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Home My WebLink AboutANDERSON HILL RD., 2380 .....1.......... '(,:.J.{.,.;(.fii,;:t(.) .....I.""i~. '. ." ." f i''',;~:i ,~\,~::,,,,,,,, .1,' . ":j~ :'I...!\i~.'..,...~~'.!:{~~;:~~? 1..:~t,:,:,:",".I.~.,\ .,,1' ,.,;'.tlJ!;:lJ12n.'IJ}/PERMlT If/sleeT10IV , ',' ';" '-, "'t ," -:.. " ~', > ' ,.. ., . , .' " ~-, ( , '~'" ' . .' - . " ".....:.c:."'.~:"R: "0' ,. ".' , " , ,~ , " , , ;'" ' <, ::~.?,. ';, ::'~., ,_" ,i :', '. ' ,', , . . ,,""tlOTt~TtHis';;ARD FROM THEWEA THER_ ".' " ,- ~~'~i ,)iti,Address(.: ......,.' ~ ""~'" ,,:,:.\:,:'tMd': "."', .' ...:,., . ",:,:, ,'..;'Il"",:~ ":;;',' . .''r':J. '......." '.' ". .... ........ ....'~.... "". .".' :".'11.':1 J ...,....".'....r1.i.::1 " ....;.,.,'...'..' . .~.' ':9:i:i'.t;jf~:~.,!"li:'.!',;} .t)".~~Oj.~t 'tsc",ri~'f;~" ,,' ..e..,.aAA:, O. , ,I',t."" . .': . ':,. " '-~;-"r:,....,' ,.,,,~. , " .', ,', . ,;~_ \,.,,---:;..:, -......;..:.' .,' ",', t.. : " : ' ' " ',0" , ~ " " "'P~r.D1ii#B ']3,0 "" '.-'.', " ,c" .,:-..a..,___ , 'IFot'~~sBectj6,~sCaU [P@@lt@I~Ji~DJJ[~' A.pproved, , , , ' , . . R(}UNDA TION 'rio Nor P:0UR . CONCRETE 'PRIQRTO AP-pROVAL . ......Ef(Jsio1)C.~nrl'fJlInPlace F oundatidnF'ootirlg/ChecftSethacks). ..' Foundation. Walls , ,,~. . '.' . .', , -,' '..' , ',' p. lti1nbing'QriJund.Work.'. , "" " ," , .M~cha'nicaiGr.~undWoPkl , .. . Ulid~ifl;j~l' Framirif;., , . F!ootitiglnsu[atirH PLUMBING W1EClIANICAL .. GAS PIPE FRAMING (1#:.tS~:.~i~D<~RE APPROVED) ", 'I" .. 'r' , ' .INSULATION . ".'~:~S:t;~S~E:EtR()CK (Firf Spriuklel;mz{stb0appr01>qtl priOrt()sheeirock) DO NOTOCCUPYBU. fLIHNGwtrHoUT B'UILnING DEP ART.'l\1ENT APPROVAL.. PROTEiN flus CARDP'ROM THEWEATHER' ReY.AuguoI2007 t3!3D7 00 8!~ [r?,., 1 i':1 I ,,,..., III h I ,J. .' iJIL,.~r.~3:, O)I!.. '. r:> PERMIT CENTER Building Permit Application Dept. of Community Development * 345 - 6th Street. Suite 600 * Bremerton * W A * 98337-1873 (360) 473-5275 * Fax (360) 473-5278 ; ~:"'mmw-"/1$1iIIK1.... :'''~\'' '.04" '.. D"A:'0"'1Jijrl')$t\':":'fii'a"'>~:'''' "/"~'./';:"i'.:. ..~ ~ Dntl1aC~o''''~'' -nU n-~l'~e a ent ' ,>'" ,<< .::.~fr.;.~.'.'::<;:c-.:;~.~.~.;.i~ ....... .:iw.<.~"":,"; '~~.':",' .. ..wi' Y-tZ>W , " .h% .SI;; ',.kw."~,v ~i~liCant;~~'Ow1tef . Site Address: "2 ~ A().IDE:a>00~tt.. e (). & \.u , What is the application for? (Please check one) o NEW SINGLE-FAMilY RESIDENCE D NEW DUPLEX o NEW MANUFACTURED HOME D RESIDENTIAL REMODEL D RESIDENTIAL ADDITION D RESIDENTIAL REPAIR D NEW COMMERCIAL o COMMERCIAL REMODEL D COMMERCIAL ADDITION OWNER: C l 114 0 Address: Cit , State, Zi : Phone #: Authorized Agent Name: Address: 5 City, State, Zip: Phone #: o COMMERCIAL REPAIR D NEW MULTI-FAMilY' o TENANT IMPROVEMENT D NEW GARAGE/CAR PORT D NEW ACCESSORY BUilDING D NEW SIGN D STRUCTURE DEMOLITION D GRADING (Cubic Yards: ~ OTHER: '1),- kDl-< Tl u t\J IS THIS PROPERTY WITHIN 200 FEET OF A SHORELINE? YESD NO D Scope of work proposed: ~l( A-L. D t= S~ l U I} f- Square Footage: Dwelling: ~ Valuation Plan Review Fee Garage: ,~JC~ Surcharge I Total Fees Permit Fee d-.- ' . of 4.50 I j Application for which no permit is issued within 180 days following the date of application shall expire by limitation, and plans and other data j submitted for review may thereafter be returned to the applicant or destroyed by the building official. The buildIng official may extend the tim~ \ for action by the applicant for a period not exceeding 180 days on request by the applicant, showing the circum'stances beyond the contr3!-.df th~ , applicant have prevented action from being taken, No applicant shall be extended mo~e than once, In order to \enew action on an apl'lHcation after expiration, the applicant shall resubmit plans a pay a new plan review fee. ~~..~................ c \ \ 'l. 07 Date '<. CITY OF BREMERTON DEPARTMENT OF COMMUNITY DEVELOPMENT PERMIT NUMBER: 880700812 DATE ISSUED: 11/13/2007 345 - 6th Street, Bremerton, WA 98337 (360) 473-5275 Fax: (360) 473-5278 ASSESSOR NUMBER: APPLICANT NAME: OWNER NAME. CONTRACTOR: LENDER NAME: 332401-3-023-2005 BREMERTON CITY OF BREMERTON CITY OF SELF SITE ADDRESS: 2380 ANDERSON HILL RD SW ADDRESS: 345 6TH ST STE 600, BREMERTON, WA 98337 345 6TH ST STE 600, BREMERTON, WA 98337 ZONING: WS PHONE: (360) 473-2316 PHONE: (360) 473-2316 PHONE: PHONE: ADDRESS: ADDRESS: ADDRESS: SUBMITTED: 11/02/2007 EXPIRATION: 05/11/2008 STATUS: ISSUED VALUATION: Demolition Fee $29.04 2218 $4.50 0236 $33.54 DEMOLISH SFR Building Code Edition: Occupancy Group: Type of Construction: Flood Zone: Setbacks: Sanitation Method: Number of Bedrooms: State Surcharge TOTAL FEES: Inspection Requests DCD: Building Inspections L&I: Department of Labor and Industries Fire Inspections HID: Bremerton, Kltsap County Health Distnct PW: Department of PubliC Works (360) 473-5870 (360) 415-4000 (360) 473-5380 . (360) 337-5285 (360) 473-5270 This permit shall become null and void if the described and authorized by this permit has not commenced within 180 days from the date of issuance, or if the work is suspended or abandoned at any time after the work is commenced for a period of 180 days. It is the responsibility of the permit holder to see that the required inspections are made. Failure to obtain required inspections may result in stoppage of the work until such time that the permit holder can susbstantiate to the City of Bremerton 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 provisions of any State or local law regulating construction orthe performance of the construction. If listing the owner as general contractor, I certify that I am exempt from the requirements of the State Contractor's Registration Law under Section 3, Chapter 126, Laws of 1967. All revisions to an approved plan require DCD review and approval prior to performing work. All building and tenant occupancy permits are required to pass final inspection prior to permit expiration and obtain a certificate of occupancy prior to use or occupancy. SIGNATURE OF OWNER OR AGENT: <-. DATE: II ' j'~ rol I have read, and agree to abide by the conditions of this permit including all.condi on of zoning, building codes, and State and Federal laws. ~. 1;:. T~ PRINTED NAME: '\<o'e., -~ CONDITIONS City of Bremerton's approval of this application pertains only to the City's regulatory jurisdiction, and thus compliance with City regulations does not necessarily ensure compliance with federal or state laws. 10. (DCD-01) DCD: Prior to performing any renovation or demolition work, Puget Sound Clean Air Agency (Clean Air Agency) and Washington Department of Labor and Industries (L&I) 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-certified (AHERA) building inspector (except renovation or owner- occupied single family residences).DCD: For more information, please contact Clean Air Agency through their web site at www.cleanair.org or by phone at 800-552-3565 or 206- 689-4058. The L&I web site can be found at www.lnLwa.gov/p-ts/asbestos/asbestos.htm. DCD: Validity of permit. The issuance or granting of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the Washington State Building code or of any other ordinance of the City of Bremerton. Permits presuming to give authority to violate or cancel the provisions of the Washington State Building code or other ordinances of the City of Bremerton shall not be valid. The issuance of a permit based on construction documents and other data shall not prevent the building official from requiring 10. (DCD-02) -LL~ fl- Page 1 of 2 CITY OF BREMERTON DEPARTMENT OF COMMUNITY DEVELOPMENT PERMIT NUMBER: 880700812 DATE ISSUED: 11/13/2007 345 - 6th Street, Bremerton, WA 98337 (360) 473-5275 Fax: (360) 473-5278 ASSESSOR NUMBER: 332401-3-023-2005 APPLICANT NAME: BREMERTON CITY OF OWNER NAME: BREMERTON CITY OF CONTRACTOR: SELF LENDER NAME: ZONING: WS PHONE: (360) 473-2316 PHONE: (360) 473-2316 PHONE: PHONE: SITE ADDRESS: 2380 ANDERSON HILL RD SW ADDRESS: 345 6TH ST STE 600, BREMERTON, WA 98337 ADDRESS: 345 6TH ST STE 600, BREMERTON, WA 98337 ADDRESS: ADDRESS: SUBMITTED: 11/02/2007 APPROVED: 11/08/2007 EXPIRATION: 05/11/2008 STATUS: ISSUED 22. (DCD-11) the correction of errors in the construction documents and other data. The building official 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. ENGR: Temporary Erosion & Sedimentation Control shall be according to BMC 15.04.042 DCD: No stormwater shall be allowed to drain onto adjacent private properties or the public right-of-way. DCD: Once demolition work has begun, it must be completed and ready for inspection within 60 days. (7~ ~ 20. (ENGR-) 21. (DCD-O?) r2..~ MINIMUM INSPECTIONS REQUIRED To request an inspection, please call (360) 473-5870 and be sure to provide your permit number, name on permit, site address, contact phone number, and inspection type. Final Inspection - Building Page 2 of 2 'l~: "\ Il SCOTT W. LINDQUIST, MD, MPH, DIRECTOR 345 6th Street. Suite 300 ..'l~\ Bremerton, Washington 98337-1866 (360) 337-5285 FAX (360) 337-5291 ~p,Or~ 357 ON SITE SEWAGE SYSTEM TANK PUMP/INSPECTION REPORT OWNER& PROPERTV.INFORMATION- Property OWC~ t"' y, R{"c('I'\ \7 ~.\c --- I Contact Phone # '\ ),'/ 0\ :..1 '..... t..... Property Address f City Zip Code r<. ~ cJ Ar-7.)ft75t:--... l--l fIt ~ fl<~~~~'~ C",-J f", Pc-OS ~':--- Assessors Account Number I E-mail Address Tank#t Information (check all that apply) . Tank #2 Information (check all that apply) I51:Septic Tank D Trash Tank DATU D Septic Tank D Trash Tank DATU Tank Size: / J <;...,-.u gallons Tank Size: gallons Tank Condition: DGood DNeeds Repair Tank Condition: DGood DNeeds Repair Soec'i"-: Nob/ems in notes if "needs rena/I" is selected Snecifu;:;rob/ems in notes if "needs reoail" is selected How deep is the main compartment lid? vr inches How deep is the main compartment lid? inches Is a riser installed to grade? 9Yes DNa Is a riser installed to grade? DYes DNa Drainfield effluent backing into tank? DYes DNa Drainfield effluent backing into tank? DYes DNa Effluent Screen cleaned? j;;lYes DNa DN/A Effluent Screen cleaned? DYes DNo DN/A Was the tank pumped? jtIYes DNa Was the tank pumped? DYes DNo Condition of baffles? p1taod DNeeds Repair DNane Condition of baffles? DGoad DNeeds Repair DNane Both compartments pumped? JzjYes DNO DS/ngle Both compartments pumped? DYes DNO DSing/e 1 st Compartment 2nd Compartment 1 st Compartment 2nd Compartment Mat Depth 0- inches p) inches Mat Depth inches inches Sludge Depth / - '2 inches 1;. inches Sludge Depth inches inches .r Pump Tank (if applicable) . Tank Size: )! S. () gallons How deep is the main compartment lid? inches Tank Condition: l2Itiaod DNeeds Repair Is a riser installed to grade? DYes DNo Snec'ifu;:;rob/ems in notes if "needs rena/I" is selected Was the tank pumped? I2lYes DNa Do the on/off floats function correctly? DYes DNo DN/A Sludge Depth r;.>( I G>f inches Is the pump functioning? DYes DNa k::-. Effluent Screen cleaned? DYes DNa DN/A Does the alarm function correctly? DYes DNa DNIA NOTES ,.--" ( .. r'>. ~- (-...... L .~ ,'.... \ ., A ,......" I; 'fV' h .1"'" -./ --'-,/-: ,/ .i \ / -1 I\-~ \......-' ~"./ \.., ! L - .__,,;"'~ ,r ' '-._ Cc Gt I ;VO u -SY: {:{ rc:p'\6:-..'{' P t 0'''-' S rf f - - " \...... \j /~ ) l~ (^"1. " -t-l_."\ ~- '. t-.... /? t\ --~ ' -,'\;t ..L ( - \ -;--, / '. /:-r;;If1/J h , P /" i/ ~) / ~1 "'--.---"'''' Community Development , __,..r- _~'...,. I ,/-" ..---,.-," -:>~. './ Pump Company ))- lc V Pumper signaturt/'.......I./r // ,.// Date /7G I.-~ !^'11 :11 Ii ':.f )' /' /.- // _' "). ~7 ;'l1 (/1(",'" ./ ,'7' .. ,/ ~/ .~ ,-- _-<~r ~ _",'- J' This report indicates the condition of the above septic tanI\:Jsll'(nd/or ~lJlP-tank~,..at'fffiTime of inspection and pumping. In no way does it guarantee that it/they'will~inue to function satisfactorily. MAINTENANCE COMPANY INFORMATION L ML~Y~I SEPTIC TANK CLEANING, INC. PIERCE COUNTY KITSAP COUNTY BREMERTON SILVERDAlE POULSBO 373-0621 692-7432 779-1507 GJG HARBOR LAKEBAY 651-3432 664-5013 TACOMA 627-0626 PUYALLUP 641-7171 PORT ORCHARP 676-5629 \ CUSTOMER NAME JOB ADDRESS . C~\ ~,/ D\ \s(R \~jV\T,:~\C'-- (';~~C6() J.1AJ'D~-a..,~j/v- HIlL f{\),"-:~\ CLEANED SEPTIC TANK: APPROX TANK SIZE .I j "S" ,- GALS. LIQUID LEVEL APPEARED: 0 NORMAL 0 HIGH 0 LOW q FLOODED SEPTIC TANK DUE FOR CLEANING: 0 YES HOME VACANT: 0 YES BAFFLES INTACT: INLET O'YES 0 N9\.~ REPLACED OUTLET 0 YES 0 NO 0 REPLACED . SEPTIC TANK CONSTRUCTION: j2J' CONCRETE 0 FIBERGLASS 0 METAL PUMP SYSTEM: JZI;'ES 0 ~9...--e.YMP INSPECTED: 0 YES 0 NO 0 CUSTOMER DECLINED INFO FROM :\ '\b~!~X'"!' ! : i i ~A~ i i ! ! : i ! I HOMEOWNER -j- . ~ ~~IT"".,_w____m___^_~_.'_.m~___- "'YE~il~ui~T'" --Hi' i . i- i-T; i-I + 1-:- ! _! ! i! ' ; , ~,...........: ~,...........--+-..............-f.._"""""....~..................-+~,...............,i.....~....: : j \ j j \ \ \ i; j . . . . . . . . . . . . . . . . . . . . : \ j _~_~___.w~._..-l__..+_,,--\_-+--L ' ST YEAR PUMPED GARBAGE DISP. DYES ONO . . . , . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . , . . . . . . . . , . .+.- ~ . . . . " " r ......... .........i---~--~....,......... =tH~~htt~T+i1-h-I- ----"-".1---'--~'-- --7..-rtJ--....; =t\-'----i---i-........i..,.".-~-'---'-- \ tit i-I ~i.: +){d+1" !~~:- , +t--t--+. ;' -+-W~\J .r 'j""'1' ~.^t--~+-+-- 'l ' . . . . ,.r, i '10 J I : , ' . , ~ ~ i t-+-t+.r-~t- 0- -t,. '! . i i 'i:..' ! ,...,...,,"",....L_............_---L, j ~. . . . . . . . . . . . . . . . NO. IN FAMILY Recommend Cleaning Every .;-. :'1 Years To Prevent Failure THE TERMS AND CONDITIONS ON THE REVERSE SIDE LIMIT OUR LIABILITY AND PROVIDE GENERAL INFORMATION. PLEASE READ THEM. TIME IN TIME OUT ") ...,In,, ./ '.... SERVICEMAN N\\(' .',~b.-",-::." i.. <L, /""f) 0 f\r ..ct"t-. r-.iQ X (,)",-: ~. ,.,\~~-' '", . PROPERTY OWNER or AUTHORIZED REPRESENTATiVE REceiVED NOV 01 Z007 MAIN OFFICE ,~303 54th AVE. NW Bremerton Departme~ HARBOR, WA 98332 Community Developme Please Pay From This Invoice MASON COUNTY JEFFERSON COUNTY BELFAIR 275-7134 SHELTON 427-6262 PORT TOWNSEND 379-6646 TOll-FREE 1.600-699-7654 CITY PHONE DATE OF SERVICE (.; Ho~r ACTUAL CHARGES 10" /71'''' J. '''-''1 f' I (, '"1'/(..' ' ESTIMATE SEPTIC TANK CLEANED SEPTIC TANK CLEANING... UNCOVER TANK .... DIGGING/COVERING ........ TRUCK TIME:...@ HR, ~. .~, f'::\ I\..;jl/O::.. . " I' .-":> ...........1 ~~t..::'\ ,-/) .t('-JC., u~ (/ Cf./", ()\ '._' . _)~,_ .r /.. ( @ EXTRA GALLONS It PER GAL. /VII ) ).J I "}.O~.A( ~ '\<.j'/jf .... ,-" _. -7t'i .'-.1"'; ~'-"" ,_~ _..... ~...:.""'- 1 ....... .;v -..... " '\. \ \ \ ,. ... ,~~ \ SUB TOTAL ({ .:~ ~rl~ t~ ~dlP ~~vl' ...~., tf.iii X CUSTOMER SIGNATURE ~,-' .."'~" ..) SUB TOTAL~) .:.';<'1 (j(j TYPE OF PAYMENT [:J CASH [:J CHECK [J VISA Cl MASTERCARD Cl DISCOVER [:J PREPAID [:J BILL [:J ESCROW $40.00 RETURNED CHECK FEE c" ,.f ""b. t"'I~;TAX l-lt Of / '^. .__ , "'1 TOTAL AMOUNT DUE oU j () I ':.: . , '.'~ ,,..; .:'-.--:-._-~-~-~. T.~,\,~~"",.,;." ( .>,.... F1LE BREMER TON PEJRM%az... T C.ENTER 286 4th Stre$t,. Br;in$rton" WA 98337 Phone: ('360) 478-5275 FAX: (360) 478-5278 GRADING PERMIT -exR.~4 h. D . C/V\ 'Se .ecJi ivlS lO-;}-ot Permit No; 02-0507 Status: ISSUED Applied: 09/05/2002 Issued: 09/06/2002 Expires: 03/05/2003 Job Addr: 2380 ANDERSON HILL RD Location: ANDERSON CREEK Parcel No: Applicant: BREMERTON CITY OF/WATER UTILITY 478",2315 3027 OLYMPUS DRBREMERTON WA 98310 Owner: BREMER TON CITY OF/WATER UTILITY 478-2315 3027 OLYMPUS ORBREHERTON WA 98310 contractor:..5e l f Lie:li': Exp: Dese: GRADING FOR REMOVAL OF ACCUMULATED STREAM SEDIMENTS .............**.*......**.*...**...**._*........*...**1*.1****.**.***.**.**....*.....*.*...** Cubic Yards * Permit Fees: 54.50 Total Calculated Fee: 96.00 160.00 * Plan Check Fees: 37.00 Additional ~ees: .00 * Other Fees: 4.50 Total Permit Fee: 96.00 )!:: >>:)f( *)1:* )/(>>OlOI:)f(){()I:)I( * * ****l!: **)4()\()I()I( 11: * * **){(){()j( JI()j()I()\( *){( *)j( ** * * **)\( >>: *****:1< *)\()I( l!()t( *)I()/(::t.: llOI()I: * lli)l( **)1( * *)1( * *)1()1( *lIOIOI()I: * **)/( * * This p~Ymit shall becOl'lle null and void if the buildiru;) 01" work authod.zedby .this permit is not. COIl1rlleliCed within 1$0 days fyom the date of weh pe)'mit. 0)' if this building 0)' work authorized by such pe'(mit i.s $U$P~mded 0'( abandoned at .any time afta)' the WOy!.: is commenced 'For a peYiod of 180 days. NOl'ICE -.It:. is the i'e1!ilPonsdbility Qf the peymit holder. nQt the City of 8Yeffieyton 0)" Buildin9 Official to $t!'e to H that required il"ll$pec'l:io!1$ an- made. The permit holdey must notify the Buildi'fllZl Official when ready foy inspl!!Ctiom.Failure of the penl'lit holder to notify the 6ui.ldil"l9 Official c)'f yequiyed inspections ma)' yewlt in the stoppa9(& of the woyk until such time t.hat t~ peymlt holdey can subst.antiate to the buildil19 official that the concealed wo)'k l'1'!E'!ets Qyexce-eds Code '((;;quiYEffierl't:s. Any demolition. testirl9. 0'( flnal"K~ial buYC:len shall be bome directly by the peymit holder. FailuYe' t.o eubst.antiate code n~quiYement$ will indemnify thE- City against an)' and all yespomibHity OY liability cOl1l'1ected with the constyuction. I heni'by d~~'tifY thlat I have yead and examined this pe)'mit and know the sam(t to be hue and .coYrect. All pycl\Ilsionsof 1.u,.!$ <1lndo'r"dina,nces SlOvt<mil19 this tY'Pe of woyk will be complied with ..'hethel' $pecified heYE.'in or rot. The 9 'an't:.irIS if' a peymit ~s not pye$lJfl'lEl' t.o give authority to violate or cancel the pYovisiom~ of any othey eta 01" lotSa l'iw y~atl ~lJ(CI<Ii1$t.Y\JCtio'n 0'1" t.he peYfcmTlance of construction" -", ~/ /11. '1' _ _ .' Slgm:d::lJye: .~ Date=_ r t 0 '-_ f ' I ceyt.i fy tz:t. am ex"empt fi'OlrI t.he yequi rements of the: $t.a.t.e cc,ntY:ll,ctoY'$ '(egistn9.tion laM. undey $oction ..Ie toy 11'1/t" of 196U Signatu'((ir:. _~^.!!!~~__,^__ Dat.e:-.1..:'ft.-Q~ I \ ' ......*..*.~...*..........* / . Permit Center--Approved BY:~ /l / . "'"\ Dat e : Ci ~_iL.L::.{)J-;~ ; . .~" ",." \ If;, '. r ':'.' .~ ", , ,'ij, - ,.., ;'~ I , ~,;;,., r TON PE th street, Br 360) 478-5275 CENTER rton, WA 98337 ( 360) 478-5278 Building -ex/) wd h () ~ 'Sp<?cfi?- Ov'lS Perm! 1\ (No 9Q~ryao.7 Status: ISSUeO Issued: 09/06/2002 Expires: 03/05/2003 job AddresS$;: 2380 ANDERSON HILL RD Location: ANDERSON CREEK. Assr Acct No: R EQ U I R ED INS PEe T ION S Item: 01000 EROSION CONTROL Item: 02800 SOILS COMPACTION Item: 02700 FINAl--BLDG Dept: PUBWORKS Division: Dept: TESTING Division: Dept: BLDG Division: I I ***********************************************************************%********* TESTING: Must be recognized by the Washi ngton Association of 8uildi n9 Of'riclals SPECINSP: t"'lust be reGistered with the state of WA ST OF WA: sf~te of WA Dept. of Labor and Industries HEALTH: Bremerton/Kitsap Health District 478--4921 478-5235 , ~r l , ALL INSPECTIONS PERFORt-1ED BY THE CITY OF BREMER TON MUST BE SCHEDULED THROUGH\~HE PERMIT CENTER. (360)478~5275. . i' . . - . ' ************~*****~************************************************************** j ~~ .._JlL~ Date:~ z... _.~_~"""'...;.._: f ==::::.=:=: ~ ==.::t: r:::.:=:::= =~ . . . .===~==~====~~==~======~=========W~= '~~J 'I I 'I -ex JD Uli c(, Penni t No: 02J:0507 Y'!Y~)9~'V\,<;""p '(" ::= = ~:J::=.~'= =.~%= =r:i:::;:cr. ~ = =:= =: =='::=::=:::: =.=::: 1;r.:C; ==':e::=:::::= ==;=::; ==:t:te: = n:::=::= ~:: r:::.=:::=: =:=:=:=::::: :c:::.;=~ ~ -::::':!l\. =. '="==.' ~ =1:::::- =: == '::. =- " (;f.",(>c~ 8REMERTON P_ MIT CENTER PERMIT CONDITIONS Job Address. 2380 ANDERSON HILL RD Assr Acct No: Location: ANDERSON CREEK Applied: 09/05/2002 AppYoved: 09/06/2002 Issued: 09/06/2002 Applicant: 8REMERTON CITY OF/WATER UTILITY Owner: BREMERTON CITY OF/WATER UTILITY Contractor': Description: GRADING FOR REMOVAL OF ACCUMULATED STREAM SEDIMENTS Conditions: 1. L~ND USE CONDITIONS OF APPROVAL: '7 l'h, A) FOLLOW DNR GUIDELH,IES THAT ARE INDICATED IN HYDRAULIC PROJECT APPROVAL. p,:r~ Holder's Jt/L,#! U/I 5 1. 9 Ii a t\.l* e ,_-----..______---"-_--w-_._~ . JI,'i!# , 'iI ,f Date r~.tf - ~2- f j, . ' i{jk} CITY OFBREMERTONO ~ - () 507 DEP.A.R..-rMENT OF COMM'UN"ITY DEVELOPMENT .. REQUEST FOR COMMENTS DATE: 07/25/2002// STAFF CONTACT: ****************************************************************************************** APPLICANT: CAHALL KATHLEEN/PUBLIC WKS 3027 OLYMPUS DRIVE BREMERTON WA 98310 PROJECT NO: PL02-0044 LOCATION: ANDERSON CREEK ENCLOSURES: PROPOSED PROJECT AND ACTION: REMOVAL OF ACCUMULATED SEDIMENTS FROM ANDERSON CRK ****************************************************************************************** Please review and comment on this proposed action in respect to your department's activities and resJonsibilities. Your reply will become part of the record for consideration at tle Planning Commission/City Council meeting scheduled for 00/00/0000. Please address the following concerns in your comments. as appropriate. Use the back or additional pages. 1. Identified problems (related to your specific responsibilities). 2. Specific requirements. standards. or regulations that will apply to this proposal. 3. Other comments or recommended conditions from your department to address specific problems or issues. Please be as specifi~ as possible. **************************************************************************************** * Completed by: * * Name: Date: * * * * Title: * * * * Agency: Please return this form by: 00/00/0000 * * * **************************************************************************************** PUBLIC WORKS & UTILITIES Water Resources Division \ D . J1 ~~~\W~~ I' If i : C) 4: 2002 jJ '-''-'_ r... ::.; BREMERiON BUILDING DEPARTMENT ~:" "'Ir:J:' ,,J r,tHf Ctl"l\' 0' P/ltGII'1AffPl,PPlfOlffUNltci' 'r i ,,' l' c" TO: FROM: DATE: RE: Adrianne Ralph, Planner Kathleen Cahall, Water Resources Manager iNJV July 24, 2002 SEPA Checklist Submittal for Anderson Creek Sediment Removal The Public Works and Utilities Department Water Resources Division operates a water intake and fish ladder on Anderson Creek. Maintenance activities are covered by Hydraulic Project Approval #00-92-02 issued by the Department of Fish and Wildlife. Removal of accumulated sediments is now needed. This maintenance is to be completed before September 15, 2002 and is expected to take about two days to complete. Since the amount to be removed is greater than 50 cubic yards (it is estimated to be about 160 cubic yards) a SEPA review is required. Attached is a completed check list for this project. Please call me at x2315 if you need more information. "'''''-'. .................... ...~.-.......- jI~~~j!r~~: ~~J~I~~ -.:::::;.:::=::;: ::::i:::=;:;:;: .-..-.... ....--.. ;:.}::=:::\ "':::~::::::::: _n.... ._...._ ....-.....?... .......".....- ::-:-:.;->:-:-' -:-):-:-:.;-: ~~ PERMIT CENTER rJ'" l~ CC; ~ 0 Wi ~ 1-=\, , I '..'. ;0 ~ 1 .nu f': r;, '10 200? I..) i u "V~r... ... L.I BREMERTON BUilDING DEPARTMENT Department of Community Development * 286 4th Street * Bremerton * WA * 98337 (360) 478-5275 * Fax (360) 478-5278 WAC 197-11-960 Environmental checklist. ENVIRONMENTAL CHECKLIST Purpose of checklist: The State Environmental Policy Act (SEPA), chapter 43.21C RCW, requires all gOvernmental agencies to consider the environmental impacts of a proposal before making decisions. An environmental impact statement (EIS) must be prepared for all proposals with probable significant adverse impacts on the quality of the environment. The purpose of this checklist is to provide information to help you and the agency identify impacts from your proposal (and to reduce or avoid impacts from the proposal, if it can be done) and to help the agency decide whether an EIS is required. Instructions for applicants: This environmental checklist asks you to describe some basic information about your proposal. Governmental agencies use this checklist to determine whether the environmental impacts of your proposal are significant, requiring preparation of an EIS. Answer the questions briefly, with the most precise information known. or give the best description you can. You must answer each question accurately and carefully, to the best of your knowledge. In most cases, you should be able to answer the questions from your own observations or project plans without the need to hire experts. If you really do not know the answer, or if a question does not apply to your proposal. write "do not know" or "does not apply." Complete answers to the questions now may avoid unnecessaty delays later. Some questions ask about governmental regulations, such as zoning, shoreline, and landmark designations. Answer these questions if you can. If you have problems, the governmental agencies can assist you. The checklist questions apply to all parts of your proposal, even if you plan to do them over a period of time or on different parcels of land. Attach any additional information that will heir describe your proposal or its environmental effects. The agency to which you submit this checklist may ask you to explain your answers or provide additional information reasonably related to determining if there may be significant adverse impact. Use of checklist for nonproject proposals: Complete this checklist for nonproject proposals, even though questions may be answered "does not apply." IN ADDmON, complete the SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (part D). For nonproject actions, the references in the checklist to the words "project." "applicant," and "property or site" should be read as "proposal, If "proposer, If and "affected geographic area, " respectively. A. BACKGROUND 1. Name of proposed project, if applicable: Removal of Accumulated Sediments from Anderson Creek 2. Name of applicant: City ofBremerton Public Works and Utilities Water Resources Division WAC (4/15/98) [CH. 197-11- WAC-Po 53-64] , ' TO BE COMPLETED BY APPLICANT 3. Address and phone number of applicant and contact person: Kathleen Cahall, Water Resources Manager 3027 Olympus Drive Bremerton, W A 98310 360-478-2315 4. Date checklist prepared: July 24, 2002 5. Agency requesting checklist: City ofBremerton Department of Community Development 6. Proposed timing or schedule (including phasing, if applicable): Per the HP A from the Department of Fish and Wildlife. the sediments accumulated in Anderson Creek must be removed before September 15, 2002. 7. Do you have any plans for future additions, expansion, or further activity related to or connected with this proposal? If yes, explain. The City has plans to modify the fish ladder to reduce accumulation of sediments. 8. List any environmental information you know about that has been prepared, or will be prepared, directly related to this proposal. None directly related to this proposal. 9. Do you know whether applications are pending for governmental approvals of other proposals directly affecting the property covered by your proposal? If yes, explain. None directly related to this proposal. 10. List any government approvals or permits that will be needed for your proposal, if known. There is already a HP A for this project. 11. Give brief, complete description of your proposal, including the proposed uses and the size of the project and site. There are several questions later in this checklist that ask you to describe certain aspects of your proposal. You do not need to repeat those answers on this page. (Lead agencies may modify this form to include additional specific information on project description.) The City operates a fish ladder on Anderson Creek. The accumulated sediments are removed annually. If the amount of these sediments exceeds 50 cubic yards, then a SEPA must be filed. An estimated 160 cubic yards needs to be removed. It will take approximately 2 days to complete. 12.Location of the proposal. Give sufficient information for a person to understand the precise location of your proposed project, including a street address, if any, and section, township, and range, ifknown. If a proposal would occur over a range of area, provide the range or boundaries of the site(s). Provide a legal description, site plan, vicinity map, and topographic map, if reasonably available. While you should submit any plans required by the agency, you are not required to duplicate maps or detailed plans submitted with any permit applications related to this checklist. Please see attached map. 2380 Anderson Hill Road SW Port Orchard, W A 98366 WAC (5/15/98) Page 2 [Chapter 197-11-WAC - P.5-64] TO BE COMPLETED BY APPLICANT % SECTION SECTION TOWNSHIP RANGE NE 33 24N O1E 47031' 26" lat 122040' 58" long B. ENVIRONMENTAL ELEMENTS 1. Earth a. General description of the site (circle one): Flat, rolling, hilly, steep slopes, mountainous, other... EVALUATION FOR AGENCY USE ONLY The area to be worked in is fairly flat. b. What is the steepest slope on the site (approximate percent slope)? 1 - 3%. c. What general types of soils are found on the site (for example, clay, sand, gravel, peat, muck)? If you know the classification of agricultural soils, specify them and note any prime farmland. Clay and sand. d. Are there surface indications or history of unstable soils in the immediate vicinity? If so, describe. Not related to the work being performed. e. Describe the purpose, type, and approximate quantities of any filling or grading proposed. Indicate source of fill. None. f. Could erosion occur as a result of clearing, construction, or use? If so, generally describe. Not related to the work being performed. g. About what percent of the site will be covered with impervious surfaces after project construction (for example, asphalt or buildings)? None. h. Proposed measures to reduce or control erosion. or other impacts to the earth. if any: None needed. 2. Air EVALUATION FOR AGENCY USE ONLY WAC (5/15/98) Page 3 [Chapter197-11-W AC - P. 5-64] TO BE COMPLETED BY APPLICANT a. What types of emissions to the air would result from the proposal (i.e., dust, automobile, odors, industrial wood smoke) during construction and when the project is completed? If any, generally describe and give approximate quantities if known. Minor amounts of exhaust from a diesel backhoe will be generated for two days. b. Are there any off-site sources of emissions or odor that may affect your proposal? If so, generally describe. No. c. Proposed measures to reduce or control emissions or other impacts to air, if any: None needed. 3. Water a. Surface: 1) Is there any surface water body on or in the immediate vicinity of the site (including year-round and seasonal streams, saltwater, lakes, ponds, wetlands)? If yes, describe type and provide names. If appropriate, state what stream or river it flows into. Yes - the work will be performed in Anderson Creek according to the hydraulics permit. 2) Will the project require any work over, in, or adjacent to (within 200 feet) the described waters? If yes, please descn"be and attach available plans. Yes - the work will be performed in Anderson Creek according to the hydraulics permit. 3) Estimate the amount of fill and dredge material that would be placed in or removed from surface water or wetlands and indicate the area of the site that would be affected. Indicate the source of fill material. Approximately 160 cubic yards of accumulated sediments will be removed and deposited upland beyond the high water line. 4) Will the proposal require surface water withdrawals or diversions? Give general description, purpose, and approximate quantities ifknown. During work, the stream flow of about 3 cfs will be diverted around the work area to re-enter downstream. No water withdrawals will be needed. EVALUATION FOR AGENCY USE ONLY WAC (5/15/98) Page 4 [Chapter 197-11-WAC - P.5-64] TO BE COMPLETED BY APPLICANT 5) Does the proposal lie within a loo-year floodplain? If so, note location on the site plan. Yes. 6) Does the proposal involve any discharges of waste materials to surface waters? If so, descnbe the type of waste and anticipated volume of discharge. No. b. Ground: 1) Will ground water be withdrawn. or will water be discharged to ground water? Give general description, purpose, and approximate quantities if known. No. 2) Describe waste material that will be discharged into the ground from septic tanks or other sources, if any (for example: Domestic sewage; industrial, containing the following chemicals. . . ; agricultural; etc.). Descnbe the general size of the system, the number of such systems, the number of houses to be served (if applicable), or the number of animals or humans the system(s) are expected to serve. No. c. Water runoff (including stormwater): 1) Describe the source of runoff (including storm water) and method of collection and disposal, if any (include quantities, ifknown). Where will this water flow? Will this water flow into other waters? If so, describe. Not applicable. 2) Could waste materials enter ground or surface waters? If so, generally describe. Some sediment could be stirred up during the removal process; however, equipment will be operated to minimize turbidity. d. Proposed measures to reduce or control surface, ground, and runoff water impacts, if any: None needed. EVALUATION FOR AGENCY USE ONLY 4. Plants a. Check or circle types of vegetation found on the site: ./ deciduous tree: alder, maple, aspen, other ./ evergreen tree: fir, cedar, pine, other ./ shrubs ./ grass pasture crop or grain wet soil plants: cattail, buttercup, bullrosh, skunk cabbage, other WAC (5/15/98) Page 5 [Chapter 197-11-WAC- P.5-64] TO BE COMPLETED BY APPLICANT water plants: water lily, eelgrass, milfoil, other other types of vegetation b. What kind and amount of vegetation will be removed or altered? No vegetation will be removed or altered. c. List threatened or endangered species known to be on or near the site. No threatened or endangered plants are known to be at the site. d. Proposed landscaping, use of native plants, or other measures to preserve or enhance vegetation on the site, if any: None needed. 5. Animals a. Circle any birds and ~nim~ll; which have been observed on or near the site or are known to be on or near the site: b. List any threatened or endangered species known to be on or near the site. Chinook may utilize the lower reaches and nearshore area of Anderson Creek which are down stream of sediment removal site. c. Is the site part of a migration route? If so, explain. No. d. Proposed measures to preserve or enhance wildlife, if any: Water will be diverted around the work site. EVALUATION FOR AGENCY USE ONLY 6. Energy and natural resources a. What kinds of energy (electric, natural gas, oil, wood stove, solar) will be used to meet the completed project's energy needs? Describe whether it will be used for heating, manufacturing, etc. Diesel powered backhoe will be used. b. Would your project affect the potential use of solar energy by adjacent properties? If so, generally descn"be. Not applicable. c. What kinds of energy conservation features are included in the plans of this proposal? List other proposed measures to reduce or control energy impacts, if any: None needed. WAC (5/15/98) Page 6 [Chapter 197-11-WAC - P.5-64] TO BE COMPLETED BY APPLICANT 7. Environmental health a. Are. there any environmental health hazards, including exposure to toxic chemicals,.risk of fire and explosion, spill, or hazardous waste, that could occur as a result of this proposal? If so, describe. No. 1) Oescn'be special emergency services that might be required. Nothing special will be needed. 2) Proposed measures to reduce or control environmental health hazards, if any: None needed. b. Noise 1) What types of noise exist in the area which may affect your project (for example: traffic, equipment, operation, other)? None that affect this project. 2) What types and levels of noise would be created by or associated with the project on a short-term or a long-term basis (for example: traffic, construction, operation, other)? Indicate what hours noise would come from the site. Just the noise of the backhoe operation. The area is not residential. 3) Proposed measures to reduce or control noise impacts, if any: None needed. EVALUATION FOR AGENCY USE ONLY 8. Land and shoreline use a. What is the current use of the site and adjacent properties? Water supply operations. b. Has the site been used for agriculture? If so, describe. No. c. Describe any stroctures on the site. Water pump station, fish ladder, and one residence. d. Will any structures be demolished? If so, what? No. e. What is the current zoning classification of the site? Utility Lands. f. What is the current comprehensive plan designation of the site? Utility Lands. WAC (5/15/98) Page 7 [Chapter 197-11-WAC - P.5-64] TO BE COMPLETED BY APPLICANT g. If applicable, what is the current shoreline master program designation of the site? CS-ll Utility Lands. h. Has any part of the site been classified as an "environmentally sensitive" area? If so, specify. The site of the worle is near the City ofBremerton Anderson Creek WeUfield; however, worle will not impact the weUfield i. Approximately how many people would reside or work in the completed project? None. j. Approximately how many people would the completed project displace? None. k. Proposed measures to avoid or reduce displacement impacts,. if any: None needed. 1. Proposed measures to ensure the proposal is compatIble with existing and projected land uses and plans, if any: Project is needed to endure area can continue to be used for Water Utility purposes. EVALUATION FOR AGENCY USE ONLY 9. Housing a. Approximately how many units would be provided, if any? Indicate whether high, mid- dle, or low-income housing. None. b. Approximately how many units, if any, would be eliminated? Indicate whether high, middle, or low-income housing. None. c. Proposed measures to reduce or control housing impacts, if any: None needed. 10. Aesthetics a. What is the tallest height of any proposed structure(s), not including antennas~ what is the principal exterior building material(s) proposed? Not applicable - no structures are involved in this project. b. What views in the immediate vicinity would be altered or obstructed? None. c. Proposed measures to reduce or control aesthetic impacts, if any: WAC (5/15/98) Page 8 [Chapter 197-11-WAC- P.5-64J TO BE COMPLETED BY APPLICANT None needed. 11. Light and glare a What type of light or glare will the proposal produce? What time of day would it mainly occur? None. b. Could light or glare from the finished project be a safety hazard or interfere with views? No. c. What existing off-site sources of light or glare may affect your proposal? None. d Proposed measures to reduce or control light and glare impacts. if any: None needed. WAC (5/15/98) Page 9 [Chapter 197-11-WAC - P.5-64] TO BE COMPLETED BY APPLICANT 12. Recreation a. What designated and informal recreational opportunities are in the immediate vicinity? None are allowed. b. Would the proposed project displace any existing recreational uses? If so, descnbe. No. c. Proposed measures to reduce or control impacts on recreation, including recreation op- portunities to be provided by the project or applicant, if any: None needed. 13. Historic and cultural preservation a. Are there any places or objects listed on, or proposed for, national, state, or local preservation registers known to be on or next to the site? If sO, generally describe. No. b. Generally describe any hmdmarks or evidence of historic, archaeological, scientific, or cultural importance known to be on or next to the site. None. c. Proposed measures to reduce or control impacts, if any: None needed. 14. Transportation a. IdentifY public streets and highways serving the site, and describe proposed access to the existing street system. Show on site plans, if any. See attached map. Access will be from Anderson Hill Road. b. Is site currently served by public transit? If not, what is the approximate distance ~. the nearest transit stop? This area is not served by public transit. c. How many parking spaces would the completed project have? How many would the project eliminate? Not applicable. d. Will the proposal require any new roads or streets, or improvements to existing roads or streets, not including driveways? If so, generally describe (indicate whether public or private). No. WAC (5/15/98) Page 10 [Chapter 197-11-WAC - P.5-64] EVALUATION FOR AGENCY USE ONLY TO BE COMPLETED BY APPLICANT EVALUATION FOR AGENCY USE ONLY e. Will the project use (or occur in the immediate vicinity of) water, rail, or air transportation? If so, generally descn1>e. No. f. How many vehicular trips per day would be generated by. the completed project? Ifknown. indicate when peak volumes would occur. None will be generated. g. Proposed measures to reduce or control transportation impacts, if any: None needed. 15. Public services a. Would the project result in an increased need for public services (for example: fire pro- tection, police protection, health care, schools, other)? If so, generally descn1>e. No. b. Proposed measures to reduce or control direct impacts on public services, if any. None needed. 16. Utilities a. ~irc~~. ntlyavailable: 1~~natornI ~refuse serv- lce,~ samtmy sewer€c syste 0 . b. Describe the utilities that are proposed for the project, the utility providing the service, and the general construction activities on the site or in the immediate vicinity which might be needed. None needed. C. SIGNATURE The above answers are true and complete to the best of my knowledge. I understand that the lead agency is relying on them to make its decision. Signature:.....~..~........................................................................................................ Date Submitted: ..~.~.~..~t?5............................................................................................................ WAC (5/15/98) Page 11 [Chapter 197-11-WAC - P.5-64] TO BE COMPLETED BY APPLICANT EVALUATION FOR AGENCY USE ONLY d. SUPPLEMENTAL SHEET FOR NONPROJECT ACTIONS (do not use this sheet for project actions) Because these questions are very general, it may be helpful to read them in conjunction with the list of the elements of the environment. When answering these questions, be aware of the extent the proposal, or the types of activities likely to result from the proposal, would affect the item at a greater intensity or at a faster rate than if the proposal were not implemented. Respond briefly and in general terms. I. How would the proposal be likely to increase discharge to water; emissions to air; pro-duction, storage, or release of toxic or hazardous substances; or production of noise? Proposed measures to avoid or reduce such increases are: 2. How would the proposal be likely to affect plants, anima!!:, fish, or marine life? Proposed measures to protect or conserve plants, animals, fish, or marine life are: 3. How would the proposal be likely to deplete energy or natural resources? Proposed measures to protect or conserve energy and natural resources are: 4. How would the proposal be likely to use or affect environmentally sensitive areas or areas designated (or eligtble or under study) for governmental protection; such as parks, wilderness, wild and scenic rivers, threatened or endangered species habitat, historic or cultural sites, wetlands, floodplains, or prime farmlands? Proposed measures to protect such resources or to avoid or reduce impacts are: WAC (5/15/98) Page 12 [Chapter 197-11-WAC- P.5-64] TO BE COMPLETED BY APPLICANT 5. How would the proposal be likely to affect land and shoreline use, including whether it would allow or encourage land or shoreline uses incompatible with existing plans? Proposed measures to avoid or reduce shoreline and land use impacts are: 6. How would the proposal be likely to increase demands on transportation or public services and utilities? Proposed measures to reduce or respond to such demand(s) are: 7. Identify, if possible, whether the proposal may conflict with local, state, or federal laws or requirements for the protection of the environment. WAC (5/15/98) Page 13 [Chapter 197-11-WAC- P.5-64] EVALUATION FOR AGENCY USE ONLY " ~/ " CITY OF BREMERTON INTERFUND TRANSFER \.: \ . CITY DEPARTMENTS ONLY DATE September 9, 2002 T COMPLETE THIS FORM IN DUPLICATE AND RETURN TO ACCOUNTS PAYABLE ,,-.. 1 TO oeD FROM Water Utilities DESCRIPTION TOTAL $96.00 1 1 Permit ~02-0507 'Includes: 1100 1500 2000 Building Plan Check Fee Grading Permit Fee State of WA Surcharge $37.00 $54.50 $4.50 Attn: Kathleen Cahall - Water Utility 478-2315 Project #45102 ~ ACCOUNT PROJECT 16.329.000 (2211) 643-237.13 ACCOUNT 91.50 4.50 ACCOUNT PROJECT ACCOUNT 96.00 (Sign Here) REVE (Sign Here) EXPENDITURE DEPARTMENT SUPERVISOR , , -, f " PERMIT CENTER Id: ACTP135D Keyword: AACT User: COUNTER 09/05/02 Activity Maintenance - Fee Item Summary. Permit No=02-0507 Applicant: BREMERTON CITY OF/WATER UTILITY Status: PENDING Address: 2380 ANDERSON HILL RD I NJ"'fi\Jff'1j\JfI\}fl1i'1HMHMHHHMNMMMMHNI111M"'fi'1I'1MNHHMMHMMHMHHMl'1H/'111!1H""I'1NMHMl1Hj\}fMf-'fMI1N!1MNHMI1MHNMI111HfrWI ;' Calculated Fees: 96.00 Total Fees: 96.00= ;' Additional Fees:. .00' Pa)lments: ~e~' : Tota.l Fees: 96.00 Balance: /'96.00= HMM.f.'IMMMt1fo1.t>1HHHM"'fHHMt1Hl'1NMMNHHHHHHHMf"'fN.MHHHHHfrfHMMNNHMMMHI"INHHHMNMH"'fNMl"'fl'1HfY//1MH~MM!'!/I4MM . .' 1 I"fMHHH/'1M/'1MM"'f/'1HflINfrIMMHMI'1I1f1MI'1MMMt1J'1MMHMMMMMMMMMMHMMI'1MMMl'1t1t1HMHMI'1MM!1HJ\I/MMMMMMMHJY~M; . . . Item Oeser iption Fee Payments Balance: GDDODDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDDODDDDDDDDDDDD6 1100 BUILDING PLAN CHECK FEES 37.00 37.00: 1500 GRADING PERMIT FEES 54.50 54.50: 1700 BLDG REINSPECTION FEES 2000 STATE OF WASURCHARGE 4.50 4.50: 2200 PRINTING & DUPLICATING : .HMt1I'1MM.MI1HMHMMMfYIMMJV,fMMJ'1MJYfJ"/t1Mf1f'1f'1Ni'1HHMMMI"IMMi'1MMM/'"Il'1i"'fI'1MNHi'1NMNNJ'1!1f'''.If1MMMNHMf1!1HMMMMHI1MMMMM ( ESC:::;:New Option '1;;/ ; '>h ~(: ,;j:",': ) . ,0 ~ 'I S V1\.-:-:- e...'.....'..;,..I.f )~.........tl. CI/. . (.,", C" ~ t ~Me.. '(;JclJu" /-1, (J r- 2J.e cr 4t- , . . 4S I 0 ~ Itv fud-M :e el) ~l? - S r''t . r ." . C cZi\a{( ---~'-~~~1~1<':S . Building Permit Application City of Bremerton, WA 98337 Phone: (360) 478-5275 Fax: (360) 478~527~ 00-0501 coi:-/1 _ ~ 1. APPLICAJ.'IT: ~OWNER DCONTRACTOR DAUTHORIZED AGENT : O\vner: T:1X .\ccount =:-';umber: 3aa:c-lOt -.3 - O~3 -QUlOSI I I tv/ft , ; Expir3.uon Date: I jJ j It. , (onu:lcwr License;:;:; . Contact Person: ~Cl.i'+<1If't~ C~ i COnt3.ct Phone#; J.l7S - 0\ 01 s;- Check the type of application for below: o SF RESIDENTIAL NEW 0 COMMERCIAL NEW o DCPLEX 0 COMl\tlERCIAL REl\tl0DEL o NL\J.'ffiFACTURED HOME 0 COMMERCIAL ADDITION o RESIDENTIAL REMODEL 0 COMMERICAL REPAIR o RESIDENTIAL ADDITION 0 :\t!ULTI-FA.l.vlILY o RESIDENTIAL REPAIR 0 TENANT IMPROVEMENT o GARAGE o ACCESSORY BLDG o SIGN o DEMO---- $GRADING (Cubic yards: 'lAD o OTHER: Scope of Work Proposed: K-emov& o-F QCCt.t vYW.ld.uI~Am ~ m-e~ a:J- f"r.Ild.u6ffr1 ~ e K. )tr tt p J4. . Sf.(>~~ ~'/~ DN~ Square Footage: Dwelling: &.pt. /2../ zooz. kill- Decks: NIl! Garage: IS THIS PROPERTY WITHIN 200 FEET OF .-\. SHORELINE? YES/' NO Valuation I Plan Review Fee Permit fee Surcharges i Enez!,). S:::O.98 '. ! State: 3 -+.50 . r.':Total-Fees g ~ ?f?-~ Applic:l.tions for which no permit is issued within 180 days following the date of application shall expire by limitation, .IUd p!J.ns and other data submitted for review m:lY thereafter be returned to the applicant or destroyed by the building official. The bUlldin~ official may extend the time for action by the applicant for .1 period not exceeding 180 days on request by the applicant'5ho\v1n~ that circumstances beyond the control of the applicant have prevented action from being taken. No applicant shall be <:xtend<:d 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. APPLICAJ.'J"T'S SIGNATURE: dlLJI!.I1Uf . C-' " 1';-;: (Q'.~.l I':(:~j U'i II j),;,;;:, f-d Ii? ; e. ! \'/1 Ie: Ul .t..:;:;!. -" --, \J '.." '-'I qi U <..h DATE: Ifu~Jt1':;'002 BREMERTON BUILDiNG DEPAHTMENT