The URL can be used to link to this page

Home My WebLink AboutKITSAP DR., 1508 Fran: 03/23/2009 15:04 #781 P.002/003 Mar 23 2009 3:03PM HP LASERJET FAX P.2 CITY OF BREMERTON PERMIT NUMBER: BB09 00156 DEPARTMENT OF COMMUNITY DEVELOPMENT DATE ISSUED: 03/16!2008 945-8th Street,Bremerton,WA 06337 (360)473-6275 Fax:(360)473-6278 ASSESSOR NLMaI3R:4659.0W-013.0003 ZONING:R10 !SITE ADDRESS: 1806 KITBAP DR APPLICANT NAME: FA07WA7MHIATIR PHONE: (425)838.7054 ADDRESSt 12601132MAVE NE,KIRKLAND.WA9a034 OWNER NAME: ANDERSON AM MORE C JR PHONE: (360)377.1026 ADDRESS: 1508 K1TSAP DR,9REMERrt7N.WA 99312 CONTRACTOR: FAST WATER HEATER COMPANY PHONE: (428)938.7054 ADDRESS: 128M 132ND AVE NE,KIRKLAND.,WA 68034 LENDER NAME: PHONE. ADDRESS. SUBMITTED: 03118/2009 APPROVED:OWIM2009 EXPIRATION: 09H412009 STATUS: G D VALUATION: ItschaNcaaPkartbkeg Penna Mooltanlaal Fisbao Fee Saa.15 2215 GAS HOT WATER HEATER INSTALLATION IN SFR TOTAL FEES: _--— $44.15 Building Code Edition: vkt Oeeupllnry Group: (/( � Type of Construction: Flood ks: Setbacks: Sanitation Method: Number of Bttdrooms: Inspection Requests Fire Inspections (360)473-5394 DCD:Bullaing Inspections (380)4734870 HID:Brernarton,Kltsep Caurty Health Di=lct (350)337-5265 L81:Department of labor and Industries (360)415-4000 Pw:Department or Public Works (360)473-5270 This pam+it shelibecome null ead vokl lithe desalbed and authorued by"pema has not commeneedwithin lea"a tn:m the date of lssuenee•er V die work is suspended a ahardoned arany"after theworklseormencedroraperiod Of180days.it is ibetesponsieft ofthe permit a000rtosea that therequired Inspections ammade.Falt retoobialnrageurea I empactlonsmayrewkinstoppageoftheworkvntdsuch time that Onpar ft Wrier coil ausbeantlacetothaChyor9ronterionlMtlhoeonceekdwor4me"orescmdevode If requaements.Any demolition,tesilro Or flnenClai burden shat be barna dktct ybythe pemdtholder.Failure w aubsmnUalo coda mqukmn0etswD ktdamnty dee Ctp egairst arty end all responskiligorliability connected wkhthe coesuuclbn Ihereby careiythat Ihave mad And esaminedNkpourka dknowthesametobehueandcount AaProvisions oflaws and we inancea govwnktg ttds type cf work wg be eompsed wlthwhedlarapeew4d harem ornot The erandrg ore pormit does not Presume W give sudtorityto folate or caned prowmions or arty State or krostlew regulo0ngeon7uuctbn ortlto perlbrmanoe of the oens7Nd en if estiN theosstrras general coneeew(cerYfy tlui l am eaempefrom the requkanarts atom State conuactors Reglsestlan Law urderseedon 3,Chepter138.Laws of 1957.Allrevislons to an approved pian regale DCD relAew and appaivd pier to periorrakrg work AO baitlkq end tenant Occupancy Permits am rewired to pass final Inspection prior topemltupkerionand ehtafiaoartaicsleoroecuponcypdeetowas oreeeupancy. I have,read,and agree to a We by a ndlt tM It 11eo elle dMotgof toeing,building codes,and State and Federal Ion. SIGNATURE OF OWNER OR AGENT: 1 " I — '�Z- MIdTED NAME: dau l I CONDRIONS City of Brwterton's pproval of this applieation.pertslne only to the City's regulatory)unisdlction,and thus compliance with City regulations does n neceseai lly ensure compliance with federal or state laws. 1D. (DCD-D1) DCD: Prior to performing any renovation or demolition work,Puget Sound Clean AlrAgency (Clean Air Agency)and Washington Department of Labor and Industries(LBI)regulations require an asbestos survey be performed to determine whether there are asbestos- containing materials in the work area or structure. The asbestos survey must be conducted by and EPA-eartMW(AHERA)building inspector(exI renovation or owner. occupied single family residerx:es).DCD: For mare information,please contact Clean Alr Agency through thelrweb site at www.deaneir.org or by phone at 800-562.3685 or 206- 6W4068. The L&I web site can be found atwwwlni.wa.gov/p-tsivabostostasbestw.htm. 10. (DCD-D2) DCD:Velidtty of permit.The issuers or granting.of a permit shall not be construed to be a perms for,or an approval of,any violelion of any of the provisions of the Washington State Bullding code or of any other ordinance of the City of Bremerton.Partite presuming to give authority to violate or cancel the provisions Df the Washington State Bu Ilding code or other ordinances of the City of Bremerton Shea not be valid.The Issuance of a permit based on l construction documents and other date shall not prevent the building official from requtring Page 1012 i i From: 03/23/2009 15:05 1781 P.003/003 Mar 23 2009 3:03PH HP LASERJET FRX p. 3 CRY OF BREMERTON PERMIT NUMBER: 0508 00156 DEPARTMENT OF COMMUNITY DEVELOPMENT DATE ISSUED! 03/18/2009 845-6th Street Bremerton.WA 98337 (360)473.0275 Fox-(860)473.5276 ASSESSOR NUMBER;4650-M)"13.0003 ZONING:R10 SITE ADDRESS: 15MXITSAP DR 1 APPLICANT-4AME: FASTWATERHEATER PHONE: (425)038.7054 ADDRESS: 12601132ND AVE HE.WRKLAND.WA98094 OWNER NAME: ANDERSON AMBROSE C JR PHONE: (390)377.1026 ADDRESS: 1508 VJTSAP DR.BREMERTON.WA98312 i CONTRACTOR: FAST WATER HEATER COMPANY PHONE: (426)636-7054 ADDRESS: 128D1132NDAVE NE,KAKLAND,.WA98036 LENDER NAME: PHONE. ADDRESS: SUBMITTED: 03MEFAM APPROVED;0311612009 EXPIRATION: 08114/2000 STATUS: ISSUED the correction of errom In the oonstruoeon documents end other data,The building ofticlal is also authorized to prevent occupancy or use of a structure where in violation of the Washington State Building code or of any other ordinances of the City of Bremerton. MINIMUM INSPECTIONS REQUIRED To request an blspectism,please Call 1380)4734MID and be sure to provide your pentyl number,nam an pomdt,site address,contact 1 phone number,and bgpectlon type. ' Mechanical Plumbing Rough-In FO(TURE LIST 1 Civ Deacr) tin en gt)` Desertntior 1 Gas Water Heater Vent 8 Combustion Air i 1 Gesplpe System LPGINATUOIL I I I ; I I I Page 2 of 2 FILE City of Bremerton Department of Community Development ti 345 - 6 1h Street, Suite 600 Bremerton, WA 98337-1873 Phone: (360) 473-5275 Fax: 360 473-5278 Mechanical/PlumbingInspection Card og .Permit No. C) o Address: 4? l1t9do S � `.J.•. .. Vii�„`:,:f: .,,..,..V.^,:ice.':!"". i. .R �yh Gas Piping (outlets) ,. la-1 Furnace Hot Water Heater Wall Furnace Room Heater Gas Fireplace Gas Logs �'• Gas Stove Gas Range Gas Clothes Dryer Wood Stove Pellet Stove Boiler* *cross-connection approval req'd by Pablic Works Propane Storage Tank* *Location must be approved by Fire Dept Other: Other: Additional Comments: FOR INSPECTIONS: CALL 473-5870 R VAL TO SET METER: FAL INSPECTION/APPINO Building Inspector Date DEPARTMENT OF COMMUNITY DEVELOPMENT BUILDING DIVISION 345 — 6th Street, Suite 600 • Bremerton, Washington (360) 473-5275 INSPECTION REPORT PERMIT #: &D 0 ( C0156 ADDRESS: �' F 14-51-P P.r. 3-7 -7 - rc� as 73-5-Z 9 Date: Phone: J� q73"S ZZJ LA INSPE OR Washington State Amendments 608.5 Relief valves located inside a building shall be provided with a drain,not smaller than the relief valve outlet,of galvanized steel,hard drawn copper piping and fittings,CPVC,or listed relief valve drain tube with fittings which will not reduce the internal bore of the pipe or tubing (straight lengths as opposed to coils)and shall extend from the valve to the outside of the building with the end of the pipe not more than two(2)feet(610 mm)nor less than six (6)inches(152 mm)above the ground or the flood level of the area receiving the discharge and pointing downward. Such drains may terminate at other approved locations. No part of such drain pipe shall be trapped or subject to freezing.The terminal end of the drain pipe sh th Exeeption: Replacement water heating equipment shall only be required to provide a drain pointing downward from the relief valve to extend between two feet(6 10 mm) and six inches(152 mm)from the floor. No additional floor drain need be provided. (Insert Facing Page 104) Effective July 1,2007 RECEIVIIv FILE City ofBremerton From:. 03/16/2009 10:26 IE649 P.002/002 MAR 16 2009 Fax 360-473-5278 /l / 5 & ony-IfV ' 6W X -- Type of Fuel: Electric I X Gas I Oil Propane Occupancy: Residential nCommercial 437464 Site Address: 1508 KITSAP DR 4558-000-013-00 Qwnerl ANDERSON ARA :FAST WATER HEATER COMPANY Add s ••1508 KITSAP DR Address 12601 132ND AVE NE BREMERTON,WA 98312 KIRKLAND,WA 98034 (360)377-1025 Fag: 425-636 7 055 Phone: 054 Contractor's License Number/Exoitalion Date: O FASTWWH948BC 01/04/2010 3 j (0D 9 NO. TYPE OF EQUIPMENT NO. TYPE OF E UIPMENT piz �v�QS S, W&99!QLOSF--T- WOOD/PELLET STQVEtGASFIREPLACE BATHTUB AS FURNACE btu: LAVATORY(bath sink) VBIJRNES btAL SHOWER - tied' ` UNIT HEATERINK BOILER btu: DISHWASHER GAS PIPING LAUNDRY TRAY EVAPORATION COOLERS btu: CLOTHES WASHER AC UNIT btu: 1 WATER HEATERe5jj- HEAT -5 PMP btu: URINAL REHEAT BOX btu: DRINKING FOUNTAIN AIR HANDLING UNIT btu: FLOOR SINK OR DRAIN EXHAUST FANS SLOP SINK RANGE HOOD residential) WATER PIPING&ALTERATION RANGE HOOD comtnett:ial GREASE TRAP/INTERCE11TOR CLOTHES DRYER HOSE BIBBS INCINERATOR LAWN SPRINKLER SYSTEM DUCT ALTERATION SWIMMIN POOL TANKS BLDG SEWER C1 mobilef moved house/ REFRIGERATION UNIT ROOF DRAIN OTHER: OTS: MECHANICAL FEES: I PLUMBING FEES: G� l CITY SURCHARGE: TOTAL FEES: $60.50 APPLICANT'S SIGNATURE: _ -� � "�� DATE: 03/16/2009 Print Parcel Search Map Page 1 of 1 Kitsap County Parcel Search Legend ............. Parcels Road Names Military .......................... 1.q1� CT O ......_.................... LLI x 4 LU s JDERSON AMBR OSE C JR �O . X58-aaa-013-0003 Copyrinht.,520013 Kit-gap Count DISCLAIMER This map is intended for display purposes only and is not intended for any legal representations [Click here to Print] http://kcwppub3.co.kitsap.wa.us/ParcelSearch/PRINT.ASP?CMD=INIT&PID=1696905 3/16/2009 e t �• J B R E M E R T O N B U I L D I N G D E P A R T M E N T P E R M I T Application Date 12/06/1995 Application Number 95AP09158 Issue Date 12/06/1995 Permit Number 16760 Assessor Acct # Project Group Site Location 1508 KITSAP DR Owner - Last Name ANDERSON First AMBROSE MI - Street 1508 KITSAP DR - City BREMERTON State WA Zip 98310 - Phone (206) - Tenant 's Name Phone(206) - Agent ' s Name Phone(206) - Architect ' s Name [ ] Building [ ] Grading [ ] Sign [ ] Paving;' [X] Mechanical [ ] Move Building [ ] Burning [ ] Underground [X] Plumbing [ ] Mobile Home [ ) Land Clear [ J Demolition --------------------------------------------------------------------- Building Contractor: Work will be completed by owner. ` Nature of Work: Gas water heater, piping. Gas furnace, piping. ---------------------------------------------------------------------- Council District Census Tract Construction Sq Feet Inspections Type Required Residence [X] Zoning Foundation [ ] Business [ ] Type Framing Insulation ion [ ] New [ ] Plumbing [X] Repair [ ] Status Mechanical [X] Remodel [ ] Code Wallboard [ ] Addition [ ] Final [X] ------------------ - -------------------------------------------- Receive Approved By : IL �+ e B R E M E R T O N B U I L D I N G D E P A R T M E N T M E C H A N I C A L P E R M I T A P P L I C A T I O N Application Number 95AP09158 Work will be. completed by owner. Stoves Fire Place Inserts 1 Furnaces 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 Dryers Incinerators Duct Alterations Tanks Refrigeration Units Other Items --------------------------------------------------------------------- B R E M E R T 0 N B U I L D I N G D E P A R T M E N T P L U M B I N G P E R M I T A P P L I C A T I O N Application Number 95AP09158 Contractor GAS WORKS SALES AND SERVICE Street 2760 MARINE DRIVE City BREMERTON Phone ( 206) 377-6331 State WA Zip 98310 .':i Representative RICK SLATE '. State License # GASWOSS081K7 Expiration Date 05/18/1996 City License # Expiration Date Toilets Bathtubs Basins Showers Kitchen Sinks Dishwashers Laundry Trays Clothes Washers 1 Water Heaters Urinals Drinking Fountains Drains Slop Sinks 1 Water Piping and Alterations Interceptors Hose Bibb Lawn Sprinkler Private. Pools Public Pools Building Sewer Gas Pipe Roof Drain Private Hot Tubs Public Hot Tubs Other Options i °E ,�ti B R E M E R T 0 N B U 1 L D I N G D .E P A R T M E R T RECEIPT # 089209 This Is Not A Permit: a Dec 07 , :1.995 Permit Fees Amount Pais]. Plan Check Fees Amount Paid, Mechanical. $ 27 .00 $ 1.3 . 50 652•••322 . 1005 Plumbing $ 30 . 00 62-322A003 w . 00 $ .00 62-345 . 8300 Other Fees Storz Adapter $ . 00 34-388 . 1000 Zoning Fees Gen Payment other Fees $ .00 City Sur-Charge$ 5 . 00 81-322 . 1009 State SIC 543-.237 . 1;3 --------- Total Fees $ 6111 . 00 Rmount Paid y 1.3 . 50 Pr-io.r. Payment $ 30 . 50 Balance Daae $ 18 . 00 57 . 00 $ .13 . 50 Received From: On 12/07'r 2%07;1995 ,as Works Sales #2365 For. ##95AP091.58 BAER RTON BUDDING DEPARTMENT Udy of&eweffon, Was *wn 98310 Phone.(206)479.5275 FAX(2061478.5278 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. REQUIRED-INSPECTIONS Foundation,before placement of concrete.. 2.. Frame;before coversng inside walls and after all concealed construction, including plumbing, mechanical and electriW are installed and aQprai►ed. 3:. tusulation,before covering. 4. - Wallboard-or lath before fnw"g_ 5. Finan;-after completion and before occupancy.- 6. any otheir 'vn.r . for tal. : itsw a�nspectt egaued spec' perm 7. Any insppctt 4ceand necesmy bye building'-official. : 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 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 law lating 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 Sec. 3, Chap. 126, laws of 1967. Signature Date Permit Number p=ft.� P MIT APPLICATION City of Bremerton, Washington 98310 Thonet (206)478--5275 FAM (266) 478-5278 MTC`HAN�CAI, PMMMING APPLICANT: F-1 OWNER OTHER: COMMENTS: fa.CPNTRACTORFJ SITE ADDRESS: OWNER ADDRESS: CONTRALTO ADDRESS: ;z�� CONTRACTOR LICENSE# � EXPIRATION DATE: OWNER PHONE# S CONTRACTOR PHONE# NO: --: TYPE OF E UIPMENT FEE NO.. TYPE OF FIXTURE FEE �W, RANGE WATER CLOSET WOOD/PELLET STOVE BATHTUB GAS FURNACE btu's. LAVATORY CONVERSION BURNER btei k SHOWER UNIT HEATER brnr's: KITCHEN SINK BOILER btu's: DISHWASHER ✓ GAS PIPING LAUNDRY TRAY EVAPORATION COOLERS btu's: CLOTHES WASHER AC UNIT btu's: WATER HEATER HEAT PUMP bus's: tons: URINAL REHEAT BOX btu's: DRINKING FOUNTAIN AIR HANDLING UNIT btu's: FLOOR SINK OR DRAIN EXHAUST FANS SLOP SINK RANGE HOOD (residential) WATER PIPIING&ALTERATION RANGE HOOD(commercial) GREASE TRAP/INTERCEPTOR CLOTHES DRYER HOSE BIBBS \ INCINERATOR LAWN SPRINKLER SYSTEM DUCT ALTERATION SWIMMING POOL TANKS ty pe. BLDG.SEWER (mobile/ moved house) REFRIGERATION UNIT ROOF DRAIN OTHER: OTHER: APPLICANT'S SIGNATURE. • 8 R E M E R T 0 N B r.1 1 L D i N G Pj E P A R T M E N T RECEIPT # 089206 * This.. Is Not A Permit * Dec 06 , 1995 Permit Fees Airount Paid Plan Check Fees Amount. Paid Mechanical $ . 00 $ .00 62 322 . 1005 PIumbing $ 25 . 50 $ 25 . 50 62--32•x . 1.003 . 00 $ . 00 62-345 . 8300 Other Fees, Storz Adapter $ . 00 :34-388 . 1000 Zoning Fees Gen Payment 5 . 00 Other Fees $ . 00 City S ur-Charge$ 5 . 00 8:{L---j:5p22 . 1.009 / 643--237 . 13 Tata] Fees °..+" 30 . 50 Amount. .Paid $ a0 . 50 Prior Payment $ . 00 Tia l ante Due S .00 Received From, On 1.2/06/1995 0'as works #2364 For #95AP09158 �(2- BREMERTON BUILDING DEPARTMENT Plumbing/Mechanical Inspection Report Scope of work: Gas water htr, iin P * 4 ermit Number: 16760 Address: 1508 Kitsap Dr. er: Ambrose Anderson Contractor: Owner Phone: GAS PIPING Under test(10psi for 15 minutes) Proper sizing&support 12" minimum below grade when underground Coate&wrapped when underground or within 6"of car& Ground-joint unions prohibited in certain locations Bushings not allowed in concealed areas COMMENTS:_ — - GAS PIPING APPROVED: FURNACE Manufacturer's specifications on site Location,access,support Clearance to combustibles Vena :clearance to combustibles Vent sizing&su ort/conneuions Vent termination Combustion air Chimney-finer and/or separate flues as required Gas shut-off within 3' Pilot elevated off floor in garage Ducts:size&support/insulated when aired Return air COMMENTS: FURNACE APPROVED: MISC.APPLIANCES Manufacturer's spedfications on site Location,access,support Clearance to combustibles Venting:clearance to combustibles Vent SiZing&support/connections; Vent termination Combustion air Chimney-liner and/or separate flues as required Gas shut-of within 3' Wood stave&fir laces: ro hearth Wood stoves:EPA approved Gas logs:safay shut-off Wood stoves&fireplaces:tight fitting doors Gas shut-off within 3' COMMENTS: MISC.APPLIANCES APPROVED: WATER SEATER Manufacturer's-specifications on site Location,access,support Clearance to combustibles Venting:darance to combustibles Vent sizing&suppordconnections Vent termination Combustion air Chimney—,finer and/or separate flues as required Gas shut-off within 3' J Pilot elevated off floor in gars e Gate valve on cold water supply Relief valve drained to outside Copper to gaivani2ed connections Unions on water pipes Seismic stns COMMENTS: WATER HEATER APPROVED: ALL WORK UNDER THIS PERMIT APPROVED.- IZ -/Z^ l5 N° 40374 Fee $....--r-' ..............•--•------------- Receipt No. ..... �%n y-------•---•---------------- BUILDING PERMIT CITY OF BREMERTON • BUILDING DEPARTMENT F. E. IRISH, Building Inspector • ESsex 3-1411, Ext. 36 Owner's Value Bldg.Dept. Value I DESCRIPTION: $ ,-1470 Lot Block Additions Address on Job- �=`�° -;S1t.�_e� -=�`�_ Date- - __ r� 196 Building ---------------- X ---------------- and ---------------- stories ------------------------ basement. Lo --- ----------- X ------------ Front Yard ------------------------ Rear Yard ------------------------ Side Yard ------------------------ Gar -------------------------------- OccupancY/-------------------------`------------------------------------------------------------------------------------- Zone------------------------------------------ Owner -----------------------------------------------�---�------------------------ Address -------------------------------------------- Phone----------•----- Contractor --------------------------------------------------------------------Address -------------------------------------------- Phone---------------- This permit is issued for: --------------------------------------=------------------------------------------------------------------------------------------------------------------------------------------ -�_�-tK -------------------------------------------------------------------------------------------------------------- -------------------------------- - - ---------------------------------- ----------------------------------------------------------------------------------------------------------------------------------------------- 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. -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ----------------------------•--------------------------------------------------------------------------------------------------•------------------------------------------------ -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------- --------------------------------------------------------------------------------- ----------------------------------------------------------------------- ----------- ------------------------------------------------------------------ --------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- •----•--•- --------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Owner's Signature = BY His Authorized Agent �� Building Inspectors- - �'' -------------------- - ----------- --- ---------------------------------------------- By