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HomeMy WebLinkAboutHALVERSON AVE., 2833 E3 FZ 1 M FEE F-Z - F a M F: EF FR M I C_ E: " - r FEE OR 286 4th Street, Bremerton, NA 98337 Phone. (360) 478-5275 FAX. (360) 478-5,2 BUILDING PERMIT J c PvTmj t No 96- 01,41 �) Arldi 2833 HAI VF iRSON AVE I oc,ia 4 I tin HAi,VHSON AVI= t at us * T S 1) ,Prirc.el No: 392,5000 -006 0000 Ar)PliUd: 0//18/1996) P r8siled 08/'4 Apjj I i cant " PAC11 WFST (;ONS) :360-692 8388 r-.xpires! O."/16/19Y/ F)O BOX ]POO 9)1_VFRr)oiF WA 98383-1900 Owner" i Lk f 1 ) WARI* N 28:33 H01VERSON AVF RRI"• R1 ON WA 98,"310 Contrar,tnr- PAc(F(C WF , T ('ONSF 260 692 ic PA('1TFW(;0990R Fxr". 61t'P" PO ROX 1900 SIIVFRI )AI E WA 13 838,1 1 Y0 sut)corlty [)e 8u NEW 22')4 �;W F1 DFCK ti Va I Lid t IM) X Permit Fees 49.50 Tot,i( (,alculated rc;( 91 1 P 000.00 X PJan Check Fees: 112 18 Acid itional Fees 00 Other ) -eus. 9.50 1 ota I Pray m t 1, 1 ec 91J8 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. NOTICE - It is the responsibility of the permit holder, not the City of Bremerton or Building Official to see to it that requited 'Inspections are made. The permit holder must notify the Building official when ready for inspections. Failure of the permit holder to notify the Building official of reauired 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 shall be borne directly by the permit holder. Failure to substantiate code requirements will indemnity the City against any and all responsibility or liability connected with the construction. I hereby certify that 1 4 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 by 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 egu ing construction or the performance of construction. Signature: ------- ---------------- Date: _w --------------------- ------ - I certify hat I an, exempt from the requirements of the state contractor's registration law, under Section 3, Chapter 126, 'taws of 1967. Sl ignature: ................................................... Date : --- -__ I!( 'Y m 11 Cent ear APPY c)vv,d F) Y rj 1, E, a mW t1 E: 0 N D a i M I -` E_:.E: N - IF E:R t 236 4th Street Bremerton, WA 9333 Phone. ( 360) 478 F,4.X n ( 360) 479 - -.x. 1 ?. m 11, No:; 96 04 41 � , ) c a l t (Ac l c ly r , w , , ;; 1101M W ;ON AVI. S L is L l l '; 1 Y , l 1!" I ) 1 car,, 1, 1 c ary ;' 'F3; 3;3 I lAl Vf R'_ }()N t`AVI t ;sew ac, ;; t)l3 / "2011 ; 96" Aws y !At.(.l, Mo. T)', ")(BOO 006 0000 t xp 1 y t "s"; O "''a'1 61 YY1 ` a) 1 N 1 7 1) 1 G i I (1 N °> I1,t:m 0 1100 1 OUNDAI "1(IN 1 00 NW, I)t 131 C)U 1) 1v I L t'r1;; 01 /00 1 R M I N(A Oc r L> 131 DO D I v 1 I c trt ;, ,w I I,c 0. E 1 N ^il DcpL ;_ 01 DU M v tart;l YD(S4XXXXD4'D#XXXXX)(X) v3txi4xktx?tx11DtDt3f3 xxxx2tx3fxX)(Xxxp(3t3t34xxxx318{?&3 x ) XXK)(XXXX 11 '0 I N ' a;; Mt.1,41 Eats' y tatrt.acartl /( "d fay Lt t1 , tt:i.stat, i il, I t.arl car 1311 1 fi I rlt) W 1 i c.l al # ' Pl C' I N a"1 aW Ear y rc -j hi i, c cd w l t tt t liu to l a l t' of WO 131 OW; (' I ty tar 13y r tram l-31a 1 1 direr) A 7H - l s�'/'a Qi ANN I N(A ;: t; 1 1 v c a f Lay ramray 1, t art 1 E cirtrt 1 rtc I Xl ),AT L mt art t, A /H ' a;' z- �bIII3Wf)RM,i; (f L i Hyrmtarttart t1L 1 1 1efi 0(. - 1. 4)H ;);31113 IRl (:i i,y cad Ihemraytof) r 1yt - a Mclyy; la1 1 $3 () f f r,ta 4/H a Mri t,v Cal 13T ov Lon 1.ri( ) l rtr:t 1 nt) I)c 1.mr 4 /13 ' /t) ft ll Al I I I:; Hy uv L t artily i t `wr) i-I, I l Et ()t l a=ny 1, me , rl L 4 M WCtu "t,ciI c' o WA 0(-'pi' , tat I at )(IT & I ridli sty 1ols 4 xl(x3tYcxD xxxDtxxxxxxxxx x- xx3dDtAfadBQx3txx3 xDta4X3iD xxt "(XXX X) VX)(X XOX3# AtXAX) (3€` rEl {B;Dtx"x1:x3Qa4Dtxxxxxitxxx I I L iIr 1 6-y yta Y !r t y l , L � k t 3 iy is t i 1 i �l 4 J xyx;xxw)() a X Xxx hXw4 K qxx)t A xx)(Xh A X)w Xx�( CI I Y 01 1 3Id M R I HN PF 0 11 1 x x X x Xx x x x XXXXXXXX x XXX A x x K x x X.X XXX Ax XXXX x X)f X P()* x x x x x �(x x x x x X)VX Y, *X x x x 1 (11' 11) 1 Numfwi 14: 1/ ljavm(�fft, mt (A I rl I i , VW Po r m i 1 No, 0 O I I 1 131 MA NI Y III I)h PI M "11 I NO MI t'l I/ Pwr (,(r I No:: 'V?,")OM) -006 0000 s 1,(� oddyes""". "HX4 1 161 V1 W)ON OVI 1, i ()()' ','8Tt I IAI V1 I %")()N AVI I '11 1f3 Iflis ll'iymofll, ( 0 , 0 lot,O AIJ. I)MI'•, 1 19 00 Codf ll("N r lid 11M Ammint, I 1001 " 1 7 oull I.)INfA PI•IM I I I F!" 6/M l,i "loll ()I WA 'YOPCHAM11 13 1 1i1' 1 1 1 110()Y (le" I xl RM I I' 4MCI 1APOI E3 FR E: M E: FR - r C3 F)- E= FR N I - r C7- E= " - T E: FR 286 4th Street, Bremerton, NA 98337 Phone: (360) 478-5275 FAX: (360) 478-5278 BUILDING PERMIT Job Addy" 2833 HALVERSON AVE Permit No: 96-0441 L or at i ran '2833 HALVERSON AVE St rat us" PL- NDLNG P,ircel No." 3925000- 006 -0000 App lieci: 0//38/1996 1 81,Aled - App [ ic,,int" PAC TFIC WFIS] CON 360-6942-H"188 lzxPirFss" PO ROX 1900 ")ILVERDA1-F WA 98383-1900 Owner: TLJ1 "1 WARREN 2833 HALVERSON AVE BREMERTON WA 98310 Cont rAc,t or -, PACIFIC WE 31 CONS 360-692-838L.fi, PA(.TFWCOY9QIR Ex�)" 611." PO BOX 1900 SJLVERDALE WA 981383-1900 Siih,ontr: Desc.' NEW '64 $0 FT DECK XXXXXXX*XXX*XX***XX*XX**XX*X*XX*XXX*X*XXX*XXXX*X*XXXXX*X*XXX*X*XX*XX*XX*XXXX*X*XXXXXXXX**XXXX Valu,it ion X Permit Fees: 49.50 10t,il CdlrLllate(I FPMi'-' 91.18 2 -x Plan Check Fees:: . t Additional Fees .00 X Other lees" J 9.:)O Total Permit Fee:: Yl.tH *XXXX**XXXXXX*XX**XXX*XXXXXXXX*XXXXXXX**XXXX**XX**XXXXXNXX*XXXXXX*X*Rx**XXXXXXXXXXXXXXXXXXX*X 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. 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 holder must notify the Building Official when ready for inspections. Failure of the permit holder to notify the Building official of required inspections may result in the stoppage of the work 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 shall be borne directly by the permit holder. Failure to substantiate code requirements will indemnify the City against any and all responsibility or liability connected with the construction. I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Signature" -------------------------------------------- - - - - -- Date" ------------------------------- I certify that I am exempt from the requirements of the state contractor's registration law, under Section 3, Chapter 126, laws of 1967. Signature: -------------------------- _-- __-- _--- ______- ______ Date: XXXXX*X*XXXXXXX)(X*XXXXXXXXX PeYmjL Center - - Approver) By------- 0 � •�ti�`v�.. t�p�v v . � �� v vhh�:4 i'i :�'Vh�?h`\2"\`�� *'__R \� � •�`•. ' i !� i` �.��'v�Y vvaQSctia \h'�c `2 � ������� +��� C h'� .. Zs?'>\".�\�`•in� \�*7t'Q'�.+ iv� :. hL` tai.�h�tvais:.i:a•e�1\\'.�?,A�• h \'Vaah\\vwh\.ht��dti�C �\ ��aYkSci. J�.: �J20A��\' a\. iZ� \�e.�.G >��a�`�Y.hr�`o44tii:A �dv` �\ �.:.. aa.`:;.\• hh'' �a: A�nCvy` lYtNt? C4` 3' Wlai `�`i�Cr.�'•&\ \r�`aki0 \`'a;Gh� hA \ +XJ�.\ ..L`�..vhvea+rod4�•n\ \rC� � •h @�L hh: • s` ap h .. APPLICANT: OWNER CONTRACTOR OTHER U/ 0 44 Q � SITE ADDRESS: Z�3 3 LLOZS0 COUNTY ASSESSOR PARCEL 1: 3 � &-0 00-bb(. 0 000 OWNER: WAWP WTS ADDRESS: 7$33 lj& /S/L01 CONTRACTOR: PACVIC 1407 COPS? ADDRESS: P0. &4 *0 0 Sltu W W333 CONTRACTOR LICENSE # AC 11 - W 09 9211 EXPIRATI DATE. 6 - I LT 7 CONTACT PERSON: ST90 S )r- CONTACT PHONE * 30 69 FS'3 X Y t - Q SFR Q DUPLEX MULTI- FAMILY Q BUSINESS Zr OTHER IN i Q SIGN Q DEMO Q MOVE BLDG. Q MOBILE Q GRADING(yds): D JUL 1 8 1996 NEW Q REPAIR r7 REMODEL Q ADDITION Q OTHER B BUILDING DEPARTMENT rN77ENDED USE: ZONING CLASSIFICATION: COUNCIL DISTRICT NATURE OF WORK PROPOSED: &P(' 6e Pzo - TTOO ja L'r'C SQUARE FOOTAGE: Dwelling: Gauge: Docks: C7 y et�l 7�TT(TF�1�x,. For Department Use 0 l `lli.kJ4[:4I VDR'�;o `,+.. Y .rs „f .n f` ^r.S ?�. �.�w�.t �h.w f 4 TG T - �T �` a. <d •, %. y ou �,: ' IL K ••, f. YiFJ..,c h �`.i.. �U HAR (2G.� ksh kt .'. ` :3k`t:....C. f, � a` +' h' ` S $ S �/ d ENERGY: 550.00 $ 8 4 - o C) -� �m t C STATE: s4.50 , .00 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 tune 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 acnoa from being taken. No application shall be extended more than once. In order to renew action on an application after ezpirauon, the applicant shall resubmit plans and pay a new plan review fee. I hereby certify that the above information is correct to the best of my knowledge. APPLICANT'S SIGNATURE: of -DATE_ 7 /r-76 f � I I I I I I i i i I �� I i I I i � �I #,sAX Mix XXXxllgXX9f kit tx)3 xA*9XXXX -Xy3v x XAx*4�mx xwx ) I Y OF 1 ill °1I I ON Rl ( . 1 t i l l Y >l 'a4ti t ) 1 s€Di3tHt� { h�kh;��t�t# 'N x)0 -hr ' WriXkr�3:' �?i�r: E3 ( #}iJ fAX-XK M (A 1 N(1Mber a r + y � 4 llll,)��6,W ' k Mol.�l :� Y �t ' , 1H 0/ 1k 1!) . '50 Mot hurl n 1.,1-11 GK Nni, ,i 1 11 !!► = PAC I V ► ('#39W) 1 o t i, ° VW I'm m `t i, No," : 1 a 6 0441 1 y1)(, III i )GUNI..`! 131 DCi NfN 1�sj f 1 110 MI (;11! POTQJ Nw 2 006 0000 ocai Iaw " "Wl"I HAI Vl'Rd M i4 I ot'i I I 1 8 1 P ! 0 " Pay1ltl ni "1" 18 l of ,i 1 N1 113? 1 R,I J iTlt:P^ 1)9 00 A P0,V',(XX9N , �'00;�3eXX Y ^.)F Y31X)O(MY X- AY 1',X9 ')',XXXt:Xi XXy;�(g 93- Y,�NXAXxX 16 3 1 , ) ,9100 ( W)HO 1 3 1 ! 1 1 D I N G ICI oN CHI Clk 1-1 o ( y v� a7R 4 v) t, r( ('— ' v Ur i�'fth�' s �" ♦ 'o t ) , #'a�!' } � � y `i'� �f ' 3 :1 r' y P ri t?n $ 3. J °t 'Vf�d� .�.� / = A A �a. �,40 4J£4 �3 BUILDING F>r'PM1T ,Wji r)ciclr ° '<'H 3.i IIAI VI PSON oV1 Pormit Nc.!. 96-0 or.,at; tonz IIAI Vt WAN AV1 - Nt 110I G lin rc e I Nn: "19 006 0000 App I,i(.aril,° 1't`1t` >ll iI. wi- ;f tCIMS1 :30 -6% 6 t X13iYo��3; m Hox Igoo sII Vf "itl>,t I wr) 911n; 1 goo t )b non It It I t,r WORM N ' IIAI VI lL�Atl oVP IMI I1t RI ON WA 9Wit10 Cont.rrjr,l or ;, PM IF IC U III t OW,1 .360 - 6 ;1 13 fu it P,)C1,FW(;09Y1jR I pX ,' 611''2197 PO f It1X 1900 ',1 f Vf' R AI I WA 9838J 1900 ;,lal3r €3r1tr 9 l la.rgt NI W 264 1 0 1') DI X)(XAXMD xV XX)(3tqX;(Y X XAX'kX'AYNrihafXXX34XX)f -X 0,:fM'Xx YXx4WXX Y I(Y#X*X A V,tllt,it,Ior, X I rmiI 1 1,o-,� W, 0 1()IoI IlaIr.l3toi,off 1 � YI 1113 000 100 X Wrir1 (.` 1H,k HIca I'� ;t:', 18 t'etl(ii f iC311,31 I - vpz,` 00 X iIf,I1 {zY I't ;ca ;3� 9, Ic11,al Porm1 r, I , er "; Y I, .1�1 :;?�X3 &hX3ftfXX7t�;X#9fliu �kn�?�f ��f lfk X?(;zXifof� ;' Xit�X, �r�` � 'Fk ;'E�€�XlfXX3tX3fXt§3'�lf XXXbfhD: X' XiE rX§ �1{ �f3C�3 < #ikX� This permit shall become null and void it the building or work altthorized by thin permit is not commenced within 180 days from the ctato of ,iuch prrmit, or if this Building or work authorized b> such permit is su6pended or ahl,tindonpd at any t imp ,aftor the work is r.ommanced for a por>od of 1011 days. NrjllCt" - It is the re- .ponslbilily of the, permit holder, not the City of Bremerton or Building3 Of ficial to sce to it that required invpectlon:i ,art; made. The permit holder must notify the Building I3fficial when ready for lrispcc,tinns, failure rat the p ermit holder to notify the Building official of Yoquited inspections mdV result in iht1 stoppage fit the work until such time that the permit holder can sub€3tantiat €, to the building offfr lal that thr: coiie work mects eY eXto -q c €;de requirements. Any demolition, testinci, Lit financial burden ehall be Iinrnu directly b the tvrmit hinder. Failure to substunti,ato code ro q uiremuntu will indemnIfy tho City a;1,33nst tiny and all responsibility or liability ronuected with thr construrtion. I hcrehy c,artify that I have read and examinud Off permit ,and knew the same to be true and correct. All proviatons of laws and ordinanues governing this type of work will bo romplied with whether uperitied hr'rein oy not. The granttrip of a permit does not prr'sumv to give authority to vialatp or cr3nrel the provisions of any c,ther stato or focal law roaulatinLx construction or the porformance of construction. signature: _ - �.�.� _.___... _._..W._. bate ----------------- i 1 ",'riity that I ,am e,empt from the requitement] of the etato contractor 's registration law, under Section 3, Chap 1:6, laws of 1967. f PFF,Y Pi I L ( enI er . t ppy coed fay �, �.O— Dot( 7 23 -YfP 7 — ' 5 t, 1 F;t F-r M E7 FR - r "— N W::P FEE FR (t`"t# I Y C- EF- M Y FEE � P86 4th Street, Oremerton, WA 98337 Phone. (,R60) 478-5x'?,;�5 FAX: (.960) 4,7e BUILDTNG PERMIT J ob Addr 28'3A t IAI VL 16ON AVI Permit No. 96-0441 1 ocat ion - ' HAI V1.-R.Dr)N AVF lit,ttiis" PFNDTNG ParcH No 292,5000-006 0000 Aw 07/18/199(S 10 App I I ch n t. . PACWTC W1- C(IN 160-69', 8388 FxpirL-8 PC) HOX 1900 !, I I % RI F WA 98 - 1900 Owner,: fUF I I ; WA14RPN ?H3,9 HAtVU60N AW RRI'MF100N WA 98310 Cr) n t ra (. t or PAC 1I IC 141- CION 360-69 8381 ir, it" PAt.tFW0099W r-.xj1"- 611', PO WX 1900 ')]1 %M )AL F WA 9838',; 1900 Df. NI W 264 F ;Q FT 1)113( Via I iiei t i on X PermIL 1 49.')0 1 oi a I Ca I ol I at od t er- 91 113 1 000,00 X 1 ) HT I Cheir, k Feevs 1a Addit)OTIRI Ferou 00 1, hoy I ees 9. laal Permit This permit shall become null and void it 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. 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 holder must notify the Building Official when ready for inspections. Failure of the permit holder to notify the Building Official of required inspections may result in the stoppage of the work until such time that the permit holder can substantiate to the building official that the concealr�d work meets or exceeds code requirements. Any demolition, testing, or financial burden shall be borne directly by the permit, holder. Failure to substantiate code requirements will indemnify the City against any and all responsibility or liability connected with the construction. I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of law6 and ordinanLes 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. Signature : __----------.---__-- _- __ ------- ----- -- -- - - - - -- Date -------------------------------- I certify that I am exempt from the requirements of the state contractor's registration law, under Section 3, Chapter 116, laws of 1967. Signature. .............................................. Date: Hy" -1 � Z 286 4th Street, Bremerton, WA 98337 Phone: (360) 478-5275 FAX (36 0) 478-5.2 BUILDING PERMIT .doh r)rJrJT '833 HA1 VVR50N AVF Perm 1 t Nn: 96 -0441 1 or.at I on" 2833 HAI V1 RSON AVr-- Stattis: PENDING Parcel No. 3925000-006-0000 Apr.)Hed 0//18/1996 r ssiied -, Applicant PACIFif; Wl-ST CONS 360-692 Fxpires PO WX 1900 S T [ VFRDA1 P Wo 98,98 "1 -1900 Ownoy r ILJFTS W(RRFN 2833 HALVERSON AVL BIREMIRTON WA 98310 Cont rixt or u PACIFW Wr-.Sf ("ONS] 3o-o?? 818 in it". PAcrl r. 611,2197 PO HOX 1900 S11VFRDAtE WA 98383-1900 Si ibcont r De;i(;'f NFW 264 f;Q F T DFOK V,A I I lat i on X PoTmIt lees: 49.50 lotal Calculated F,-e; 91.18 2 X Plan Cherk rnes.: 2 12 11 t 8 Additional FeeR: .00 Cat hey 1"ees: 9. lotal Permit 1-:ee: 91.18 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. 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 holder must notify the Building Official when ready for inspections. Failure of the permit holder to notify the Building official of required inspections may result in the stoppage of the work until such time that the permit holder can substantiate to the building official that the conceiaod work meets or exceeds code requirements. Any demolition, testing, or financial burden shall be borne directly by the permit holder. Failure to substantiate code requirements will indemnify the City against any and all responsibility or liability connected with the construction. I hereby certify that I have read and examined this permit and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Signature: ----------------------------------- _-- _____- _ - -_ -_ Date: I certify that I am exempt from the requirements of the state contractor's registration law, under Section 3, Chapter 126, laws of 1967. Signature: -------------------------------------------------- Date: Perm It C.f.'T1t(-T- Approver 13y" 7 e3 Z-C-D /� JW +- it J4 • - .W tv . yYMwr .rN.M.i'lYr'YM�I`�n.vr . .. y u - . _ n n .. . ..a.�.e. �...• w. 1 PLAT OF 14ALVERSON SECOND SITUATED IN SECTIONS I and 12, T.24N.R.1 E W M. KITSAP SCALE ('e 100' FEB. 106 �ci�►� PAP jo ja ro /6 ' Sr � 8 e n ��•�r os - 0 j MdOA „ 1 14 ` ~ T hereby term of sections I and 12 1 wrr that the v ti 1 _ 1 Approved b roe tl .r h t 1 = /0 1 CIT [N01"91 . .f 9 A y Approved this 23r ' 1 l d aou c ",too' AsMSTAW CHAIAYA". CfT11 f � 0TH SF 4' 0 7 -_.-- n � v Approved by the CL y° 0 II� Atfeslr f JNO TE t :f a � , s �. ® Oeno�es co�+eis /i Jvronur►ren/ 6 "�n .V � r ! dionJ• %� o�d /d` /o wilh o w�is 4 7 .;t I I, Treasurer of are exempt up tr t Filed for reci th1s of V volume jV - of pl •, VC,hv JUL � 8 199 A ti / y ✓O I �p BR €MERLON It BUILDING DEPARTMENT SHER/DAN ROAD 4 f F I 45 a noun t t PACI SIG. WeSI CO, 6 M L f W4#ALrfJ t UPT5 PO , 60,E 110a S / 39 ZS -000 -00( - 00 0 0 ao - i e l sl l N) -ro aRACe OL V 6USE N s' - fo prep i CAC &LTS 3S� O -C y" M x SPACC fiS P��c� Ou � � �� � ; I i slmpsod Z 'rlc�y� �, � 77' b (,Ur�W- �' o c C,� - Z�x N0m W ~ ` 8® *g L Imelex rt (o�r•eo o v olaoc �o17.oa s LU Fl z r` 9 4 f � rr A �y 1 n3• ,e3.t A 0 0 j 7� 92 P oe? E-W DO f w 1{ T "-• -. ,a r. 9"f r o 7. 9 ( E 30 1 r7 S-T 7 ,rI J A 4 3g 006 - 06 � ! G r 74 77 - � �Yc'O n P� —30� 15 , jP� PL z rrr o N i 3 3 5 i. --- ' s 4 d4 a� Ovq'o d 4t � rr 139.6 O ° z2 Z3 ° 1 o 3�. L U + 1s ,ae tr 4 z Z- � � coZ,e � ,, v? CD �z fi 0 N J •---� C �f U 1 � in � fry' � � fw •3G , 7.' S upon a survey of the property. It is furbished without LOS' � BLOCK RWIR TTTT A C ORPORAT ON solely for the nurbose of -- — _ _ + .. . _ _.. _ t r, 0 . a _ BREMERTON BUILDING DEPARTMENT Inspection Report Scope of work: new deck Permit Number: 96 -0441 Address: Hn VERSON AVE, 2833 Owner: TUFTS, WARREN Phone: 692 -8388 Contractor: PACIFIC WEST CON Phone: FOUNDATION Inspection card /approved plans on site Setbacks Footings required steel placement Wails required steel placement Footings required width & depth Walls required size Bearing soil (soils analysis if applicable) Special inspector (when applicable) COMMENTS FOOTINGS APPROVED WALLS APPROVED FRAMING 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 Mudslii treated material Floor joists size & span Beams /girders size & span Notching & drilling joists & beams, studs Smoke detectors all required locations Exhaust fans where required Exhaust fans insulated unconditioned space Whole house fan, outside air intakes each bedroom Fans terminating directly outisde Range hood Dryer exhaust vent All vent terminations windows & property line Fireplace combustion air _ Windows meets egress requirements Windows proper U valve Windows safety glazed where required Ceiling heights Stairs headroom clearance Stairs rise & run, proper width Fireblocking wall to ceiling, furred walls every 10' Fire blocking, stairs, soffits, lowered ceilings Fire blocking tubs /showers Fire blocking lids in void spaces, shafts Fire blocking stuff holes top & bottom plates Sheetrock backing Wall bracing Rafters size /notching Trusses specs, bracing Attic access Attic ventilation Wall & roof sheathing Shear nailing Building dried in COMMENTS APPROVED ENERGY CODE COMPLIANCE Insulation proper R value Insulation proper fastening Insulation vapor barrier Bottom plates caulked to floors Penetrations caulked as required Electrical boxes gasketed or caulked 6 mil black poly in crawl space COMMENTS UNDER FLOOR /FOUNDATION INSULATION APPROVED WALL INSULATION APPROVED CEILING INSULATION APPROVED dwj"�A U ANICAL Appliance location and access, proper support Appliance clearance to conibuslibles Venting clearance to combustibles Venting size & support Vent termination Combustion air Ducts size +& support Gas pipe under test Gas pipe size & support Gas pipe underground min 12" below grade Gas pipe within 6" or underground- coated Gas shutoff within 3' of appliance Gas logs safety shut -off Gas logs damper permanently open Woodstoves EPA certified Woodstoves & fireplaces Tight - fitting doors Woodstoves & fireplaces proper hearth Manufacturer's specs on site Chimney liner when required Chimney separate flues when required COMMENTS GAS PIPING APPROVED FURNACE APPROVED OTHER APPLIANCES 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 cleanouts Vent termination All fixtures vented properly Water supply proper sizing Shut -off valves on all fixtures Water heater gate valve on cold water supply Vacuum breakers where required Water heater relief valve drain to outside Water heater siesmic strap R -10 pad underwater heater when required Water- piping insulated as required Grease traps/interceptors where required Proper Indirect wastes where required COMMENTS PLUMBING GROUNDWORK APPROVED PLUMBING ROUGH -IN APPROVED S HEETROCK Proper fastening nails -7" o c horiz plane 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 pla ( 1/2 ") - 24" o c framing Proper fastening screws -12" o c horiz plane (5/8 ") screws -12" o c horiz plane (5/8 ") - 24" o c fr aming Proper fastening screws- 16" o c vert plane (5/8 ") screws -12" o c vert plane (5/8 ") - 24" o c framing Area & occupancy separation walls Draftstops where required Usable space under stairs (5/8" required) Waterboard where required (not on ceiling) Corridors COMMENTS SHEETROCK APPROVED FINAL Energy code requirements met, exhaust fans Plumbing & mechanical Garage /dwelling door self closing solid core Smoke detectors where required Handrails & guardrails, as required Fire ratings maintained Exit signs when required Emergency lighting when required Occupant load posted when applicable Building weathertight Wood siding to earth separation (6" Building Address posted Radon monitor when required COMMENTS FINAL APPROVED `b �V PERMIT CITY OF BREMERTON BUILDING DEPARTMENT PHONE 478 -5281 " JOB ADDRESS Warmen F. Tufts, Jr. 2833 Halverson, Bremerton, WA. 377 -4711 ` OWNER MAIL ADDRESS ZIP PHONE Sam CONTRACTOR MAILADDRESS PHONE LICENSE NO Bremerton Roofing Class of work ❑ NEW ❑ ADDITION ❑ ALTERATION It] REPAIR ❑ MECHANICAL ® PLUMBING CHIMNEY (No fee information only) INSPECTION Groundwork Gas Test Masonary Lines Unlined Wasted Vents Water Factory Mfg Type B Type L Htg Ruffin Chimney Location Internal Outside Wall Stove or Insert Refng No Type of Equipment Fee No Type of Fixture or Item Fee STOVES Gas_ Oil Wood_ 1 WATER CLOSET (TOILET) 3 50 FIREPLACE INSERT 1 BATHTUB 3 50 FURNACE Gas (Nat LPG ) Oil_ LAVATORY (WASH BASIN) Wood add on Other Electric_ SHOWER BTU KITCHEN SINK Er 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 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 Et TREATING EQUIP EVAPORATION COOLERS Roof_ Wall WASTE INTERCEPTER (Grease) BTU_ VACUUM BREAKERS Et BACKFLOW DEVICE AC UNIT Electric_ Gas'Elec Combo LAWN SPRINKLER SYSTEM BTU_ SWIMMING POOL - Private Publi i HEAT PUMP Single Package_ Split_ GROUNDWORK Add on BTU Ton_ SUMP MIXING OR REHEAT BOX CFM_ BTU_ ALTERATION AIR HANDLING UNIT CFM_ BTU_ POST Et BEAM FANS Exhaust_ Supply Bath_ RANGE HOOD Residential_ Comm PERMIT $ CLOTHES DRYER Res Comm TOTAL $ 1 50 Incinerator NOTICE ALTERATION TO DUCT SYSTEM THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR - Heating /Cooling- Exhaust_ [ZED IS NOT COMMENCED WITHIN 120 DAYS OR IF CONSTRUCTION OR WORK IS TANKS Oil_ Gas_ Propane w /OK 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 $ SLIME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOR MANCE OF CONSTRUCTION 9/17/84 SIGNATURE OF ONTRACTOR 08AU AGENT (DATE) FINAL APPROVAL 1 SIGNAT RE OF OWNER (IF �WNER BUILDER) (DATE) (SEE OTHER SIDE) RECEIPT NO 73171 PERMIT NO M 0 238 (White ORIGINAL, Yellow- INSPECTOR, Pink APPLICANT) PERMIT CITY OF BREMERTON BUILDING DEPARTMENT PHONE 478 -5281 JOB ADDRESS Warren F. Tufts, Jr. 2833 Halverson, Bremerton, WA. 377 -4711 OWNER MAIL ADDRESS ZIP PHONE Same CONTRACTOR MAILADDRESS PHONE LICENSE NO Bremerton Roofing Class of work ❑ NEW ❑ ADDITION ❑ ALTERATION )I REPAIR 0 MECHANICAL 0 PLUMBING CHIMNEY (No fee information only) INSPECTION Groundwork Gas Test Masonary Lines Unlined Wasted Vents Water Factory Mfg Type B Type L Htg Ruffin Chimney Location Internal Outside Wall Stove or Insert Refng No Type of Equipment Fee No Type of Fixture or Item Fee STOVES Gas_ Oil_ Wood_ 1 WATER CLOSET (TOILET) FIREPLACE INSERT 1 BATHTUB FURNACE Gas (Nat_ LPG ) oil_ LAVATORY (WASH BASIN) Wood add on Other Electric_ SHOWER BTU KITCHEN SINK Et 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 Et BACKFLOW DEVICE AC UNIT Electric Gas Elec Combo LAWN SPRINKLER SYSTEM BTU_ SWIMMING POOL - Private Public HEAT PUMP Single Package_ Split— GROUNDWORK Add on BTU Ton_ SUMP MIXING OR REHEAT BOX CFM_ BTU_ ALTERATION AIR HANDLING UNIT CFM_ BTU_ POST & BEAM FANS Exhaust— Supply_ Bath_ RANGE HOOD Residential Comm PERMIT $ CLOTHES DRYER Res Comm TOTAL $ 1 12 50 Incinerator NOTICE ALTERATION TO DUCT SYSTEM THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHOR Heating/Cooling— Exhaust— IZED IS NOT COMMENCED WITHIN 120 DAYS OR IF CONSTRUCTION OR WORK IS TANKS Oil_ Gas_ Propane w /OK 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 $ 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 9/17/84 SIGNATURE Of ONTRACTOR OPAV.TAtRIZED AGENT (DATE) FINAL APPROVAL SIGNAT RE OF OWNER (If "ER BUILDER) (DATE) (SEE OTHER SIDE) RECEIPT NO 73171 PERMIT NO 2385 (White ORIGINAL, Yellow INSPECTOR, Pink APPLICANT) 6 v; N ? 37191 Fee $ Receipt No � �- 0 BUILDING PERMIT CITY OF BREMERTON - BUILDING DEPARTMENT F E IRISH, Building Inspector - ESsex 3 -1411, Ext 36 Owners Value Bldg Dept Value DESCRIPTION S Lot Block Additions l 777=- Address on Job - -- - - -- a ___ ---------------------------------------- - - - - -- Date ------- - - - - -- - - -.- AZ 196 Building ---------- - - - - -- X ---------------- and ---------- - - - - -- stories - ---------- - - - - -- - - - -- basement. Lot . - -- ----- - - - - -- x - ------- - - - - -- Front Yard - -- - -- -- -- -- - Rear Yard .- -- - -- . . - Side Yard - .... . Gara e ---- - - - - -- - - -- --------- - .. -- Occupancy ---------- - - - - -- ---------- -------------------------------------------------- (- /= -- - - - - -- one - ---------------------------------------- Owner iJ= 1�t •-Y' /- - �� --j�l .7 4'tL------------ - - - - -- Address -------------------------------------- - - - - -- Phone - - -- ----- - - - - -- Contractor ---------------------- - - - - -- ----------- - - - - -- -- ----------- - - - - -- Address - - - - - -- --------- - - - - -- - - - -- - -- - -- - - - - -- Phone - - - -- - - - - -- - This permit is issued for: --------------------- - - - - -= ^- - -- - - - ---------------------------------------------------------------------------------------- --------------------------- //-------------------------------------------------------------------------------------------------- - - - - -- ----------------------------------------- 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 and before covering. FORMS shall be inspected and approved before pouring. All plumbing, wiring and the frame of all buildings must be inspected and approved before covering. Wood preservative to be used on all wood against masonry. Ventilate foundation and attic. Sepa- rate permits required for plumbing, wiring and heating. See City Engineer before working on streets or sidewalks. - ------------------------------------------------------ - - - - -e ---------------------=---------- - - - - -- ---- - - - - ----- ------------------------------------------------------------- -------- --------�,? .. ,w?� = � �' - - - -- J '` ' -- - - - -- " q�- Lr---------.-.-------------------------------------- - - - - -- ------- - -- -- - ---------- - - - - -- ------- - - - --- ----- - - - - -- r ----- - - - - -- : T -- - - - -Q ---------------------------------------------------- - -------- - - - - -- ------ - - - - -� ----- - - - -- ------------------------------- - - - - ---- --------------------------------------------------------------------------- - - - - -- ---------=-------------------------------------------------------------------------- - - - - -- - -- --------------------------------------------------------------------------------- -------------- ------------------------------------------------------------------ - - - - -- ------------ - - - - -- - - -- -------- - - - - -- ------------------------------------------------- --------------------------------------------------------------------- -------------- - - - - -- - -- - ----------------------------------------------------------------------------- - -- - -- - ---------------------------------- - - - - -- -------------------------------- - - - - -- - - -- - - - - - - - -- ---------------- - - - - -- ----------------------------------------- ---------------------------------------------------- ------- - - - - -- -------------- - - - - -- - - -- - - - ----------------------------------------------------------------------- --- --------------------------------------------------------------------- - - - - -- -- - - - - -- - -- ----- - - - - -- - - - -- - -------------------------------------- - - - - -- --- - - - - -- X ---------------------------------------------------------------------------------- - - - - -- - --------------------------------------------------------------------------------- --- - - - - -- ---------------------------------- - - - - -- ------------- - - - - -- - - - - -- ---- - - - - -- - - - - - - -- - - -- - - - - - -- - - - -- ----- - - - - -- -------------------------------------------- --------------------------------------------------------------------------------------- - - - - -- -- ----------------------- - - - - -- - - -- ------------------------------------------- - - - -- ------------------------------------------------------------------ - - - - -- ------ - - - - -- - - - -- ------------------------------------------------------------------------------ - - - - ----------------------------- - - - - -- - - - - -- - - - -- - - -- - -- ----------- - - - - -- - - - -- ------------------------------------------- - - - - -- --------- - - - - -- ------------------- ------- - -- ------------------------------------------------------------ - - - - -- --- - - - - -- ----------------------- - - - - -- -------------------- - - - - -- ------------------------------ - - - -- -- ------ - - - - -- ------------------------ - - - - -- - - - - - -- ----- - - - - -- --- - - - - -- - -------------------------------------- - - - - -- ----------------------- - - - - -- - -- - - -- --- --------------------------------------------------- - -- --- -- - - ------- - - - - -- -- ----------------------------------------------- -- ------------ - - - - -- ------ - - - - -- - - -- ------------------------------------------------------------- - -- ------ - - - - -- -------- - - - - -- - -- ---------------------------------------------------------- - - - - -- - - - - - -- - - - ------ - - - - -- ---------- - - - - -- 1 - - - - -- --- - - - - -- - - - -- - -- - i J - - - -- ------------- - - - - -- - - - - -- - -- - - - - -- --------------------- - - - - -- - - -- Owner's Signature / >� ^r�- /fy ___ By ----- - - - - -- -- �� Hu A Agent Building Inspector ----------- �, ; - -- - -- -------------- - - - - -- - DF By ----------------------------------- i: _ r BUILDING ERMIT N° 5777 A City of Bremerton, Washington Phone: (206) 478 -5281 OWNERS VALUE I BLDG DEPT VALUE PLAN CHECK FEE RECEIPT NO PERMIT FEE RECEIPT NO DATE $ 2667.00 $ 25.03 73171 1 $38.50 173171 9/17/84 SITE ADDRESS/ LOCATION 2833 Halverson, Bremerton OWNER'S NAMEWgrrpn F T1 ftg. Jr ADDRESS Same PHONES77-4711 CONTRACTOR Bremerton Roofing STATE CONTRACTOR'S LIC N ADDRESS PHONE ❑ RESIDENCE ❑ BUSINESS ❑ OTHER ❑ NEW ❑ REPAIR ❑ REMODEL ❑ ADDITION ❑ DEMOLISH ❑ FENCE ❑ SIGNS PLANNING/ZONING STORIES OCCUPANCY THIS PERMIT ISSUED FOR Re roofs TYPE M BUILDINGS NOT TO BE USED FOR HUMAN OCCUPANCY 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 INSPECTIONS REQUIRED Foundation ❑ Framing ❑ Plumbing ❑ Electrical ❑ Wallboard ❑ FINAL ❑ SEPARATE PERMITS ARE REQUIRED (WHERE APPLICABLE) FOR PLUMBING, MECHANICAL AND ELECTRICAL FOR INSPECTORS USE ONLY REINSPECTION NOT TYPE OF INSPECTION DATE TIME APPROVED APPROVED COMMENT DATE TIME APPROVED FINAL INSPECTION APPROVED BY Building Insp ISSUANCE OF OCCUPANCY CERTIFICATE REQUIRED BEFORE OCCUPYING BUILDING OWNER'S SIGNATURE BY IF Authorized Agent BUILDING DEPT BUILDING PERMIT N° 5777 q City of Bremerton, Washington Phone: (206) 478 -5281 OWNERS VALUE BLDG DEPT VALUE PLAN CHECK FEE RECEIPT NO PERMIT FEE RECEIPT NO DATE $ 2667.00 $ 25.03 73171 1 $38.50 173171 9/17/84 SITE ADDRESS/ LOCATION 2833 Halverson Bremerton OWNER'S NAMEWasren F. TlIftsa_ Jr. ADDRESS Same PHONS77 -4711 CONTRACTOR, Bremerton Roof ing STATE CONTRACTOR'S LIC # ADDRESS PHONE ❑ RESIDENCE ❑ BUSINESS ❑ OTHER ❑ NEW ❑ REPAIR ❑ REMODEL ❑ ADDITION ❑ DEMOLISH ❑ FENCE ❑ SIGNS PLANNING / ZONING STORIES OCCUPANCY THIS PERMIT ISSUED FOR Re roofs S TYPE M BUILDINGS NOT TO BE USED FOR HUMAN OCCUPANCY 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 gi aut to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction INSPECTIONS REQUIRED Foundation ❑ Framing ❑ Plumbing ❑ Electrical ❑ Wallboard ❑ FINAL ❑ SEPARATE PERMITS ARE REQUIRED (WHERE APPLICABLE) FOR PLUMBING, MECHANICAL AND ELECTRICAL FOR INSPECTORS USE ONLY REINSPECTION NOT TYPE OF INSPECTION DATE TIME APPROVED APPROVED COMMENT DATE TIME APPROVED FINAL INSPECTION APPROVED BY Buildinglnspeotor ISSUANCE OF OCCUPANCY CERTIFICATE REQUIRED BEFORE OCCUPYING BUILDING OWNER'S SIGNATURE BY Authorized Agent BUILDING DEPT BUILDING PERMIT AP PLICATI ON City of Bremerton, Washington Ph o n e. (206) 478 -5281 -5777 + OWNER S VALUE BLDG DEPT VALUE PLAN CHECK FEE RECEIPT NO PERMIT FEE RECEIPT NO DATE I a � $ �25. 3 3 171 3f-50 12 3!)/ 1 I SITE ADDRESS l LOCATION t I ) WNER'S NAME 4/ ADDRESS •Si c.�s� Tus=ss T�t2 2rfT _4w ft& L,t'tow 7 • �3+�ss.s.r io•� PHONE � 7 - y7� a :ONTRACTOR /3 t e.6 ± 1ri a STATE CONTRACTOR'S LIC # eDDRESS PHONE RESIDENCE ❑ BUSINESS ❑ OTHER ❑ NEW ❑ REPAIR ❑ REMODEL ❑ ADDITION ❑ DEMOLISH ' /ZONING STORIES ❑ FENCE ❑ SIGNS — J_3�Sf'.r�►fiv� OCCUPANCY HIS PERMIT ISSUED FOR Z(e goo YPE M BUILDINGS NOT TO BE USED FOR HUMAN OCCUPANCY _ NII 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 o give aut to vi or cancel the provisions of any other state or lo l r egulating construction or the performance of c INSPECTIONS REQUIRED Foundation ❑ Framing ❑ Plumbing ❑ Electrical ❑ Wallboard ❑ FINAL ❑ SEPARATE PERMITS ARE REQUIRED (WHERE APPLICABLE) FOR PLUMBING, MECHANICAL AND ELECTRICAL FOR INSPECTORS USE ONLY REINSPECTION NOT TYPE OF INSPECTION DATE TIME APPROVED APPROVED COMMENT DATE TIME APPROVED I i I 'INAL INSPECTION APPROVED BY Budding Inspector SSUANCE OF OCCUPANCY CERTIFICATE REQUIRED BEFORE OCCUPYING BUILDING i ) WNER'S SIGNATURE BY I Authorized Agent -_ -. Idtltt b1A1G DCL?T FOLHMIT APPLICATION CITY 0' 1EMERTON BUILDING DEPARTMEN PHONE 478-5281 OB ADDRESS VVNER MAIL ADDRESS ZIP 'HONL u 6`yu ST r6) c )NI R-CTOR MAIL ADDRF,,S F HONE I ICENSE NO AV - Class of work 0 NEW 0 ADDMON ZYALTERATICN 0 FlEiAlll .23 El MECHAMCAL PLUMBING _�_ _ 4IMNEY (No fee i•iforination only) INSPECTION (J10LJn'J�)cjrk Gas Pest sona L-nes Unlined WX;1U I VOW, Water Cory W.fg Type 8 ------Type L I-Itg Ruffin Chimney _ - - - -- at on Inteinal— - __ - - - -- Outside Stove or Inqot I Refrig Typo of Equ-pmont Fee No Type of Fixture or Item Fee STOVES Gas— Oil--- Wood C WAT CLOSET (TOILET) FIREPLACE INSERT BATHTUB FURNACE Gas (Nat --- LPG Od- LAVATOR ( (WASH BASIN) Wood add on -- Other_- Electric SHOWER bri KITCHEN SINK & DISIP Type Up flow-- Down floN-- DISHWASHER _4 llorlz.ntal — WaIL— LAUNUR ( TRAY CONVERSION BURNER Gas—(Nat LP---) CLOTHES WASHER � -- UndLr 100000 —_- Oyer 100000 WATER HEATER O L-- URINAL UNIT HEATERS BTL1----- Gas---- Elec- DRINKING FOUNTAIN bOILER G3S--- Oil--- Electric— FLOOR - SINK OR DRAIN HP-- SLOP SINK GAS SYSTEM Max 5 outlet Total— WATER PIPING & TREATING r(1jit FVAPORATION COOLERS Roof W,.11 Vi/Ac)i­F 1NIERCEPTER (Gr i e) —7— VACUUM BRFARERS Ft PACKFI-ow r)EVICE AC UNIT Elecl Clec Combo LAWil SPRINKLER 1 )) 1 )fEr I SWIMMING POOL Pfivite i)ijhljc HE Air PUMP Single PiLkJOP - S[)Ilt G fir) () NDIIIJOR K A(Idm -- BFUTon --- SHMP MIXING OR REHEAT PDX CFN1-- RIU- ALT ERATICIN AI HANDi ING UNIT CFNI--- - bllj P 0 S f (j G.A F-N' LXf0J,L---- SUP;,11-- Bah t- A LNGE iiJOD Residen ial— Conirn PERMIT T CLOTI'Ll- -'r PRYER RLs --- ("ornin- TOTAL S j L If,cinivat.), NOTICF AL FE r.A TION TO DUCT SYSTE t I THIS PF'I�J', 1 BECO ILS NULL AND VOID IF WOF,K OR CONSTRUCTION AUTHOH , I,- nnqj(:ouIsnq-- Lxhaust.— fZED IS 1101 uOlvINIENCED WITHIN 110 DAIS OR IF CONSTRUCTION OR WORY IS TAN',1,SGi1-- Gas— Propaoew/OK SUSPENDED OR APANDONED FOR A PERIOD OF 120 DAYS AI ANY TIME AFT,R I Fire I)cpt--- Gallons— WORK IS CO1ArALNCFD RL FRIGE RA^*"ION*UPJIT I HEREBY (ERfIFi( THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAIIE TO BE TRUE AND CORRECT At L PROVISIONS OF L';WS AND ORDINAN(-LS GOVERNING THIS TYPE OF WORK WILL BE COMPI IED WI rH WHIF PERMIT $ THER SPEi-IrIED HEREIN OR NOT THE GRANTING 0FAPEHMIFDO PRE- TOTAL FEE $ SUME TO 0 AUTHORITY TO VIOLA OR CANCEL THE PROVISIONS OF AN! OTHER STAFF Oil LOCAL LAW REGULA CCNS7 PUC PON OR THE PERI 08 MIANCt Oi CONSTRUCTION 51 TURE OF C ONTRA C TOR OR A U THr N t r i 1 1-1 r) VA L Sh, h'A TURF 0 A- 0 WA ER (IF O W (SEE OTHER SIDE) RECEIPT No 7 -3/ r2