HomeMy WebLinkAboutANOKA AVE., 135
,ePERMIT , e
CITY OF BREMERTON BUILDING DEPARTMENT
PHONE: 478-5281
JOB ADDRESS
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OWN,E~, ' "M,A,.ILADDRE"SS
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Class of work: ~, DADDITION~ ALTERATION
ZIP
PHONE
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')(REPAI R
LICENSE NO, '
o MECHANICAL
o PLUMBING
CHIMNEY (No fee information only)
Masonary Lines' Unlined
Factory Mfg Type B Type L
, Location: Internal Outside Wall
INSPECTION: Groundwork
Wasted Vents
Htg. Ruffin
Stove or Insert
Gas Test
Water
Chimney
Refrig.
No.
Type of Equipment
Fee
No.
Type of Fixture or Item
Fee
-.!:/..b.. l) 0,
3b 00_
-Y...2::... t) '0
STOVES Gas_ Oil_ Wood_
FIREPLACE INSERT
FURNACE Gas (Nat._ LPG,_) Oil~
Wood add on ~ Other_ Electric_
BTU
Type: Up flow__ Down flow_
Horizontal_ Wall_
CONVERSION BURNER: Gas_(Nat._ LP_)
Under 100,000_ Over 100,000_
OiL-
UNIT HEATERS BTU_ Gas_ Elec,~'
BOILER Gas_ Oil_ Electric~
Other_ H P_
GAS SYSTEM Max. 5 outlet Total_
EVAPORATION COOLERS Roof_ Wall_
BTU_
AC UNIT Electric_ Gas Elec, Combo
BTU_
HEAT PUMP Single Package_ SpliL-
Add on_ BTU Ton_
MIXING OR REHEAT BOX CFM_ BTU_
AIR HANDLING UNIT CFM_ BTU_
FANS ExhaUSL-- Supply~ Bath_
RANGE HOOD Residential_ Comm._
CLOTHES DRYER Res._ Comm.__
Incinerator
ALTERATION TO DUCT SYSTEM
Heating/Cooling_ ExhausL-
TANKS Oil_ Gas_ Propane wlOK
from Fire Dept._ Gallons_
REFRIGERATION UNIT
/2-WATER CLOSET (TOILET)
/2-. BATHTUB
(z..-,LAVATORY (WASH BASIN)
SHOWER
/'2.-I<ITCHEN SINK & DISP.
DISHWASHER
LAUNDRY TRAY
CLOTHES WASHER
/LWATER HEATER
URINAL
DRINKING FOUNTAIN
FLOOR - SINK OR DRAIN
SLOP SINK
WATER PIPING & TREATING EQUIP.
WASTE INTERCEPTER (Grease)
VACUUM BREAKERS &BACKFLOW DEVICE
LAWN SPRINKLER SYSTEM
SWIMMING POOL - Private Public
GROUNDWORK
SUMP
ALTERATION
POST & BEAM
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PERMIT $ -----:i 5 0
TOTAL $/7'1' So
PERMIT $
TOTAL FEE $
NOTICE
THfs PERMIT BECOMES NULL AND VOID IF WORK ORCONSTRUCTION AUTHOR-
IZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF CONSTRUCTION OR WORK IS
SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER
WORK IS COMMENCED,
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND
KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND
ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHE-
THER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRE-
SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY
OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFOR-
MANCE OF CONSTRUCTION,
FINAL APPROVAL
9'-/3---8
{DATE}
(SEE OTHER SIDE)
RECEI PT NO.
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE)
PERMIT NO. ~
(White-OR I GINA L, Yellow-I NSPECTOR, Pink-APPLI CANT)
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5471
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City of,;Brem.erton,Wash:i,ng:tgrl
Phone: (2Cl61478-528',1
OWN'BR'S I1i%U!JE -
1..10 eO,
$ 1400
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PHONE
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,IX REPAliR
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STOBI!ES
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AU Pr!!l~isio~s pf laws antll ordi~~ticesi0VerllljAgfli1iS typeiof w~rk wil,i be compl ie!ll witli1whel~er speeifie~ herein or not. Tt;Ie ~ranH~!l af aper~Ii\;t!loe~ not ~r~$\;Im~
togive <Il!ltl1loJ11tY to .,.ir0J at8:'Qf, caJilcel ttile ,pro'lii:Si 0"s'Of ,anYQlher$tateli1,r ,local law rE!gul'a:tingcor;HiltrU!;lti!!li:lo~ the pefforn:)anceCilfcon~truction..
liNSP~CTI.oNS :AEQUIIRED; Foulil(latiiOnO Fram;ing I)l Plumb'lng'O EI(1ictrical 0 Wa1'lboard 0 ;FiIN~L )t
SEPAJRATE !PERMITS AiR~ :REQUIReD (WMER'E APPLICABLEjF'ORPLUMB'I'N,G. ~ECHANICAL AND ELECTRICAL
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ReINSPECTION:
FOR tNSPECTORSllI$EOM:LV:
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nPE OF INSPECT/.ON IilA]:1\! 11IME ~PPROVeD APPROVED
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COMMENT DATE, l'IME APPRo.VED
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