. . . . . . . . . . . . . . . . . .. . . . . . $;
Was tewa ter ............................... $
s t 0 rm Wa t e r .................. .. . . . . . . . . . . *
g!m,~ral FaQ.i 1 iJ~zJee :
Water .......j of ,units
Wastewater ..I,of units
Storm Water .1 of units
(It $
(i $
(It $
$
$
$
'-
~stem~ey~~opment Charges:
Water
Wastewater
Storm Water
$
$
$
Temporary Service $
Road Permit [] City [] County ..$
Street Restoration [] Asphalt [] Concrete $
Tapping Fee ............... 0 . . . . . . . . . . . . . . . . $
Deposit $
Other $
j(',
TOT AL. 0 . ,,' . . . . . . . . . . . . . . $
3o.ff)
---------------------------------------------------------------------------
\fowner's
j\ Agent's
Utility charges are the responsibility to the, owner regardless of
whether the property is occupied by the owner or tenant. Unpaid
charge shall become a lien on the property serviced.
By this agreement, the undersigned owner acknowledges that the owner
assumes the risk and the City disclaims responsibility for all claims
for damage or injury to. person or property resulting from the
following: ,: ,..'
a. Installation, m~intenance and operation of all plumbing, fixtures
or appliances connected to the water meter or wa~tewater main.
(Building permit inspections are limited in scope\and do not
guarantee plumbing design or workmanship.)
Changes in pressure, flow or temporar~shut-off of services due
to system maintenance, emergency or non-payment of charges.
-rIlI:v'l1t5 ('. mvt'F..eS01/ rbJ( C'~LL :'1..<,:1- ;2..08 ~ 2/:2. ,-
Name /J-IvxJz-i'SoAI LJt-;vu IXvf'Lf)f34t€N'T ColffJ Phone Number (.;?S""3) 1)-L/1 - ~r39:2-
Billing Address Po BJX' lit'? .
Ci ty GOX /st.ANt:J St,ate tv" ZIP '1>r333
Signature,..:;,;'::~~:::;~. /."<,'.~>,"..,,:?/~ Date . J:' /"95' , 19
Signature ' , Date , 19_
2 .
1.
b.
Accepted on bcehat.t::of Bremerton Municipal Utili tie's.~,
By: ~ -I~.-/'/ Date
J../"'- / - V '. "
Original & Yellow Copies: Utilities Accounting
Pink Copy: Utilities Engineering Goldenrod.Copy:Customer
f17O:d1t'[ K&1r~ /.4-l'FitAJru fi:>>e t-PT ~A!... /}V/~n~
CH/!/ 'S7t/;:' 51w'E,.-.(. 6/u../AIt: t//VT7i.. y;v~..g,\,
q~ol
I;
, 19?-9
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******MH**********M*****MMH*******MH*****M***MM*****NM*****M****
RET~E. J Pl
NN******M~*********M****M~***.M*****MM***I*******M*M************
RECEIPT Numben 9900CH?4 Am()unt~ ??SO 06/04/?') 13H)t:)
P,:fymcmt r1ethod~ CI\ NDtatIon: ANDEf~l~mN LAND lnit~ Jl
Pe'rm'l. t NO;I
Pa.rcHl ~h:H
S 1. 'I; (0) AddY'f:H'.lO ~
91)'''0:'.H4 ryp('~: DEMO
a'l J bOOO"{)1 (~..ooo:?
643 N cot~~nTTllrl()N (WE:
Tota] F!;)f!~~~~ ?? .E;O
~~;? .:;10 Total ALL. Pmt;&~!: ~:~';;~ .~)O
EM ] ;mce : ,.00
***********~*****~***M******************************************
Acc()tmt Code f)f.)scr i pt :1 on Amount
t (~1'" 3~?? " l. OOB (;::~;~ 1. B ') ClEMO!.:r T r. ON PErm t T FEF:S 1. B ,,00
64::}...;:.\;:r?,1.;;3 (O?86) S'TATF OF WI'! SUHCi'I(~f(f:;F o4.f.lO
DEMOL I "( 1: ON PElm T r
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I' oharle: shall btlcolIl!l a: 1 hm on ,'the;'; Jl:roper:t,y JSorv lee,;!.. . . i
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.'.''':', .or applil&nQes' co"mCloted.:,\b:~t.~.,t\"",tl!or""lllet.e:r"'or WliIIl,tewa1oer lIlain,'
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guarantee plu!IIbint ,deBi'n~~ol',..:wor:klll&n.hip.) "" . " .:':', ':".' . .
ChanCe. in: pre0l8ure,! flow;"n<temporarY'shut_off of seryioe.. '.du", :'
to 8)"9 tell maindmallce I 'alller,enoy (11" non-payment of Ohal'.e8, ., ,I ,
:r~~ c ~. ~ _ .' ~i:U .}.<"'2- .L1tr~.
IJ&llle____ O:;.s1A ' ~/ &:-Aff ("~.Ph_ PhoM NUllIber ~S-s~ ~.-~3?'4:
BHlin. Addrens _~ ~ __~_._ ' ,_
City _ ~~_~ Stat.8 li Z~p 1.f'.?~~
\/OWnl:li"1J Si.nature~&(_, . ~,D.te. //1/</7<'" " ,"19......:.
j\ASent '8 Signat.wn, ___ ,. ~_.:..___ ,pate, -.:.__ ___, 19__,
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AQoeptl.'d or,. beh~rt(l%i MuniQipal UtilitiCoe: , "~c:,, ......,.... .... I.... ':1'
By; ---~ ".' __,_ Oate .~,-.,;.1971 ,: '.
' '. ". .'.'. I
Original'" Yellow Copil!l$: .UtUitiell AooQunHnill' '. '.. .'" ""'~'i":"<ii:;':::1
P.ink Cop)'; Utilities E~S'.i.neel"in. ,.' ',Goldenrod Oopy:. CuatolllcH" ,: "',' ,>:.
i.",~"6e1(D }' ~vb::L::;)..... /I?()'1I't~ ,(tH'~ IM'EA-OU) Ii:!< t$ ~ /)~6m ., .: ::,J
r;;?. 9~ -;..p CIhv OS.",,"" 'SE wf,{ tJ,I U/~ t/N77J... 7'# 1:4-", g,,~;, i
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BUILDING.PERMITAPPLICATION
286 4th Street Bremetton, WA 98337 · Phone: (360) 478-5275 FAX: (360) 478-5278
APPLICANT: D OWNER ~ONTRAcrOR D OTHER: ct~ - Ol~ ~
.. .
E;'~
~ITL ADDR[~~: 6l.(3 :)I CO/1s1rfv1"~
OWNER: tk:c I..e-.e-V\. Me-e.-V\~
CUNTRACTOR: ~Dr'""\ ~) fkv {';p.
c..( >NTRACTOH LICENSE # 11J1~J~1!blJ_c:n- ~ 'J IS
U INTACT PERSON: -J;;n1
ASSESSOR PARCEL #:.3'7/) t.::1tQ:? CJ/t5' t'JtY{?Z
ADOHESS: 6 Ys y; 4s17'Tt/1'7dn
,
ADDRESS: PtJ.JJ(!){)( ill 'j ror)... Is- I, lt4.. 9cfsJ..3
EXPIRATION DATE, cPy ~/(,)tYCJ
CONTACT PHONE #
D 51;R 0 DUPLEX D MULTI-FAMILY D BUSINESS D OTHER:
o SIGN D DEMO. D Mo.VE BLDG. G2(Mo.BlLE D GRADING(yJs):--.BBE.MERION
BUILDING DEPARTMENT
D NEW D REPAIR D REMODEL D ADDITION D OTlIEH: .
DSEWER DSEPTIC' SF- 3; CD# 2?
INTENDED USE: 5/175'~ /b1Y7'''~ <<(,/~i---C I r~/t;c:-('_ e;..lShny 5't;ij h0/'/ ~
. ,. -J
NATURE OFWORK PROI'OSED:;1/l.-LJ 5"'2 d 6t.... tv, d-e.- /ndi:,;-/~ Jld~/~ fc.-7:
0;;2 )< ::J. 7 ,F Y P Q/z,u () 0 d,
~QlJAR[FOOTAGE: Dwelling: /37S- Garage: Decks:
. F, lJ rt tV Of
'or eJ111 mell ...e my
VALUATION PLAN REVIEW Hm : ...... PERMI'r FE.E .. SURCJJARCES TOTAL FEES
$ $ $ Jt.NI::'RGY:' $50.60- $ -
,} STATE: $4.50 . /8crC::O
< - / , -.---/
Applications for which no permit is issued within 180 days following thc date of application shall expire by
limitation, and plans and other data submitted for review may thereafter bc returned to the applicant or
Jcslwycd by the building official, The building official may cxtcnd the timc for action by the applicant for a
period not exceeding 180 days on request by the applicant showing that circumstances beyond the cOlllrol of the
applicant have prevented action from being taken. No application shall be cxtended more than once. In order to
renew action 011 an application after expiration, the applicant shall resubmit plans and pay a new plan r<.'View fee,
I hereby certify tlult tbe above infirmation is correct to the best olmy knowledge.
APPLICANT'S SIGNATVRE: 4~4~
DATE:
(;/9,9
""dl'I,.JIl' rC\'i.aJ ~f Bf97
PERMIT CENTER
286 Fourth Street
Bremerton, W A 98337
360-478-5275
II
INSPECTION REPORT
II
PERMIT#: 97/'~-7g'/
ADDRESS:
~y-~ IU ~sf(-V-h~
~ ~.f i
. ,~....
- /"
(g;fLL-G(.~d =,,"- ~ - r-- ~e4 /Lc;.-
Ir /'U>I- /~ l' ~II~ r
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/ f1tk>1( /.eue-I--
I ::~" c~ >
! . -d ~
~ z.-- {r-- ~
-I
IZ' /"'lAY 6e/o0
per 3r~ ~f~
( I
Schedule a reinspection when the above items are corrected. Call 360-478-5275
by 5:00 p.m. for next day inspection". ....,. ~
Date:~ Time: II! () 1J'''''\.
y{/
INSPECTOR
fiB ->l rz-
BREMERTON BUILDING DEPARTMENT qq- - 8, !tJ/rO{)G,:: ~~
Inspection Report qq -- d-D '"f e-S p~
f4j11~::/ermit Number:g CJ ~ 0 d-2 {
. -OV.L lL!L-.ih{
Phone:
l~. Phone: ,;JF;,3-,:-:if, - d,!~5
FOUNDATION
Inspection card/approved plans on site Setbacks
-- --- --- Wails required steel placement
Footings: required steel placement
---------- --- --
Footings: required width & depth Walls: required size
----. ----., --"_.--- --- Special inspector (when applicable)
Bearing soil (soils analysis if applicable)
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
f ~_._---------
Beams/girders: size & span Notching & drilling: joists & beams, studs
..------ --- _._-----~----_._------
Smoke detectors: all required locations Exhaust fans: where required
-.----. .--- --- ____k_____~__.
Exhaust fans insulated: unconditioned space Whole house fan, outside air int,akes each bedroom
------ ~---_.-
Fans terminating directly outisde Range hood
--- -- ..-----.-- All vent terminations: willdolNs & property Iinc------
Dryer exhaust vent
-~--_._- ----------------------------- '--'-'."-' --.----------,---.---.--~--------._---.,'-.--,---"~--
Fireplace combustion air Windows: meets egress requirements
--- ._--_._-~ --- ----- Windows: safety glazed where req-llii-';JT----------
Windows: proper U valve
----- -'---- ..------.--.-
Ceiling heights Stairs: headroom clearance
~-- .- ~--_.- Fireblocking: wall to ceiling, furrecf"walls every 10'
Stairs rise & run; proper width
---, Fire blocking; stairs, soffits, lowered ceilingS--- ----.---- ---------- - ---~--
Fire blocking: tubs/showers
- .... . --~--- "---
Fire blocking: lids in void spaces, shafts Fire blocking: stuff holes top & bottom plates
---.. --
Sheetrock backing Wall bracing
-- - ,.-
Rafters size/notching Trusses: specs, bracing
Attic access --.
Attic ventilation
----
Wail & roof sheathing Shear nailing
--
Building dried in
FRAMING
COMMENTS:
APPROVED:
ENERGY CODE COMPLIANCE
Insulation: proper R value Insulation: proper fastening
_~ns~lation: vapor barrier _______ ~ttom pla!es caul~d to floors
_________ _!:.ene_~~ons_~a~~ke'!..~~_~~g~!!:~~____________________. _____ _~~r::.!r:~c!:,!_ tl_c:.xes gas..~eted or caulked
_ f) mil black poly in crawl space
COMMENTS:
UNDER FLOOR/FOUNDATION INSULATION APPROVED:
VIJALL INSULATION APPROVEO:__________CEILlNG INSULATION APPROVED:____________
~
.~!....
A"ppli<lllce 10catio!1 <lnd access, proper support Appliance clearance to combustibles
------_. ---- -- -. -----.-.--------.---.
Venting clearance to combustibles Venting: ~ize-&sur~port . -------.----
-- - ---- --.- .
Vent termination Combustion air
---,-- ---- ----------. ----,- -.-----
Ducts:Sfze&support Gas pipe under test
-- ------------------
Gas pipe size & support Gas pipe underground min. 12" below graele
- Gas pipe: within 6" or underground-coated Gas shutoffWithin 3' (;t"appllance
-- Gas logs safety shut-off _.. ... Gas logs. damper permanently open
.--- -------------- -- -- . ------------
Wood stoves EPA certified Woodstoves & fireplaces: Tight-fitting doors
Wood stoves & fireplaces. proper health Manufacturer's specs on site
Chimney liner: when required Chimney: separate flues when required
MECHANICJ\L
\
COMMENTS:
GAS PIPING APPROVED: ~
OTHER APPLIANCES APPROVED:
1/"7--- 94i"
FURNACE APPROVED:
PLUMBING
DWV & water piping under test DWV: proper grade
-- .---.------ ----.---. ------------------
DWV: proper sizing DWV: proper drainage fittings where required
DWV & water piping: proper support DWV: required c1eanouts
'-~- All fixtures vented prorerly
Vent termination
Water supply prorer 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: siesmic strap
---- 1----------.------.-------------------- ---- ----.-------
R-10 pad under waler healer when required Water-piping insulated as required
-- - - ---
Grease traps/interceptors: where required Ploper indirect wastes where required
COMMENTS:_
PLUMBING GROUNDWORK APPROVED:
PLUMBING ROUGH-IN APPROVED
SHEETROCK
Proper fastening nails-7" o.c. horiz. rlane nails 8" o.c. vertical plane
Proper fastening screws-12" o.c. horiz. plane (1/2") screws-12" o.c. horiz. plane (1/2") 24" o.c. framing
Proper fastening screws-16" o.c. vert. plane (1/2") screws-12" o.c. vert. plane (1/2") - 24" o.c. framing
----
Proper fastening screws-12" 0 c. horiz. rlane (5/8") screws-12" o.c. horiz. plane (5/8") - 24" o.c. framing
--.
Proper fastening: screvvs- 16" 0 c. vert plane (5/8") screws-12" o.c. vert plane (5/8") - 24" o.c framing
---_.
Area & occurancy separation walls Draftstops where required
.--- -------. - ----
Usable space under stairs (5/8" required) Waterboard where required (not on ceiling)
-- ._--- ---~
Corridors
COMMENTS:
SHEETROCK APPROVED:
-
Energy code requirements met, exhaust fans Plumbing & mechanical
- -------.-----.- --- ----- .--.
Garage/dwelling door self closing solid core Smoke detectors where required
--------------- 1----- ---------
Handrails & guardrails, as required Fire ratings maintained
------------.--.-.-.-------- ------ .-- - ---
Exit signs when required Emergency lighting when required
- --
Occupant load posted when apr1icable Building weathertight ,
-- ._~ --- -- --
Wood siding to earth separation (6" Building Address posted
.---. -- --.---
Radon monitor when required
FINAL
COMMENTS:
FINAL APPROVED:______
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B REM E R TON
B U I L DIN G
D E PAR T MEN T
PER M I T
~====================================================================
, '
'If
I
. Appl icatioD Date
Il:1sue Date
Assessor ,Acct #
Site Location
Owner - Last Name
- Street
- Ci.ty
- Phone
Tenant's Name
Agent~5 Name
Archi teet's Na.me
[ ] Sui), ding
[X) Mechani eal
( ] Plumbing
09/26/1995
09/26/1995
Application Number 95Z\P08945
Permit Number. 16577
Project Group
643 N CONSTITUTION
MOEN
643 N 'CONSTITUTION
BREMER TON
'(360) 479-3951
First AW HI
state WA Zip 9B310
Phone(206)
Phone(206)
:..f.......",,".
[ ] Grading
[ ] Move Building
[ ] Mobile Home
[ ] Sign
[ ] Burning
[ j Land Clear
[ ] Pavil1,g '\1:
[ ] Underground
( ] Demolition
<>
Building Contractor:
Work will be completed by owner.
Nature of Work:
Gas furnace and piping
~;-
"~
, 'rr:::: -' ~,
.;..j,( ;..
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council District
Census Tra.ct
Construction
Type
Sq Feet
Inspecti.ons
Required
I
.0
it.
!~
Residence [X] Zoning Foundation [ ]
Business [] Type Framing []
Other [J Insulation [ ]
New [ ] Plumbing []
~~epair [], status Mechanical (X]
Remodel [] Code Wall board [ ]
Addi t:ton [] Final [X] ....
;~~~~ ~~d -;; ~ - (\" ;,-;;:iJ -;! - ~ -~;f - - ;;; ;~~:d -;; ~ - - - - \: - - ~- ~ - - - - - - - ~ -'\.-
:: ~;=:::: ===:: ~ ==== ~':;~~~ :"::;'::; :::"-: ::~':I~:'.:=:: == =~:::: ===== == =':1:: ="~==(== ~~'i~ 1:: '1=~ .
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B R E M it" R T 0 N B U I J..l D i N G D 11; p A R T M E N '1'
,,'
M E C H A N I C A L P E R M I '1' A P P L I C A 'r I 0 N
===~=========~~===============~==============;===~===:==~~===~=~======
Application Number- 95AP08945
Contractor
street
City
Phone
Representative
state L.icense #
City License #
RAY'S HVAC
1215 IVY RD
BREMERTON
(206) 377 -,SOOS
RAYSHI*130D7
State WA Zip 98310
Expiration Date 02/01/1996
Expiration Date
stoves
Fire Place Inserts
1 FurnaGE!'S
Conversion Burners
Unit Heater
Boilers
1 Gas System: Max 5 Outlets
Evaporation Coolers
Air Conditioning Units
Heat Pumps
Mixing or Re-Heat Box
Air Handling Units
Fans
Range Hoods
Clothes Dryen;
Incinerators
Duct Alterations
Tanks
Refrigeration Units
Other Items
-~~----------~--~--~-~--~-~-~-------~-------~--------~-----~-----~---
--__~____~_~___~~___~~_~_~___~_~~__w~_~______~_.____~_,____._~u___~___~~~__~
..
':.~_"'._
D!:::11:::::i~:I!~::::.1..1.1:;::1::::::~:~~!11:!:~::i::::ii_I'.i::~!i::~!i!~:1::i:!!1:I:!~:1:~;:i1:.!:::.~:::~I.1~::O:i1:!;:::;i1!:::.:::!1.:;~~;~~:::~::!:~::~::::::~.::::1::.::~::1ili:!1:!:~RIiJ:__"':!:!:::::.:::.:1::!::1:.:.:.:..::.:!!::!::::::::!::1::..!:ii:::::.I:.'1
APPLICANT: JE1 OWNER ~ CONTRACfOR ~OTHER:
COMMENTS:
SITE ADDRESS: 643 N CONST nun ON
OWNER: A W MOEN
ADDRESS: fi4:i N rmlC;TTTIITTml
CONTRACfOR: RAY ISH. V .A. C.. INC
CONTRACfOR LICENSE # RAYSHI 13007
ADDRESS: PEi IVY Rn
EXPIRATION DATE: FFR qf1
OWNER PHONE # 479"-3951
CONTRACfOR PHONE # :i77 -t:)nn1
:Nolr :im:::i:::@:I!:::i!iii::::@I::i~$t~ltJi~m~.$S$t:::!I:::::!imiI!:::fIl !::::tP.~l~ti@ J$1tltt ::::::::i:..::;::t::iI!t::::::f:_~:!~ut:I\'~1.~El:::I!fl::::tttt:i:!::: fI:I!'$t{
RANGE
WOOD/PELLET STOVE
X GAS FURNACE btu's:
CONVERSION BURNER btu's:
UNIT HEATER btu's:
BOILER btu's:
X GAS PIPING
EVAPORATION COOLERS btu's:
AC UNIT btu's:
HEAT PUMP btu's: tons:
REHEAT BOX btu's:
AIR HANDLING UNIT bttt's:
EXHAUST FANS
RANGE HOOD (residential)
RANGE HOOD (commercial)
CLOTHES DRYER
INCINERATOR
DUCf ALTERATION
TANKS tytJe:
REFRIGERATION UNIT
OTHER:
MECHANICAL PERMIT FEE
$15.00
WATER CLOSET
BATHTUB
LAVATORY
SHOWER
KITCHEN SINK
DISHWASHER
LAUNDRY TRAY
CLOTHES WASHER
WATER HEATER
URINAL
DRINKING FOUNTAIN
FLOOR SINK OR DRAIN
SLOP SINK
WATER PIPIING & ALTERATION
GREASE TRAP/INTERCEPTOR
HOSE BIBBS
LAWN SPRINKLER SYSTEM
SWIMMING POOL
BLDG. SEWER (mobile / moved house)
ROOF DRAINS
OTHER:
PLUMBING PERMIT FEE (15.00 or 4.50)
MECHANICAL FEES:
PLUMBING FEES:
TOTAL FEES:
APPUCANTS SIGNATURE: ~!!' 4
DATh o/~/5
BREMER TON BUILDING DEPARTMENT
City uf Bremerlon. Washington 9-8310
Phone: (1(J(j)J78..5t7S
FAX: (206) .J71f-5Z78
NOTICE OF PERMIT REGUlATIONS
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.
.L
2.n
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....... ". '. -.. .'.'-. ".- .. ..... .........
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...:u.....~~~n;~!9fr.~Y:~~~;<j.:..:.lIi<i.r...:....................i.:......nn..........:. .. ........
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. ..~. .. - . . ...... .............. - ".. . ............ ... . ... ..
. '.n, .... '. . _ "...... ...... ........... ............ . ......_........... .
". .:'.: '. '. '. .: '.. . -:.:...:..:-:.:.:.:.:->.:.:.:.:.:.:..:..:-:.:.:.:..... '.:'.:...:'.:.:" ..' ". .....
"". . "'" -- . ...... ... ...... .... ...... ..... .. ..
.unF~~;~c.q~1~tii>>i.M1d~f9~~~;'~~~~Hi........... . ......
Alty... .'.otltCt}n~~bJ1.rtriBifedfbt.~i3i:~;urn<....n. .......
..u..An:........ .y........mspection.........:.:.:.::.~7aeeme:::...:....-}....::.:::.>i:.:.d.... ...~n..nec..>~bY~0th.).:.'e...<:.b.:.~uiI.:.<!"~.....d........:..Ill...':'::'g(:o'.::"ffi.:.:l...C.. W.U .....
. .... . .. .. ....... .... '. ....
.' ...'. . .:.... :-: . ". .:.:. . ":'. .:. . '. : .. .
. ". . . . . . . .. . .. .. .. . .. '. . . . .
.. ". ". ... . ...... .. .
. --.. .
.3..
4~
5~
6....
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NOTICE - It is the responsibility of the permit holder, not the City of Bremerton or Building Official to see
to it that the required inspections are made. The permit holder must notify the Building Official when ready
for the inspections. Failure of the permit holder to notify the Building Official of required inspections may
result in the stoppage of the work until such time that the permit holder can substantiate to the building
official that the concealed work meets or exceeds code requirements. Any demolition, testing, or fmancial
burden sha11 be borne directly by the permit holder. Failure to substantiate code requirements will indemnify
the City against any and all responsibility or liability connected with the construction.
I hereby certify that I have read and examined this permit and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work will be complied with whether specified herein
or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any
other state or local law regulating construction or the performance of construction.
sft~Y,t ;;.~
Slg ture
~~ /7'5~
ate I
I certify that I am exempt from the requirements of the state contractor's registration law, under Sec. 3,
Chap. 126, laws of 1967.
Signature
Date
Permit Number
permit.doc
.
BREMERTON BmLDING DEPARTMENT
Plumbing/Mechanical Inspection Report
,'.
PennitNumber: 16577
Owner: MOEN, AW
Phone:
Scope of work: GAS FURNACE/PIPING
Address: 643 N. CONSTITUTION
Contractor: RAY'S HVAC
..-"1
Under tadlOpsi for 15 ~_~~~tcs) Prope~iz.i~.e.eort
12" minimum below gra~le when underground Coatcd1wrappcd When undcfRround or within 6" of earrh
Ground-joint unions proh.ibited in certain locations Bushin~ not allo~ in concealed areas
GAS PIPING
COMMENTS:__
GAS PIPING APPROVED:
Manufact~'s~~.J]_cations on site Loca.tion, ac.c.ess, su~ort
Clc:aranoc to combustibles Venting: dc:arance to combustibles
Vent si7jn~ & su.pportlconnections Vent tenniruuion
Combustion air CJ.1imney: liner andJor separate flues as required
Gas shut-off with.in 3' Pilot elevated off floor in ~rae.e
. -
Ducts: size & support/insulated when required Return air
FURNACE
COMMENTS:
FURNACE APPROVED:
Manufaaurer's speciti<:a!j~ ili~e Location, ac.c.ess, ilu~t
Clearance to combustibles Venting: dea.rance to combustibles
Ventsizing & s~~rt/corlllections Vent termination
Combustion air Chimney: liner ~or separate flues ~uired
Gas shut-off within 3' Wood stove & fireplaces: proJ)C:l' hearth
Wood stoves: EPA approved Gas I~ety shut-off
Wood stoves & fireplaca: tiAht fitti_~oors Gas SllUt-off within 3'
MISC. APPLIANCES
COMMENTS:
MISC. APPliANCES APPROVED:
~anufactUrer's specitica~ons on site Location, ac.c.ess, support
Clearance to 'combustibles Venti.ng: dea.ranoc to combustibles
Vent sizi~ ~~ortlconnc:crions Vent termination
Combustion air Chimney: liner and/or separate flues as required
Gas shut-off within 3' Pilot elevated off floor in..&.~e
Gate valve on o;;ld water su~ly Relief valve drained to outside
Copper to galvanized connections Uiftons on water pipes
Seismic stnp
WATER BEATER
COMMENTS:
WATER HEATER APPROVED:
ALL WORK IJNDER THIS PERMIT APPROVED: 5'/~
/tJ!Y /4j/~/
. .
SUI LDI NG ~ERMIT
t N!
'5214
AI
City of Bremerton, Washington
Phone: (206) 478-5281
//
~/
OWNER'S VALUE BLDG. DEPT. VALUE PLAN CHECK FEE RECEIPT NO. PERMIT FEE RECEIPT NO. DATE
$ /YtJ ~ --- $ - ~ $/0,00 7 ;'~tJo 9'-/J.-&3
SITE ADDRESS/LOCATION '.Y3 lj a4r~ 7i 7v 7,~,r/
OWNER'S NAME /tIoEIV 41(> An:1.I...1::> ADDRESS
CONTRACTOR ~ UJ bE.'"
ADDRESS
~RESIDENCE
PLANNING / ZONING
o BUSINESS
o OTHER
o NEW
PHONE
STATE CONTRACTOR'S L1C. #
PHONE
~
REPAIR
o . REMODEL
o ADDITION 0 DEMOLISH
o SIGNS
OCCUPANCY
THIS PERMIT ISSUED FOR:
STORIES
Ife -If tnr{
~~
INSPECTIONS REQUIRED: Foundation 0
Framing 0
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 10cal'law regulating construction or the performance of construction.
Plumbing 0
Electrical 0
FINAL
Wallboard 0
SEPARATE PERMITS ARE REQUIRED (WHERE APPLICABLE) FOR PLUMBING, MECHANICAL AND ELECTRICAL.
FOR INSPECTORS USEONL Y:
REINSPECTION:
. NOT
TYPE OF INSPECTION DATE TIME APPROVED APPROVED
.
FINAL INSPECTION APPROVED BY
COMMENT DATE TIME APPROVED
.
ISSUANCE OF
Building Inspector
OWNER'S SIGNATU
ED BEFORE OCCUPYING BUILDING
'M~
BUILDING DEPT.
~ Authorized Agent
~._-
e
e
N~
. 42888
Fee $m:/::;S!~~~.__u_._._________.m.....u________._._.._. Receipt No. ...;~~:/~~;?.~:~._____m.._____'
BUILDING PERMIT
CITY OF BREMERTON BUILDING DEPARTMENT
F. E. IRISH, Building Inspector . ESsex 3-1411, Ext. 36
~
Owner's Value Bldg. Dept. Value DESCRIPTION:
#) .:,.,~..
$ _:>11'", Lot Block Additions ..
/' ~,/ -;;> :;?;7 /" /-'~r:- '7'-; r _.. - '.,_
Address on Job __ _fc2. -;C-: _~:?.m ~"-!1-.L....~~t;-:t..g.f-'a~,,::':~=d:(-C,,,:r.::!),i' __. _ ___. ___ 00 __ _ __ _ _ __ _ _ _m _ Date ___ u<e._ ::_. ~ :~. _ :::~~ _I:. __~:=____
Building _________m___. X .m._____mm and __n_.nUn.n. stories __n__.._____mnmm basement. Lot _____m__n_n_ x ____m___m...
Front Yard .m_m__n__._________ Rear Yard m_____m.mm..m. Side Yard __.__nm_mm____m Garage ____m__._.n____._n._______
Occupancy ~"--7 -- ?/~- __;.:.;;~~:;;;;,m --.- ---- --- - -. - n .-- - -- - - -- -. -.- - --~. no -- --- -- -- - - -- ---- - -,: -- ---- -n;tl Z9ge. -----.y-;;?7":-""--- -- -- - -- - --- ---...
Owner -n__(t:;~~______:a~?;,1::~~(.L~:----n._n_n______ ___.______ Address __6_(!.:~q--t(d-h~-~~c~1t..r'd~~e ______________n_
Contractbr _._ ._____. 00_ _ ___ _ _ __ _ _ _ __ .__. _ __ _ _ __ _ _ _._ __ _ _ _ n _ _ n _ _ _ _ _ _ ___ _ _ _ _.__ Address _ __. _ _ _ _n _. _ _ _ _._ _ _. _ .__ __ _ __ _ _ __ ___ _ _ ___ _ _ Phone _ _ n_ _ _ __ n __ _ ___
This permit is issued for:.J ,/
~ ~: ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~ ~ ~: ~ ~ ~~ ~ ~ ~ ~ ~ ~: ~ ~ ~: ~ ~ ~ ~~ ~: ~~: ~ ~ ~~: ~~~::~=~:~~~~:::';~:~~:~~:~ ~ ~ ~~ ~ ~ ~ ~ ~ ~: ~ ~: ~~ ~: ~ ~: ~: ~: ~:~ ~ ~: ~ ~ ~: ~ ~ ~ ~~ ~ ~ ~~:: ~ ~ ~:: ~ ~: ~~ ~ ~ ~ ~ ~ ~: ~ ~ ~: ~ ~ ~ ~ ~ ~ ~: ~ ~ ~ ~ ~ ~ ~: ~ ~ ~: ~ ~: ~~ ~ ~ ~
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 stee!1 must be inspected alfter placi,ng and before covering. FORMS sha'u be inspected
and approved before pourilng. All plumbing, wiring alnd the fralme of alt buildings must be inspected and a1pproved
before covering. Wood pre'servative to be used on all wood a,ga,inst masonry. Ventila:te foundation a'nd a:ttic. Sepal.
ra,te permits requ'ired for plumbi:ng, wiri'ng alnd heating. See City Engi1neer before working on stree'ts or sid~wa,lks.
............... --.................................... -........ --.......... -..-............ -........ -.... -- - - - - - - -- - - -.. -.. - - -.. -.. - - - - - - -- - -.. .. - - - - - - -.. - - -.. - -.. - - -..- - - -.. - - - - - - - - - -.. - - - -- - - - - - - - - - - -.. - _. - - - - - - - -- - - -... - -... - - -- - - - - -....-...-
- - - - - - - -- - - - - - - -.. - -..-.. - - - - - - -.... -.... - -...... -- - -.. -.. -.. -.. - - - -.. - - - - - - - - -- - - - - - -.... -.. - - - - - - - -.." - - - - - - - - - - - - - -.. - - - - - -.. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -.. - - - - - - - -- - - - - - - -.. - - -- - - - - - - -.... -..
- - - -.. - - --.. - - - - - -.. - - - -.. - - - - - - - - - -- - - - - - - - - - - - -.. - - - - - - - -.. - - - - - - - - -- - - - - - - - - - - - - - -.. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -.. - - - -- - - - - - - - - - - - - - - -.. - - - - - -.. - - - - - - - -.. - - - - - - - - - -.. -.... -....... - -.. --
- - - - - - - -.. - - - - - - - - - -- - - - - -.. - - - - - - - - - - - -.. - - - - - - - - -.. - - - - - - - - - - -.. - - --.. - -- - - - - - - - - - - - - - _..- - - - - - - - - - - -- - - - - - - - - -.. - - - - - - - - - - - - - - - - -- - - - - - -.. - - - - - - - - -.. .. - - - - -.. - - - - - - - - - - - - - - - - - - -.. - - -- - --
---- ..-- --- --..- - --- -- - -- -- ---- - ---- --- - - ------- ---- - --.. - --.. --- -- --..- ---- --- - --- ---- - -- -- - - - -- -- - --- --- - ---- - ----.. -.. - -.. -- -..- ---- - ------ -- -- -- -- -- -- -- - - - ..---- --- --.._--- -- ------..--
- - - - - - - -- - - - - - - - - - - - -.. - - - - - - - - - - - - - -- - - - - - - - - - - - - - -.. - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - -.. - -.. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -.. - - - - - -.. - -- - - - - - - - - - - - - - - - - - - - - - --
- --....- --- --..- ---- -- -- - -- -- -- - -- --- - - - - - -- -- --- - --- ---- - -- -- -- - - --- --- - - -- - - -- - - -- - - --- - - - -- - -- --- -- - - -- -- -- --- -- --- - -- - -- - - --- - - - -- -- -- -- - -.... - - --- -- -- - -- -- -- -- -.. - - ---- -- - --- ---
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