HomeMy WebLinkAboutADELE AVE., 650
BRBMIIRTON BUILDING DBPAIlTMIINT
Inspedion Report
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Scope of won: NEW SFR
Addrea: 650 ADELE AVE
OWner: MASADA DEVELOPMENT
Contractor: SAME
Permit NIDDber: 14326
COMMENTS:
Phone:
Phone:
Hable)
FOOTINGS APPROVED:
~/~ z/~ .,A ?wAUSAPPROVIID'~ 31~ !~
COMMENTS:
aCle
Hoe
~..e.tb
uift!d
10'
~'~ ~~q-/~-7;S
APPROVED:
COMMENTS:
UNDER FLOOR/FOUNDATION INSUlATION APPROVED:
WML INSUlATION APPROVED: W ~ ~YiCEIlJNG INSULATION APPROVED:
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MECHANICAL
ort
ound-coated
b.eartb.
COMMENTS:
GAS PIPING APPROVED:
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--~~cEAPPR:~~:---1/~~J-----
OTHER APPLIANCES APPROVED:
DWV Be water piping under test
DWV: proper sizing
DWV Be water piping: proper support
Vent termination
Water supply: proper sizing
Water heater: pre valve on cold water supply
Water heater relief valve drain to outside
R-IO pad. under water heater when required
Grease tn lin tors: where uired
COMMENTS:
f-; X (.e-J-
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PLUMBING GROUNDWORKAPPROVED:j2~ I- f' 9)PLUMBING ROUGH-IN APPROVED
SBBETROCK
nails-8" o.c. vertical plane
_12" o.c. boris. pLane(1I2") 24" o.c. fnming
saews-12" o.co vert. pIane(1I2")-24" o.c. framing
saews-12" o.c.laoriz. pIane(S/8")-24" o.Co framing
saews-12" o.CoIaoriz. pIane(S/8")-24" o.Co framing
Draftstops whae required
Waterboard where requiftd (not on dog)
Proper fastening: nails -7" o.Colaoriz. plane
Proper futening: _12" o.c. boris. plane(1I2")
Proper fasreniing:saews-16" o.co vert. plane (112")
Proper fastening:saews-12" o.Colaoriz. plane (5/8")
Proper fastening:saews-16" o.Co vert. pIane(5/8")
.Ala Be oc.<:upanc:y separation walls
Usable spaCle under stairs (5/8" requiftd)
Corridors
COMMENTS:
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INfA' > f' b '"
5~(n,,/tJ ·
d1,/~
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SHEETROCK APPROVED:
Energy code requirements met, exhaust fans
GangeJdwdling door self dosing solid core
Handrails Be guardrails, as required
EDt signs when required
Oa:upant load. posted when applicable
Wood siding to earth. separation (6")
Radon monitor when required
COMMENTS:
{/~ fa Ijf7FJ
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FINAL APPROVED:
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CITY OFBREMERTON - BUILDING DEPARTMENT
478.5275 - 286 FOURTH STREET, BREMERTON, WA 98310
INSPECTION REpORT
PERMIT NO.
/Y37-fe:'
I have this day inspected this structure and these premises and have found the following violations
of City, County and/orStatelaws governing same:
(j) HotJt----./ ?P-1.-~ k.e -J P ~ ~r ~,fV (21 ~c--€-
(f) ~~ s~-I---y()~/<:.... Vvt~.,;'. $~;r-s.
. (~" t-rfL- 'X:)
@ fro'; ck-~~;I ~., .e.-r.fe"-,,, 71,-"~
You are hereby notified that no more work shall be covered upon these premises until the above
violallons ara corrected. When corra~ions have been ma~. '. ~or re-inspa~'l.e' . ~ "
Do Not Remove This Tag DATE 1. ../1 7 2)"Z---. c/'
INSPECTOR FOR BUILDING DEPT.
~DF
CITY OF BREMERTON - BUILDING DEPARTMENT
478~5275 - 286 FOURTH STREET, BREMERTON, WA 98310
PERMIT NO.
IV] V t:=.
INSPECTIONREPORT
I have this day inspected this structure and these premises and have found the following violations
of City, County and/or State laws governing same:
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You are hereby notified that no more work shall be covered upon these premises until the above
violations are corrected. When corrections have b~en made, call for re-inspection.
Do Not R.emoveThis Tag DATE ~-I';-?j ~
. INSPECTOR FOR BUILDING DEPT.
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B R EM E R TON
BUILD I NG
D E PAR T MEN T
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PERMIT
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ApplicatidnDate
Issue Date .
Assessor Acct#
site Location
Owner - Last Name
- street
-:- City
- Phone
Tenant's Name'
Agent's Name
Architect's Name
LX] Bui Iding
[X] Mechanical
[X] Plumbing,
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11/06/1992
01/12/1993
3783~004-007~0107
650 ADELE AVE.
MASADADBVELOPMENT
29629 GAMBLE PLACE NE
KINGSTON
(206) 2,97-4028
Application Number 92AP06075
Permit Number 14326
Project Group
First HI
state NA Zip 98346
Phone(206)
Phone(206)
[ ] Grading [ ] Sign [ ] Paving
[ ] Move Building [ ] Burning [ ] Underground
[ ] Mobi Ie Home [ J Land Clear [ ] Demolition
- -- - - --.......... - -.--'- -'- ---- - -.....- -~:- ---- _.....:-"",,: - "':""--_. ......-......'- - - - - -... - ---,-- - -, -- - -- - --- -- - --- -- ......---
Bu~lding Contractor:
Contractor
street
City
Phone
. .
Representative
state License:fl:
city lticense#
Work:
Buil~ingValuation
MASADADEVBLOPMENT
29629 GAMBLE PtACE
KINGSTON
(2Cl6) 297"'"4028
TIM LOUNSBERRY
MASADDCIOINZ
NE
state WA
Zip 98346
Expiration Date
,Expiration Date
$94666.00
Council District
, . -.
-:----~-~--~------,-----~,~----~------.----------~-------'----------------
Census Tract
Construction
Type
8
SqFeet
2200
Inspections
Raquired
Residence [X] . Zoning Fo\indatitm [X]
.Business [] Type .. Framing [X]
other [ ] Insulation [X]
New [X] Plumbing . [X]
Repair [] . Mechanica 1 [X l
Remodel I: JWall board [X].
Addition . I: ] . . 1 Final'. (X]
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B REM E R TON
M E C H A N I C A L.
FAR TM E NT
P E R.M I T
A P P L I CAT ION
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Application Number 92AP06075
Work will be completed by owner.
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stoves
Fire Place Inserts
1 FurnaceS
1 Burners
1 Heaters
Boilers
1 Gas Outlets
1 Cool ers
Air Conditioning Unit.s .
Heat Pumps
Re.-Heat Boxes
Air Handling Units
.3 Fans
Range Hoods
'Dryers
Incineran~.ts
Alferations
Tanks .
Refrig~ratiD~nnits
Ot.herltems
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B REM E R TON
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D E P AR T MEN T
P L U M BIN G
PER M I T
A P P L I CA T ION
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Application Number 92AP06075
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Work will be complete.d by owner.
2 Toilets
2 Bathtubs
2 Basins
Showers
1 Kitchen Sinks
Dishwashers
Laundry Trays
1 Clothes Washers
1 Water Heaters
Urinals
Drinking Fountains
Drains
Slop Sinks
1 Water Piping
Interceptors
Vacuum Breaker
tawnsprinkler
Fire Sprinkler
Private pools
Semi-private Pools
Public Pools
Groundwork
Sumps
Alterations
Kidney Machines
Private Hot Tubs
Serot-Private Hot Tubs.
Public Hot 'rubs
other Options
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Applica,tionNumber 92AP06075.
Permit Numbe]': 14326
. .
---~--,---'--~~---~---~-~~~-~--~_._-~----~~----~------._---,--------------
Engineering- - .
.1. All improvements shall be completed per approved
roadway and..utilities plan (7/10/92), including
comments letter prior to occupancy.
2.$2,000.bond and right..;.of-waypermit required for
roadway cut. To obtain permits, a .Certificateof
Insurance, na~ing City as an additional insured is
required.
3. Construction of infiltrat.ion system will ]':eguire
enginee1':'s stamped acceptance letter after completion.
Planning--Approved with condition that all driveways
be paved and all retaining walls over 3 feet in height
must maintain a 3 foot. setback from adjoining property
lines.
Building-..;.approved as revised.
~'Water-~Contact util i ty for connection fees and
assessments for water and sewer service..
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Date: . January 12, 1993
To: BUILDING DIVISION
From: PLANNING DIVISION, JACK ALLINGHAM
Subj: Masada Development's single Family residences at 640-652
Adele Ave.
-------------------------------------------------------------~---
-----------------------------------------------------------------
All of teh building permits are approved subject to the following
conditions:
1. All driveways are to be paved.
2. All retaining walls over 3 feet in height must maintain a 3-
foot setback from adjoining property lines.
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A PP L I CAT 1 0 N
. '
Application'Date
Issue Date
Assessor Acct# .
Site Location..,'
Owner - Last Name
- Street
- Ci,ty
-,Phone
Tenant's Name
Agent;'sName,
Archit~ct'sName
(X]auilding.
[X] Mecharlical
[X] .PI umbing
11/06/1992 ,,"
...... .'00'1.".. .
37 e,3-.D-81-007-()l,07
650. ADELE AVE'~;
MASADA DEV~LOPMENT
29629 GAMBLE..PLACE NE
KINGSTON
(206) 29774028
. Application Number 92AP06075
Permit Number.
P.ro jectGroup
First MI
State WA Zip 98346_
Phone(206)
, . Phone ( 206-)
[ ] Grading ( ] Sign ( ] Paving
[ ] Move Building [ ] ,Burning, , [ ] Undergro'und
'[ ] Mobile Hqme [ ] 'Land Clear [ :] Demolition
, -----'~---~'~-~------------,-~.---~---~-----~---,-----._-~._-------~--------
Buil.d,i,ng Contractor:
Contractor
street
City, '
Phone
Rep res en ta 1;.i ve;
state License f
City-License'#
Nature~of Work:
New SFR
Buildin~~Valuation
",MASAPA'DEVELp,PMENT' ,
29629 qAMl3LEPLACE NE
KINGSTO.N
(206) 297-4028
TIM', LOUNSBERRY
MASADDCI01NZ
Zi.p .98346
State WA
Expiration Date'
Expiration Date
$94666.00
Counci lDistrict
. , . . - ,
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8
'censUsT~act
Construction
-'"
Type
Sq, Feet
'2200
.,. Inspections
Required
Residence [X] Zoning Foundation [X]
Business [] - ,Type Framing, [X]
Other [ ] Insulation [xl
New ...[X ]PIum~ing, [Xl
Repair [] . ." Status 'M.echanipal [X]
Remodel [] e Code - Wallboard [X] ri?l\
Addition [] 1 Final [X] ~-<:~J~ I
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B R EM ER T ON
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ApplicatioD.,Number 92AP06075
.WorkwiLl be. completed by oWJ:'ler.
stoves
Fire. .Elace Inserts.'
1 Furnaces
Burners
Heat~rs
Boilers
1 Gas Outlets
Coolers
,Air Conditioning Units
HeatPumps . .
Re-~eatBoxe~
Air HandJiJ:'lg:Units
3 F~ms
1 Rang e H o,od.s '.
1 Dryers
Inci.nerators
Alt~ratio,ns'.
cTanks
Refrigeration Units
Other Items
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Application Number 92AP06075
Work will be completed by owner.'
2.. TO:L lets
.2 Bathtubs
2 Basins
Showers
1 Kitchen Sinks
Dishwashers
Laundry Trays
1 Clothes Mashers
1 Water Heaters
Urinals
Dririking Foun~ains
Drains ..
Slop Sinks
1.. Water Piping
Interceptors
2 Vacuum Breaker
Lawn Sprinkler
Fire Sprinkler
Private Pools
Semi-Private Pools
, .
Public Pools
Groundwork
Sumps
Al terations
Kidney Machines
Private Hot Tubs
. Semi-Private. Hot Tubs
Public Hot Tubs
Other Options
.. .
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APP. NO. q~ A-PO (PO ? $'
OWNER:
NO. PLANS
TYPE OF CONSTRUCTION
SQ. Fla.
OCC. lOAD
VALUATION PLAN CK. BLDG.
SACHG.
- _........."'......... __"............__ .'......'_~....".".......'.,,~~..._......_ ..-.".0.-.-.. ___",.__~,..,_
OTHER
FEES PAID: PlBG. MECH.
ROUTING:
DATE DATE
SET /I SENT RETURNED
APP. WI NOT
APP. COMMI:NTB APP. REVIEWER
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M-E-M-O~R-A-N-D-U-M
November 13, 1992
TO:
Janet Lunceford
FROM:
Derek Skanes
SUBJ:
NEW SINGLE FAMILY RESIDENCE
Building Application Number:- 92AP06075
Site Location: 650 ADELE AVE.
Tax Lot Number:3783-002-007-0107
OWner: MASADA DEVELOPMENT
The development of the proposed site does not conflict with utility
systems located within the 6th Street or Adele Avenue right-of-way.
Contact utility for connection fees and assessments for water and
sewer service.
Approved: :iffi: J-P M ~IL :
Logged In. I //3 /crL
d
Date /1-/7-?2-
Logged out 1I-/7-i'::L
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CITY OF BRE
B REM E R -r ON B U I {, f) 1 N (* J) 11: 1< It R T M it N ~" MERTON
PERM I '(' A p' P LIe Pi. T ION iv,.. , "NO V 1 3 1992
. \..;i'00/iJp,L
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Appl:i.
Issue Date
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Ownet'
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~~. Name
A~ent ! s N:alU}J!!l
Archit 'sName
[X] Bllil n9
[Xl Meohan.:tcal
I: X.] Ii'l ultlb:tng
06/199'2
t00'1"(H07
6 L~
MA~ADA OmVELOPMSN'1'
:2 fa OAKBf"E PLACE
KINGS'I'ON
( 6) 2
I: :1 Gradin9
[ ] I-tove BI.:d 1
[ :1 Mobile Hr:!llle
App 1 i l\lUlnber 91APO
P e t'ffli t N urnber
p~o :je(}t Oro'll'"
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state MA Zip 98346
PhOl'if~(
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or
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Natu)':e
New
Wor'k.l
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MASADA PEVELOPM~NT
19629 (UUllJBU.~ PLACE Nit
KINGS'l'{)N
( .6):2 ~4028
'l'IMLOUNSaiiRRY
MAJ5AiJDC101NZ
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Zip
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------- ~~~----------~~--~--------------------------~----~-----
Tract
C()nstruction
Type
(,'it
8
Inspect! 01;1 a
Requ 1.
[xl:.?oning ro\u\dation Lx
r J Framing [
[, 1 !nsul it)ll [:X
[Xl Plumbing [xl
r [] stat Meohanioal [xl
RemcHiel [J Wallboard [X]
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M E C H A N I C A L
PEl~MI'11
A P P L ! CAT ION
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At,};!], :i,
ion Number 92AP06075
Wcu,"k wi,11
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Hll'~at:ers
Boi 1 et"S
1 Gas lli!!t$
let"s
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Re-Hell'lt Berxes
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Appl icatio:r'l Number 92AP060:75
WOI::'k wi 11 be com~}l eted hy owner',
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:2 '1'011el:$
2 Bathtubs
2 Basius
Showet"s
1 Kitchen Sinks
Dild:awasbers
t,aundt"~y 'rr"ays
1 OJ W..hera
1 Wab;H; He<aters
IJx:inal ~J
Drinking Fountains
llr.ai tiS
Slop Sin,ks
1 Ka'blH Piplng'
In tei:'cept,ors
;2 V!!uJuum Breake:r
Lawn Spt"inkier
FLee spld:nkl er
l?'ri vate Pool s
Semi-Private Pools
Public Pool.
Gl:coundwork
Sumps
Al te,t ;a.t.i ons
Kidney Maohtnes
Private Hot Tuba
Semi-Private Hat Tubs
PublIc: Hot Tubs
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D E PAR T MEN T
PER M I T
A P P L I CAT ION
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======.================================================='=======.:======
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Application Date
Issue Date
Assessor Acct #
Site Location
Owner - Last Name
-:- street
.;. City
-/Phone
Tenan'tf,i s Name
Ag en tits Name
Architect's Name
[X] Building
[X] Mechanical
[X] Plumbing
11/06/1992
. OO<:j . .'
3 7 83-0~()2-007 -0 107
65.0 ADELE AVE.
MASADA DEVELOPMENT
29629 GAMBLE PLACE NE
KINGSTON
(206) 297-4028
Application Number 92AP06075
Permit Number
Pro ject. Group
First MI
state WA Zip 98346
Phone(206)
Phone(206)
[ ] Grading
[ ] Move Building
[. ] Mobile Home
[ ] Sign
[ J Burning
[ ] Land Clear
( ] Pavi.n,.g
[ ] Underground
[ ] Demolition
~-~---~--~-----~--~-,-----,~-----~--------~~-~------~-----~------------
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Representative
state License #
city License #
Nature of Work:
New SF'R
Building Valuation
MAS ADA DEVELOPMENT
29629 GAMBLEPl:,ACE NE
KINGSTON
(206) 297-4028St~te WA
TIM LOONSBERRY
MASADDC101NZ
Zip 98346
Expiration Date
Expiration Date
$94666.00
Council District
. ,
, .
-----~._--------------~------'-----------~.--------~_.--'----,---'-----~--~--
Census Tract
Construction
Type
8
t<t_\ -.~;
Sq Feet
2200
Inspections
Required
Re~idence [X] Zoning Foundation [X]
Business [] Type Framing [X]
Other [llnsulation [X]
New .. [X] Plllmbing [X]
Repair [] Status Mechanical [X].
Remodel [] Code Wallboard [X]
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Application Number 92AP06075
Work will he completed by owner.
.Stoves
Fire Place Inserts
1 Furnaces
Burners
Heaters
Boilers
1 Gas Outlets
Coolers
Air Conditioning Units
Heat Pumps
Re"';a:eat Boxes
Air Han~ling Units
3 Fans
1 Range Hoods
1 Dryers
Incine:rators
Alterations
Ta.nks
Refrigeration Units
Other Items
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PER M I T
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Application Number 92AP06075
Work wi 11 be campI etedby owner.
2 Toilets
2 Bathtubs
2 Basins
Showers
1 Kitchen Sinks
Dishwashers
Laundry Trays
1 Clothes Washers
1 Water ,Heaters
Urinals
Drinking Fountains
Drains
Slop Sinks
1 Water Piping
Intel;'ceptors
2 Vacuum Breaker
Lawn Sprinkler'
Fire Sprinkler
)?rivate Pool~
Semi-Private Pools
Public Pools
Groundwork
Sumps
Alterations
Kidney Machines
Priv~te Hot Tubs
Semi..,Private Hot Tubs
Public Hot Tubs
Other Options
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BREMERTON BUILDING DEPARTMENT
1991 WSEC Compliance Worksheet-Non-Electric
APPLICATION NU~ OATh / / / r h 2..-
APPLICANT, ~ ~SITEADDRESS' 650 a~t2v-e-
I SCOPE OF WORK: D::::M~f::;::::(=]:;;;:I~~lml~NI/::Clt/ :;it::ff~QP~gf ........................~I
HEATING SYSTEM: ~ JJ-r~ BTURATING:c8~,/I~tJd
TOTAL HEATED SQ. Fr. / 0;2 0 TOTAL GLAZING SQ. Fr. ) 6 !
COMPLIANCE OPTIONS
~t:t!~~::GIAtINGGi:AZiNG'<DOORS'
::~~y : Jw)iiLPQlt: .:~y~tm:;..p~y.tt$I
...",.", :. {MiMi.: :; .,..,.,....
1. 10% 0.70 0.40
2. 12% 0.65 0.40
3.* 21% 0.75 0.40
4. 21 % 0.65 0.40
5. 21% 0.60 0.40
6. 25% 0.50 0.40
7. 30% 0.45 0.40
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R-30 R-30 R-15
R-30 R-30 R-15
R-30 R-30 R-19
R-30 R-30 R-19
R-30 R-30 R-19
R-38 R-30 R-19
R-30 R-30 R-19
JRtw~:
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R-15
R-15
R-19
R-19
R-19
R-19
R-19
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R-I0 R-19
R-IO R-19
R-IO R-19
R-I0 R-19
R-IO R-25
. R-I0 R-25
R-IO
R-IO
R-I0
R-IO
R-IO
R-I0
R-I0
'This option requires the HV AC to have a high efficiency rating (AFUE of 0.88). Applicant must provide documentation.
To comply with the WSEC you may choose one of the above options. Indicate which option is equal to or greater
than the percentage obtained by dividing your glazing square footage. by your total heated square footage. Follow
the line across to determine the required insulation values of building elements for that option. A heat loss
calculation may be submitted in lieu of choosing one of these options, but wiD be subject to review and approval by
the Building Official
WHOLE HOUSE VENTIlATION Outdoor air shall be supplied to the conditioned space at the rate of 15 efm
fo each bedroom Ius 15 cfm for the remainin Ii' area. Choose one 0 these 0 tions:
;~::~~Q\VPQ"T$:{w~:rQ"T$::~ttre~P;~QPGS~A~:.(#@ii(ijY4g:@1W~t~~ffii)
WINDOW SCHEDULE ON FOLLOWING PAGE MUST BE COMPLETED
..
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BREMERTON BUILDING DEPARTMENT
WSEC Wmdow Schedule
.::::::::IBm\NllttNfODEL1: .::u;,vAEtlEI
:.:.:.:.;_;.:.:.;.:.:_;.:.:_:.:.:.;.:-;.:.;.:.: .;.:.;.;.;.;.;.:.;.:.:.:.:.:.:-;_;.;_;.;-;.:.:.:.:.:.:.:.:.:.:':';';';':';':';';','"0 .....::......:....:..:::....:';.;.;-;.:...:.;-:...
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::~}~{:}~:~~i*?~i:.~:i:~:}~: ::::::: :::::::::::\::::::::}~:~:}~:~:t~{~.vvi.y,f:~\~v~:i~~; ."v _ :.:'. ~~{{:~:~:~:::::}::::t::::::::{
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TOTAL WINDOW SQUARE FOOTAGE: / U I
Brand and model/type must be submitted on window schedule. Any changes must be resubmitted to the
Building Department.
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============================================================.=========
Application Date
Issue Date
Assessor Acct #
Site Location
Owner - Last Name
- street
- City
- Phone
Tenant's Name
Agent's Name
Architect's Name
[X] Building
[X] Mechanical
[X] Plumbing
Building Contractor:
Contractor
Street
City
Phone
Representative
state License #
city License #
Nature of Work:
New SFR
Building Valuation
11/06/1992
oo,:f
3783-~-007-0107
650 ADELE AVE.
MASADA DEVELOPMENT
29629 GAMBLE PLACE NE
KINGSTON
(206) 297-4028
Application Number 92AP06075
Permit Number
Project Group
First MI
state WA Zip 98346
Phone(206)
Phone(206)
[ ] Grading [ ]
[ ] Move Building [ ]
[ ] Mobile Home []
Sign
Burning
Land Clear
[ ] Paving
[ ] Underground
[ ] Demolition
MASADA DEVELOPMENT
29629 GAMBLE PLACE NE
KINGSTON
(206)297-4028
TIM LOUNSBERRY
MASADDC101NZ
Zip 98346
State WA
Expiration Date
Expiration Date
$94666.00
Council District
----------------------------------------------------------------------
Census Tract
Construction
Type
8
Sq Feet
2200
Inspections
Required
Residence [X] Zoning Foundation [X]
Business [] Type Framing . [X]
Other [] Insulation [X]
New [X] PI umbing [X]
Repair [] Status Mechanical [X]
____~~~~~~::__!_J~______________::::_I=/"i-~--------:~::~::::--!:~
-~:~-----J2S==-----(5-----E:------~------------------------~
jpv
APPLICANT;. ~WNER E:ftONTRAcrOR D' OTHER:
COMMENTS:
SITEADDRFJj~~Jff-~_~
OWNEIC ~ ADDRESS, ?2t,~lf:;Jt?lE-
CONTRAcrO~-;;:/>~ -~DRESS, <.o<l~ tL>- ~
CONTRAcrORLICENSE# mA-5 ~DDC/{)/ J2/?-. EXPIRATION DATE: () t?' - tJ7 -93
OWNER PHONE # :;;06 r- d <1' 7 - Lto d- <is CONTRACfOR PHONE # ;2 e; b ~ ct 7 - 40;J- g
:~II~:::~f:::::i,::::t::::I::::::::It:::_I::IiI:::f.;fJtI!~.wI::::II::::::::::::II:::::i:[:::tl.::::::::Jtl~~II:::::::::::::::::;::::::i,;i::::::I:::;_~::l1!!titt~gI~:::::i,:II::~;::t:::::::::: ::::tl:teE:l
...................
..................
RANGE WATER CLOSET
-
WOOD/PELLET STOVE BATHTUB
-
GAS FURNACE btu s: LAVATORY
-
CONVERSION BURNER btu s: SHOWER
-
UNIT HEATER btu 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 btus: t071S: URINAL
-
REHEAT BOX btus: DRINKING FOUNTAIN
- SINK
AIR HANDLING UNIT bttt s: FLOOR 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
-
DUcr ALTERATION SWIMMING POOL
-
TANKS type: BLDG. SEWER (mobile I moved house)
-
REFRIGERATION UNIT ROOF DRAINS
-
OTHER: OTHER:
-
MECHANICAL PERMIT FEE $15.00 PLUMBING PERMIT FEE (15.00 or 4.50)
MECHANICAL FEES:
PLUMBING FEES:
TOTAL FEES:
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APPLICANT'S SIGNATURE: ~ F--UJJ, - ~ DATE;
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l:ooc.l'lo:c:...ll::ic.:.l::B._..)1::.11.."_"lo:11"..11I..1...111:0.111111
APPLICANT: goWNER EJ6~NTRACfOR D OTHER:
SITEADD.RESS~~~.d!~:CCOUNTNO. 37'13-0<:)). -dOI-DM7
~ I ;210;;Lq..cr~/ULu.J1E-
OWNEIC .. ~~RESS' lu-"''Jf!,trJn 11dLJ-9F>'1k
CONTRACfOR: \ ADDRESS:~~ iXA ~
CONTRACfOR LICENSE # /J1;/--5 A- D Del 0/ IVZ. EXPIRATION DATE: 8 ~ -0 7 - c; 3
OWNER PHONE # :2 0 h -;L tj 7 - c/o d- q CONTRACfOR PHONE # ;') () b - ~ Q'7 -z/c; 211
o SFR 0 DUPLEX D MULTI-FAMILY 0 BUSINESS 0 OTHER:
D SIGN D DEMO D MOVE BLDG. D MOBILE D GRADING(yds):
[1}NEW 0 REPAIR D REMODEL 0 ADDITION D OTHER:
NATURE OF WORK PROPOSED:
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00 o::Y:l\LUA:rIQ$ :{::~tANRjJJV1!WiEl$1::::1~EltMttfj$:i/::::t:;$OR.t;J.l.AaGl1${it :::m6:l'AtFEE$::
$ $ $ 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 once. In order to
renew action on an application after expiration, the applicant shall resubmit plans and pay a new plan review fee.
APPLICANT'S SIGNATURE:
DATE:
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