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BUILDING PERMIT
CITY OF BREMERTON BUILDING DEPARTMENT
F. E. IRISH, Building Inspector . ESsex 3-1411, Ext. 36
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Owner's Value Bldg. Dept.
Value DESCRIPTION:
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$ ..:, S--U Lot Block Additions
Address on Job -"J r;:;-tf tj -;;i f~4<'_hl ........"'.' . _ , . Date 'J~? - .} (' -".... -7 '1 .
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Building m._..__._m__ x ___.h____.m__ and m.____m__m stories h______m__m_m.m basement. Lot ___mwm._._ x _____...____....
Front Yard _____m._m___m.____ Rear Yard ___mmm_mm___._ Side Yard h.._..._.________mm Garage _m___..m._.._..____.m___
Oeeu paney _. _ _ _ _.. __ _ _. _ _. __.. __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _.. _ _ _. _ _...... _. _ _ _... _... _ _ _ _ h.. _ _ _ _ _ _ _ _. _ _ _ __ _ _ _ _..._. _ _ _. _ __. _ _ Zone _ _ _ _.._ _ ___ _ _ __ _ _ _ _ _ _.. _ _. _ _ _ _ _ _. _ __ ___ _ _.
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This permit i~. issued for: ._ ,{' , . ..'1 .,.(-' '" ,.. "..
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All work to conform to all applicable building ordinances and amendments. Please note the following
special instructions and requirements.
DETACH HERE AND POST THIS SECTION ON JOB
INSPECTION - Re'inforcing stee!1 must be inspected a,fter pladng and before covering. FORMS sha,n be inspected
and approved before pouri,ng. All plumbing, wiring a,nd the fralme of aU buildings must be inspected and. alpproved
before covering. Wood preservative to be used on aU wood a,gainst maso'n'ry. VentUa,te foundation a'nd attic. Sepa-
rate permits requ'ired for plumbing, wiri1ng aind heating. See City Engiineer before working on streets or sidewa,lks.
...................... --.................................................... --............ --..................................... --.................... --........- -- .................................................................................-............................ ................ --......................-............ --......
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Owner's Signa ture_ ..d~~"6.<<'I.$..'! ..,:iX~ -/-d~'2~,,::~.::&-b.. __. _.... __ By _.. m. __ __ no m _.. __. __. _. __ _..._ __ ______ .'_ m. hum __ m _m no _. __ _. n
Ii pi His Authorized Agent
Building Inspector _... _...h..... _:;tc}fi~ __. -~C~::~"'~-4:~~( ___ __._ _.. h __n m n __ h.h... __ _h..
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WATER OFFICE OlJT;:;1DE
Sl:("J.1\. RIBS & \j1-\GES
superintendent
Service Foreman.
e storekeeper-utili tyn'?-n
~Aeterman-Pipeman 1 \
Meterman-Pipeman 11
TOT1\L S1-\lARIES & \J1-\G'ES
1K1-\I~TENA~CE &OPER1\Tl0~
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11. !.Itce. & orer. of Auto F!:luip.
TOT1\L Mi\INTEli1-\~CE & OPEMT101~
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CAP IT1-\L OUT}}. Y
1. cooling Unit
2. AUto (COlll'r of Pub. WorkS)
3. Replace 'SO Ford Ser; Truck
TOTAL CAPITAL OUTlAY
TOTAL' w'jG OUTS IDE BUDGET
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F:,DDCTET
APPROP
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\nl~TfiLY BUDGET RFJ'OllT .- EX0~
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EllCUlllBERI\NCES 1iIIJlAAN'1S ? ~arAL
jl3 Elm OF MO ISS/TOtJ11n'E;/
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City of Bremerton, Washington
Phone: (206) 478-5281
OWNER'S VALUE
BLDG. DEPT. VALUE
RECEIPT NO.
PERMIT FEE
RECEIPT NO.
DATE
.:2-/02 7/77
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PHONE '31'3 -~5'a3
CONTRACTOR
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STATE CONTRACTOR'S L1C. #
ADDRESS
PHONE
377- </-8 '12-
PLANNING I ZONING
STORIES
o REMODEL ADDITION
/ OCCUPANCY..e 2-
RESIDENCE
o BUSINESS 0 NEW
~/ FIRE ZONE :3
o REPAIR
THIS PERMIT ISSUED FOR:
Aj)j)/f/c>tJ 4-s
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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 orthe performance of construction.
INSPECTIONS REQUIRED: Foundation
INSPECTION:
]7L86 l Ii L-lEC . peRM I r ..€'G4J,
Framing
Plumbing
Electrical
Wallboard
FINAL ~
FOR INSPECTORS USE ONLY:
REINSPECTION:
TYPE OF INSPECTION
DATE
TIME
APPROVEd AP~R~VED
COMMENT
. DATE
TIME
APPROVED
FINAL INSPECTION APPROVED BY
OWNER'S SIGNATURE
BY
ISSUANCE OF OCCUPANCY CERTIFICATE REQUIRED BEFORE OCCU
BUILDING DEPT.
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.' --APPlIC}\TIO-~
CITY OF BREIlRTON BUILDING.PARTMENT
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($..gd~~~_.~....JCPERMIT FEE $..Vi,.:~...~)CLl~N CHECK S.~.-?~.~~_...) . (~.. ~~~~~~~....)
ADO,RESS/LOCAT I Ol~ OF .JOB,.. 3.i: I. ~. . .111.:. m 1.R./h. .JJ.R.,.... ..... . . ..t;.. .. ...... .... . . . . . . . . . . . .. . . . . . . . ... . . . ..... . ..
APPUCATlON ISSUED FOR: . CO.4/. S.7If..V.e.-T. .IJ.Q}),.7.if'~':' /JoS. .l.~.e. ;.J{ R.I'1W/.~ ~.. i:./!J~(1;I;-.<;~-r-!~ ~...
PLANNING ZONING............ FIRE ZONE............ OCCUPANCy............ TYP'E OF CONSTRUCTION................
OWNER.. 1 m.....RI9.~.~.!-. J...... ~........ .... ..,....... CONTRACTO~. ./:I::f. .~..c~~.~z..... ................
ADDRESS...~!.:t. ..,:t.4-.~ ./..!ftL RK.. . .., . .... '" ....... .. ADDRESS.....3. .?? eo.. 7:. f. r~......,...... h... . ..
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SlroNATURE A~PLJCAN~. . ..~.~ DATE.~.-::l~'-'-'?l". RECEJVED Bt:9'~.... '"
ACCEPTANCE OF APPLICATION DOES NOT INSURE ISSUANCE OF BLDG. PERMIT.
Pi..ANNING COI-'.MENTS/REVIEWED BT. .......^ ~/ 7' . ~
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ENGINEERING COKMEIolTS/REVIEWED BT ( ... Yv--I /7 r c "'., --;-, .. '-
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SEPARATE PERMIT REQUIRED FOR WORK IN RIGHT-OF-WAY, EXCAVATION, PAVING, SIDEWALKS,SANITARY , STORM SEWER. ~..
FIRE DEPT. COMMENTS/REVIEWED BY. ..
,~cl. #:3 d~ ~ ~. S.N.,..f'-OI'{S!; CI /(",
,TRAFFIC DEPT. COMMENTS/REVIEWED By..........d/I;j"~~ ..
PLUMBING REVIEWED BY"PJb/5' o.'1-d M{lc~. -J.." e a..c(.ol-tlrVtfj -}c Vh. if',~ c.M.e.'3 ~
SEPARATE PERMITS REQUIRED FOR PLUMBING AND MECHANICAL WORK.
ELECTRICAL REVIEWED By..........
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SEPARATE PERMIT REQUIRED FOR ELECTRICAL WORK.
BUILDING REVIEWED8yJ~L /7'f /~-.I''-'''' C:/~Cc;i~e>~?~ Cc~d'"J-
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H & S QUALITY CO&UCTION
Rt. 5" Box 270
BREMERTON, WASH. 98310
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FORM 204 Available from
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BREMERTON, WASH. 98310
Phone 377-4842
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FORM 204 Available from iNeas/INc. Townsend, Mass 01469
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City of Bremerton, Washington
Phone: (206) 478-5281
OWNER'S VALUE
$/11- () {) ;;:2.
BLDG. DEPT. VALUE
PLAN CHECK FEE
RECEIPT NO.
PERMIT FEE
RECEIPT NO.
DATE
~d' 7'
OWNER'S NAME
PHONE
CONTRACTOR
STATE CONTRACTOR'S L1C.#
ADDRESS
RESIDENCE D BUSINESS D OTHER D NEW D REPAIR D REMODEL
PHONE
ADDITION D DEMOLISH
PLANNING I ZONING
FIRE ZONE
STORIES
OCCUPANCY
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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 10cCillaw regulating construction or the performance of construction.
INSPECTIONS REQUIRED: Foundation
Framing
Plumbing D
Electrical D
Wallboard D
FINAL
SEPARATE PERMITS ARE REQUIRED (WHERE APPLICABLE) FOR PLUMBING, MECHANICAL AND ELECTRICAL.
FOR INSPECTORS USE ONLY:
REINSPECTION:
APPROVED' NOT
TYPE OF INSPECTION DATE TIME APPROVED
COMMENT
DATE
TIME
APPROVED
FINAL INSPECTION APPROVED BY
Building Inspector
ISSUANCE OF OCCUPANCY CERTIFICATE REQUIRED BEFORE OCCUPYING BUILDING
OWNER'S SIGNATURE ~~ ,/ ~ . BY , ,
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BUILDING DEPT. 9_ . ~
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APPLICATIONe
CITY OF BREMERTON BUILDING DE
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PROPERTY TAX ACCT. NO................................. ~:. . . . . . . . . . . . . . . . . . . . . . . . . .
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SIGN~rURE A~PLlCANT.~~. .~.~4:. DATE. ~;yt1'1?::.. RECEIVED -BY'~"
ACCEPTANCE OF APPLICATION DOES NOT I~SURE ISSUANCE OF BLDG. PERMIT.
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SEPARATE PERMIT REQUIRED FOR WORK IN RIGHT-OF-WAY, EXCAVATION, PAVING, SIDEWALKS,SANITARY & SYORM SEWER.
r FIRE DEPT. COMMENTS/REVIEWED 8Y..........
'-
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PLUMBING REVIEWED By..........
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WATER DEPT.
SEPARAIE PERMITS REQUIRED FOR PLUMBING ANO MECHANICAL WORK.
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H & S QUALITY CONST_lION
3513 Forest Drive
BREMERTON, WASHINGTON 98310
(206) 377.4842
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H & 5 QUALITY CONST_TION
3513 Forest Drive
BREMERTON, WASHINGTON 98310
(206) 377-4842
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H & S QUALITY CONST.eT10N
3513 Forest Drive
BREMERTON, WASHINGTON 98310
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PRODUCT10H (NE:Bs(lnc" Groton, Mass, 01450
Form 3/80
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CITY OF BREMERTON
APPLICATION FOR ADMINISTRATiVE VARIANCE
The Administrative Variance process al lows the Planning Director to consider
applications of variances to the yard setbacks, lot coverage, fence height and
parking requirements of the Residential District portions of the Bremerton Zoning
Code (see Sec. 1308.1, .12 and .3 of Ordinance 1792, as amended).
1. Name of Appl icant: _
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that a hearing
to the scheduling
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A fee of $50.00 must accompany this appl ication and in the event
is required, an additional fee of $25.00 must b~/submitted prior
of a Planning Commission hearing, if necessary?Y ~p d~ ~~
2. Street Address of Appl icant:
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3. Telephone: Home
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4. Location of the property on which the variance Is requested. Street address
or distance and direction from street intersection:
_..1.l.l. <7 d L "1;1 1..1.( /1
TAX LOT NO.:
5. Who holds legal title to this property (Name & Address):
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6. Zoning classification of the property: --4:- /
7. Variance is requested to Section(s) of the Bremerton Zoning Ordinance:
.k- .~..I.i Md.t1;/ '{~d/ .
{To be completed by Planning DePt~taf~
8. A short statement setting forth the type of variance you want and your reasons
for applying for a variance:
Required Showings: (Following to be completed by applicant) Please indicate
how your request meets these requirements.
(a) Explain what special circumstances are appl icable to the subject property
or intended use such as: shape, topography, location, or surroundings:
L .A~~+va-
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(b) Explain why the variance is necessary for the preservation & enjoyment of
a substantial property right"or use which is denied to the property because
of special circumstances:
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Page I of 3
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Form 3/80
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Appl ication for Administrative Variance -2-
(c) Explain why variance will not be materially detrimental to the publ ie
welfare or injurious to the property or improvements in the vicinity and
zone in which the property is located:
(d) Explain why the granting of such variance will not adversely affect the
Comprehensive Plan:
:741 ~L
9. A SITE PLAN TO SCALE MUST BE ATTACHED TO THIS APPLICATION (with the fol lowing
information thereon:
I. The dimensions of your property and the adjoining property.
2. Show existing and proposed structures on your property & adjoining property,
3. Show distances or structures from property boundaries,
4. The area of the variance should be noted on the site plan.
10. Present this completed application, the site plan to scale and the following
statement, to all owners of property which adjoin yours and solicit their
signed approval of the proposed variance.
INSTRUCTIONS TO ADJOINING PROPERTY OWNERS:
The applicant (line #1, page I) must obtain the approval of all adjoining property
owners in order for the Planning Director to administratively (without public
hearing), approve this variance. If all adjoining property owners do not ~pprove
the granting or the variance and so indicate by not signing, the variance will not
be considered further without a pub! ic hearing before the Bremerton Planning
Commission. After public hearing the Commission may grant or deny the variance.
ADJOINING OWNERS STATEMENT:
I hereby certify that I am the owner of property adjoining the property on which
this variance is sought and that I have read this application, have reviewed the
proposed variance, and approve of its granting.
Sign below and print your name and address if you approve of the granting of the
variance described herein and on the accompanying site plan:
:c::t;J/~tr <"1L8Z 2.
signature -~ dat-;) TS-ignature) ~
JJA VI I) Ie f{)SK E-rr-
(print name)
-lPr i nt name)
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--:";u /rlPI _" . . I( ~
(print addre5~
---rprint addressr----
3.
(signature)
(date)
(s j gnatul-e)
('Cia-t-e)
(pr j"nt name)
"---cprlnt namej-
(print address)
( p r i n t -a d d res s )
If this appl ication for variance is approved, you as an adjoining property owner
Page 2 of 3
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Form 3/80
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Application for Administrative Variance -3-
wil I be notified at the address given above and will be provided with steps necessary
to appeal the Planning Director's decision to the Planning Commission.
Section 1308.3 Right of a Hearing Before the Planning Commission provides,
liThe right of a he'aring and---appe~TannTngCommission 511-al1 remain to any
aggrieved party who wishes to object to the denial or approval of an Administrative
Variance in writing to the Secretary of the Planning Commission.11
APPLICANT'S STATEMENT:
I hereby certify that the statements contained herein are correct and agree to abide
by this appl ication, site plan and conditions of approval, if it is approved.
Further, I have contacted all adjoining property owners, presented this completed
appl ication, including the site pl~n, and sought their approval.
If any part of this application is not truthful, or approvals have not been sought
as required, the City reserves the right to revoke this variance.
By my signature as applicant, I agree to these conditions.
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FOR PLANNING DEPARTMENT USE ONLY:
Date of Administrative Action: _~~19 [y___
Sections of Zoning Ordinance varied:
Sec. 313 Rear YGrJ
KL App roved
( ) Disapproved
Conditions of Approval:
Construction to meet all codes 0 re0ulations s required. r;uilding
permit to be oLtained throush usual procedures.
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Page 3 of 3
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3542
City of Bremerton, Washington
Phone: (206) 478-5281
OWNER'S VALUE SLOG, DEPT. VALUE
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PLAN CHECK FEE
CONTRACTOR
RECEIPT NO.
PERMIT FEE
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$S2?
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RECEIPT NO.
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$'5@S-/
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PHONE
ADDRESS
RESIDENCE 0 BUSINESS 0 OTHER 0 NEW 0 REPAIR
PLANNING I ZONING
PHONE
REMODEL 0 ADDITION
o DEMOLISH
OCCUPANCY
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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. '
FOR INSPECTORS USE ONLY:
~PPROVED' NOT
TYPE OF INSPECTION DATE TIME APPROVED
FINAL INSPECTION APPROVED BY
REINSPECTION:
COMMENT DATE TIME APPROVED
,
OWNER'S SIGNATURE
ISSUANCE OF OCCUPANCY CERTIFICATE REQUIRED BEFOR
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H & S QUALITY CONSTI:TION
3513 Forest Drive
BREMERTON, WASHINGTON 98310
(206) 377.4842
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