HomeMy WebLinkAboutACORN ST., 128
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B U I 1. D I N,G
D E PA RTM EN T
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PERMIT
ApplicatibnDate
, Issue Date
ASl;lessorAcct tt
SiteI,o.catien
Qwner -- Last Name
....street
... City
-- Phone
,'renant' oS 'Name
Agent's Name
, Architect's Name
[]Bui Iding,
[K] ,Mechanica 1
[X] Plumping
02/24/1994
02/24/1994 '
Application Number 94AP07359
Permit Number 15276
Project Group
12S'ACORN
Al)R I AN
621 WASHINGTON
BREMER TON
(206)
I
First JIM MI
state WA Zip 98310
Phone(206)
Phone(206}
[ ] Gtadil"l9 [ ] Sign [ ] Paving
[ ] Move Building [ ] Burning [ ] Underground
[ ] Mobile Home [ ] Land, Cl ea r [ ] Demol i fien
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BuildirigContractor:
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, ,
,
he completed by owner.
and gas water heater.
"
Counc:ilDistrict
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Censl~sTxact
Construction
," Type
Sq .teet
Inspections
Required
Residence [X] Foundation [ J
Business []Fr:aming L ] I
ot-her [] Insulation []
New L ] PI umbing [X]
Repair ,[] status Mechanical (xl
Remodel'r J Code Wallboard [J
AcIdi tion [,] Final [X]
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~ft
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,.;, ',~ :"w
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<I
stoves
Fire Place Inserts
Furnaces
Convers(onBurners
Unit. Heater
Boilers
2 Gas SysteJn: Max 5 O'Utlets
Evaporatidn>Coolers
AirConditiO:ning' Units
Heat Pumps
Mixing or~,e~Heat Box
Ai r Handling Uni ts,
Fans
Range Hoods
ClolhesDryers
Incine'rators
Duct Alterations
Tanks
Refri~eration Units
other 'It~ms
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BR * MER TON
DE PART MEN T,
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Pt.UMBING
PERM I '.r.
A P P L I CA T ION
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Application Number 941\P07359
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Work will he completed by owner.
Toilets
Bathtubs
Basins
Showers
Kitchen Sinks
Dishwashers
Laundry TJ;ays
Clothes Washers
]. Water Heaters
Urinal s
Drinking Fountains
Drains
Slop Sinks
Water1?iping, and Alterations
Interceptors
Hose Bibb
Lawn Sprinkler
Private pools
Pub Ii c Poo Is
Building Sewer
Gas Fipe
Roof Drain
Private Hot Tubs
Public Hot Tubs
other Options
..
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B REM E R TO.
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* This Is Not A Permit *
Rt~eglpfI.' :it 087001.
MeehZl,ni ca 1
6'2'<322.1005
Pi umbin~;f
61~<322 .1003
Pe rml 1: f<'eei':!
$ 2~1,~50
$ 12.00
Ot.her.
Zoni Jl'lees
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Rece:l.ved Fnnn:
Jim Adrian '1105
l
Amount d
$ 24,50
$ 12.00
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$
::l6. 50
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D E PAR T MEN T
PI a,fl CheGk Fees A.ilH)tm. t
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$
62-:34.5,8300
Gen Payment
at trees
Emn'gy Ghaxge
Sb~t~,e Sf (~
643""23'l,:i:"i
'rota.l Feet1
Amount Paid $
pri 01:' ,P~3,yn\ent ~;
B;;:t 1 anoe Due
On 02/24/1994
[<'or # 94AN''I359
-~'*
.'
4, 1994
d
$
.00
$
.00
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$
36.50
36,50
,00
$
.00
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APPLICANT: DOWNER D CONTRACfOR 0 OTHER:
CONTRA
COUNTY ASSESSOR PARCEL #:
OWNER:
ADDRESS:
ADDRESS:
CONTRACfOR LICENSE #
EXPIRATION DATE:
CONTACf PERSON:
CONTACf PHONE #
o SFR D DUPLEX
o SIGN D DEMO
o NEW D REPAIR
D MULTI-FAMILY D BUSINESS D OTHE~:
o MOVE BLDG.
o REMQDEL
D MOBILE D GRADING(yds):
D ADDITION D OTHER:
INTENDED USE:
ZONING CLASSIFICATION:
COUNCIL DISTRICf:
NATURE OF WORK PROPOSED: ~ -~A.J -AM~
~~~~.
S~UARE FOOT A Dwelling:
~
in.>
Garage:
Decks:
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$ $ $ ENERGY: $50.00
STATE: $4.50
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$
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.
I hereby certify that the above information is correct to the best of my knowledge.
APPUCANT'SSIGNATURE:X A//(P~~ ~4./g"'<-PATE: 01/:<3/'29'-
~
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.
NOTICE - It is the responsibility of the permit holder, not the City of Bremerton or Building Official to see
to it that the required inspections are made. The permit holder must notify the Building Official when ready
, for the inspections. Failure of the permit holder to notify the Building Official of required inspections may
result in the stoppage of the work until such time that the permit holder can substantiate to the building
official that the concealed work meets or exceeds code requirements. Any demolition, testing, or fmancial
burden 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.
'/- b./-<,?;c' ~ <
Signature
d/c9.l/ /1'4_
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
pamit.dcx:
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BREMERTON BWLDINC, DEPARTMENT
PI.,pbiDglMeek&lllc:alIB.peetioD Report
~
Sc:epe of work:
Address:
Contractor:
Space heater,
128 Acorn
Self
and Water h@'at~r "gaS Penult NUIIlber:
Owner: Adrian
Phone:
15276
<Oi'~
,
GAS PIPIN,G
, Under~((10p~ifor 15l'niJlI.~leS)
12" rnjnirnqmbe1ow~dc: whMund,ol1lld
I Groqnd-joint unions J.>rohibitedin certain l()(;ations
:'--" - , .
PrQ~ sizing k support
Coa~wrapped whc:nl1lld~undor widM~[~"ofeai'th
BuS'hings not all~ in C(:)n<<aled areas
COMMENTS:
GAS PIPING APPRQVED:
PURNACB
M ~.t: " ' "6' '.
, ", ,anlUaQilll'ef s SpecllcatlO,ns on site
Ck:arancc: (ocornbustibk:s
Ventsizingk support! <;onn<<tions
C<iillbu.suonair ' "
Gasshu,t-offwith.in 3 '
~.uits:dS~7.e ~, sUf;l>ort!insulatc:dwhen~uired
L<<ation, access, support
Vccnti...g: deatana: (0 <;ornbU$tibb
Vcnttertnination
CbimneydinerandJor sefaBte f1uesasrcq~re4
Pilat _ate({ off floor inga~c: ' ,
Return air '
COMMENTS:
FURNACE APPROVED:
MISC. APPUANCES
~,f" r "v",' ~. ,',
iv,lalld;ladiUret$s tcat'lons on sue
Clearafacc: (0 'iOmbustibk:s " " ,
VenisiziNJ &:s~pJ;>ortlconnections
, 'C.inbnsUQnair ' ,
Gas~IU1(..Qff'Within3'
W~S(QYc:s:E.PA approved ','
. WoOO.stovcs&:fireplacc:s:tigin fittingdootS
',"~tiOIl, access, support
, Venti~clearancc:to c.Ornbustib1c:s '
Ventterrraination .
, Chi~ liner:and/or ~l'aratef1ues as reqtrlred
, Wood,ltave & 6repla~: l'roeer~rth "
GaslOfSlsakty lllEqt-off '.
Gas shqt-off' within 3'
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COMMiNTS:
MISC. APPLlANCI!S APPROVED:
WATER BEATER
i
ManufaaUrettllspeci.fi<:atiollS onsite L<<ation,acQtss; support
'Cku:ln41le lOQ>mbustibles Ventillg: cle:ua.Jlce to <;ornbli$tibk:s
,Val.t si71~&:su:pJ.>()rtlCQI1IIt.CtiollS Vait termination '.
Combli$tion air . Chi~.liner andIorSCl!arateflues,asreq~red
. Gasshut.,off Within3t PUotdeva.ted oiffloor in ,~. . " ".. ,.' " . . .
.. ..Ga~ v~~on <;old wa.ter su.eply. . &lief vUvedrained to outside' .
iCop,pc:ttol?i:dvaniuil ~ons ' UniOns onwa.ter,i~
~stni~Stl>lp .' . . " " ,. ~ '. '
Q)~,.~'~f""'~~~
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WATBRHMTER APPROVED:
ilL~ WOBK IfNIJER'rDIS PERMIT APPROVED:
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