HomeMy WebLinkAboutAPPLE ST., 219-21
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CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
"
FILE
PERMIT NUMBER
DATE ISSUED: 1.._Jlll..II
286 Fourth SI. Bremerton, WA 98337
(360) 478-5275 Fax: (360) 478-5278
ASSESSOR NUMBER:
APPLICANT NAME:
OWNER NAME:
CONTRACTOR:
LENDER NAME:
ZONING:
PHONE:
PHONE:
PHONE:
PHONE:
(360)275-3852
SITE ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
223 APPLE ST
331 NE MCWilLIAMS CT
331 NE MCWilLIAMS CT
3964-000-113-0002
FITZGERALD FAMILY LMTD PARTS
FITZGERALD FAMILY LMTD PARTSI
GR WILSON & ASSOC
DR
SUBMITTED:
04/23/2004
APPROVED:
EXPIRATION:
11/03/2004
VALUATION:
Demolition Fee
$50.40 2218
$4.50 0236
DEMOLISH A DUPLEX & GARAGE
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
(360) 473-5870
(360) 415-4000
Fire Inspections
HID: Bremerton, Kitsap County Health District
PW: Department of Public Works
(360) 473-5380
(360) 337-5285
(360) 473-5270
This permit shall become null and void if the building or work described and authorized by this permit has not commenced within 180 days from the date of issuance, or if this building or
work is suspended or abandoned at any time after the work is commenced for a period of 180 days. Obtaining inspections at intervals not exceeding 180 days identifies that work has not
been suspended. 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 localloaw regulating
construction or the 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.
PRINTED NAME:
DATE:
'/, ~(;'O
I have read, and agr~o abi
SIGNATURE OF OWNER'6
AGENT:
CONDITIONS
City of ...merton's app",val of ",is application pertaIns only to the City's ..gulato'Y lu,isdiction, and thus compliance Wi~ C. .i.'.t~yy. .r/.
regulations does not necessarily ensure compliance with federal or state laws. C II )f~ .")
1. DCD: Prior to performing any renovation or demolition work, Puget Sound Clean Air Agency (Clean Air Agency) and It.-I: I
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 I'
be ?onducted by and EPA-certified (AHERA) building inspector (except renovation or owner-occupied single family "'i~t '\
residences). <"-1/ I A )'
2. DCD: For more information, please contact Clean Air Agency through their web site at www.cleanair.org or by / (.,./ (j
phone at 800-552-3565 or 206-689-4058. The L&I web site can be found at WWW.lnLWa.90V/P-.a,.1" . ('
ts/asbestos/asbestos.htm. f)('
3. ANY WORK DONE IN THE RIGHT-OF-WAY SHALL REQUIRE A RIGHT-OF-WAY PERMIT. '; ~
Page 1 of 2
;I'
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER
DATE ISSUED: ~~fi_lllllllll
286 Fourth SI. Bremerton, WA 98337
(360) 478-5275 Fax: (360) 478-5278
3964-000-113-0002
FITZGERALD FAMILY LMTD PARTS
FITZGERALD FAMILY LMTD PARTSI
GR WILSON & ASSOC
ZONING:
PHONE:
PHONE:
PHONE:
PHONE:
(360)275-3852
SITE ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
223 APPLE ST
331 NE MCWILLIAMS CT
331 NE MCWILLIAMS CT
ASSESSOR NUMBER:
APPLICANT NAME:
OWNER NAME:
CONTRACTOR:
LENDER NAME:
DR
SUBMITTED:
04/23/2004
APPROVED:
EXPIRATION:
11/03/2004
MINIMUM INSPECTIONS REQUIRED
Inspection requests must be received by 8:00am in order to be scheduled for same day. To request an inspection, please call (360) 478-5275 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
Ma~ 05 04 03:27p
Engineering Division
360-478-5398
p.l
't.
Post-it' Fa){ Note 767'1
To "'ii~'/'~;';I ;f-_
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CO.lO~!;:.~D
Phone #
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Phone!! ':473,-5.73' _ .
Fax#. . __J
'pax-#"- S..I70'
PUBLIC WORKS AND UTILI11ES
__n_'___ ENGlNEERINq,~~2~_.
3027 Olymplls Drive' B.'emerton, WA 9831 O-~,799 . (360) ~.. FAX (360) 4.7;3-'.5B-tB-
J~DDRESS FORM
J .3
(360,1 47R-527C, E-L,( (3611) 47$-5398
J(NEW ADDRESS"-'~)LCH;;~GE ADDRESS---
APPLICANT INFORMATION
/: ".. L '~II ", C('Ll:
DATE: _..__~..I):~!.:;.i_....:~.._....J..:-:- - I
NAME: Flt-:~~i!Jd h:-"lIVl,J.v._h~i.1fd_t1,dl'\C,,:;h~ r PHONE: :3L:Q: 'S.1.L__l.i~lQ.___
ADDRES<:C' "::r~.Ji ~I F. iVl~c'.,/V' \II'.'.~"'A~ e.+, FAX: ?ir('.'J-)-J7C1... <{'?":4/\
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CITffS;r}~TEjZIP: --.f~.-t-r"1fJ:,.;k~_\4 A CfS~;; I
K1TSAP COUNTY PROPERTY LD, NO. (FOH LOTTO 8E ADDRESSED): "",/.,.0:. &> SoP'::> 7; \lo~ I. .)
~...a ... _ '-" 11-\.:rr:::,~.IS.~",-L:-__...
PLE.,l.SE ORA WA-DIAGRAM OF~/OUR ~: ifijC[:J6iNGADORES'SES OF NEIGHBORS. ORAV'i'DfWEVi:~\~i':;5cA T;oi~ P,ND
SnOW STREET NAME THAT DRiVEWAY ACCESSES. INOICATE WHiCH DIRECTION IS NORTH.
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ReviSf:C: 12/28199
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BREMERTON
t3UILOING DEPARTMENT
BREMERTON MUNICIPAL UTILITIES '.
3027 Olympus Drive
Bremerton, Wa983.1O-4799
(3pO)473-5270
l::,SMERTOj\J CITY.TREASURER
0854A 10
SERVICE REQUIREMENTS: .
SERVICE AREA:
PLAN ATTACHED:
SERVICE CHARGES:
Connection/InspectionFee:
Water Domestic,.... ,.... .". . Size
Irrigation. ..... ...\.. ..Size~.' .... .
Wastewater.... ...L~.M.... .e.~., .,~... .
Stormwater........ .......................... ...:... n.. ..... .
Front Footage Fee:
Water.................................. ................. ... $
Watewater.......................,....; ........ ....... ...,."".. $'
Stormwater.......... .........................".. d..... ...... $
M~>~7a!~1
BBEMER10N
BU1t01NGOEPl\tUt{I~1~..
General Facility Fee:
Water..........# of Units_ @ $
WastewateL.. # of Units -'--'-- @ $
Stormwater..# of Units _ @$
$
$
$
System Development Charges:
WateL.. ....... ..;..........;.... ;..... ,..;. ;.;; ,. .;..;.......
WatewateL.............. ,.........,. ".....;.... ......,..........
Stormwater:.. . . . . . . . .. . .. . . .. . . . . . . . . .. .. .. .
County Road I>ermit:..,
Pavement Restoration Charge
Refund
Tapping Fee:......
[ ] Asphalt [lConcrete
[ ] Yes [ ]No
"'';
. Other: . . . . . . .. . . . . .. . . . . . . . . .. . . c.. . . . . . .. . . . . . . . . . . . .. .. . . . .. .. , . . .. . .. ... $
TOTAL:.......... .......... ............. ":.....~..~ .~.... '.' .... ." $ ..:2....14 -0/0.
1. Utility charges.are the;'responsibilityofthe' owrieFregardless of whether the property is ()Sl?J.!pied by the
owner or. tenant. Unp~id charge shallbec?lllea lien on the propertyserviced. .:......:........ ". ..' ..,.. ... .."......
2. By this agreement, the undersignedo;vner~cknowledgesthlltthe owner assnmesthe riSKarrdthe'City
disclaims responsibility for~llclaimsfordamageorinjury to person or property,'.
Name: <~.j .f.z_o evoJrL
J '.i
Bi11ingAddress: 331,/JJI:T/Jf1W.ilJi4mS
. :' "i ,," ~1"- - _ ,~-.. : - A
}. /'7-- J"~' .AII
...... Owner/Agent: \.~j~y{Z;:l"/t"qIAdU
v 0.- -.,_'! j..J'
Accepted on behalfof Breme' 'Municipal Utilities:
~ ~l~
"~";c',;,- n.
c."",:. >'t:,\:;...~\"",:" ]:)'\11";' l'-''''
Phone iIumber (
377"-7to'76
. ---'.'-"',"-
, "' ,,--'._':.,:_'.....,.
:': .,.,. ..... zip:'1f31/ '.
"': ...,in'. ,$... 6....' ... /.'
f ~ I )" ' ? _ "~_,,(:-O'_/
Date: l~~ u<: /f ;:zc.t:J/
cI.~ity:6;'~.
State:
Date: if -- ;t.&. ~'() Y
CompletedBy:
Date:
Original & Hard Copies;' Accounting;' Pink Copy: Engineering, . Blue Copy: . Water,,' Yellow Copy: Customer
/A1:S67eCffCO J MR~VcP 5/61/01- V~."~~
I
"
~1 01D/7
ZON€ 1)~
1) l s "11
PERMIT CENTER
Department of Community Development * 286 4th Street * Bremerton * W A * 98337
(360) 478-5275 * Fax (360) 478-5278
Building Permit Application
APPLICANT: bll OWNER 0 CONTRACTOR 0 AUTHORIZED AGENT
Site Address 223/225 Apple Street I Tax Account Number: 3964-000-113-0002
CONTRACTOR: OWNER Name: John & Violette Fitzgerald
Address: Address: 331 NE McWilliams Ct
City, State, Zip City, State, Zip Brernerton, WA, 98311
Phone #: ( ) Phone #: ( 360) 377-9670
License # I Expir. Date: Authorized Agent Address:
Contact Name: City, State, Zip
Contact Phone #: ( ) Phone #: ( )
Check the type of application for below:
o NEW SINGLE-FAMILY RESIDENCE 0 NEW COMMERCIAL
o NEW DUPLEX 0 COMMERCIAL REMODEL
o NEW MANUFACTURED HOME 0 COMMERCIAL ADDITION
o RESIDENTIAL REMODEL 0 COMMERCIAL REPAIR
o RESIDENTIAL ADDITION 0 NEWMULTI~FAMILY
o RESIDENTIAL REPAIR 0 TENANT IMPROVEMENT
IS THIS PROPERTY WITHIN 200 FEET OF A SHORELINE?
Scope of Work Proposed: Demolish Duplex
Square Footage: Dwelling: 1440
\ lo~O )(; 0 "! ~
Valuation Plan Review Fee
Garage:
o NEW GARAGE/CAR PORT
o NEW ACCESSORY SLDG
o NEW SIGN
[gJ STRUCTURE DEMOLITION
o GRADING (Cubic yards: _)
o OTHER
YES 0 NO IZI
240 Decks:
Permit Fee
50 ki9
Surcharge
I""J
i ""''''
Application 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 the circumstances beyond the control of the applicant have prevented action from being taken. No
applicant 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 revie~. .'
APPLICANT'S SIGNATURE: ' . . DATE: /I.lJh 'f!;2J ~dY
~/
1.1L..S
7-,' ~' 'l"l' ~ "'" I OlI..
",1 ~ ,"" ,,0
1()7..(JJ~ 108.co~ I09<O~ fJO.(1)i..
.&e JIt..,&.,.
~"
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'-"
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Of::) d
~r
B [lILDL\TG PE~~:fIT
Jei~~~~~/ON
PROTECT THIS CARD FROM THE WEA THER
Building 0 PIUl11bing 0 J\1echanical
F re Alarlll/Sprinkler
DUrliNG INSJ>ECTI0NS THE BUILDING J>EI{MIT & AJ>])ROVED PLANS SHALL HE ON SlTE
Perll1it # ~ See t:AJ,:,oue
P@~~@ J{ \~~): If ~
For Inspections Call (360) 473- 5870
Approved Date
Notes
1 sf
FO Ul\T])A TIOl\T
DO NOT POUR CONCRETE
PRIOR TO APPROVAL
Erosion Con.trol In Place
Foundation Footing
Foundation walls
Plumbing Grou.nd Work
111 Slab lJlechanical
Footing Insulation
,nd
...
PLUA1BLVG
MECEL4NICAL
GAS PIPE
Rough In
Duct / Vent
Su.pport / Test / lJleter set
3rd Hold down connections
. Shear Panel nailing
FRAMIIVG L&I Electrical Approved
~
If [t & 2nd are approved
Ventilation requirements.
Framill{:
4th
11\TSULATION
Under-floor
walls
ceiling
5th
6th
FIN4L
SHEE,TROCK
,
All of the
above .'
l\1ust be
approved
Prior to
final
. BUILDLNG
rVATER 1J1
473-5870
473-5927
Driveway 473-5270
Sewer 473-5270
473-5384/5385
ALL FLl\7AL L'lSPECTI01VS COAfPLETED
DO ~OT OCCG"TY Bl:JILDL~G \'i'ITHOUT BUILDTh'G DE .4...RTMENTAJ'PROVAL
OCCt3PANCY VIOLATION IS A :MISDETvIL4.NOR - SECTION 305(d)
PROTECT THIS C4.RD FROjlf THE HEA THER
~)
. ,>'
,Bf ;1 L ~RMIT NUMBER
DATE ISSUED: 1111III.'11_1
..
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
286 Fourth SI. Bremerton, WA 98337
(360) 478-5275 Fax: (360) 478-5278
ASSESSOR NUMBER:
APPLICANT NAME:
OWNER NAME:
CONTRACTOR:
LENDER NAME:
3964-000-112-0003
FITZGERALD JOHN DANIEL GENL
FITZGERALD JOHN DANIEL GENL
GR WILSON & ASSOC
SUBMITTED:
04/23/2004
VALUATION:
Demolition Fee
$43.20 2218
$4.50 0236
State Surcharge
TOTAL FEES:
ZONING:
PHONE:
PHONE:
PHONE:
PHONE:
SITE ADD RESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
219 APPLE ST
331 NE MCWILLIAMS CT
331 NE MCWILLIAMS CT
DR
(360)275-3852
APPROVED:
EXPIRATION:
11/03/2004
DEMOLISH A DUPLEX
Building Code Edition:
Occupancy Group:
Type of Construction:
Flood Zone:
Setbacks:
Sanitation Method:
Number of Bedrooms:
Inspection Requests
DCD: Building Inspections
L&I: Department of Labor and Industries
(360) 473-5870
(360) 415-4000
Fire Inspections
HID: Bremerton, Kitsap County Health District
PW: Department of Public Works
(360) 473-5380
(360) 337-5285
(360) 473-5270
This permit shall become null and void if the building or work described and authorized by this permit has not commenced within 180 days from the date of issuance, or if this building or
work is suspended or abandoned at any time after the work is commenced for a period of 180 days. Obtaining inspections at intervals not exceeding 180 days identifies that work has not
been suspended. 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 iocalloaw regulating
construction or the 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 approvai 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.
PRINTED NAME:
zoning, building codes, and State and Federal laws.
~.
'1,.:;UJ()#
CONDITIONS
City of Bremerton's ap roval of this application pertains only to the City's regulatory jurisdiction, and thus compliance with City /'1
..gulations does not , ecessartly ensu.. compliance with fede",1 0' slate laws. . Jt;t~
1. DCD: Prior to performing any renovation or demolition work, Puget Sound Clean Air Agency (Clean Air Agency) and C.-f;.. '~ <
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 IJEI1
residences). iAl'~ ,
2. DCD: For more information, please contact Clean Air Agency through their web site at www.cleanair.org or by -/ V
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. j .'
3. ANY WORK TO BE DONE IN THE RIGHT-OF-WAY SHALL REQUIRE A RIGHT-OF-WAY PERMIT. ~.
MARYELLEN BABBIT 4735337. I
Page 1 of 2
..
CITY OF BREMERTON
DEPARTMENT OF COMMUNITY DEVELOPMENT
PERMIT NUMBER
DATE ISSUED:
286 Fourth St. Bremerton, WA 98337
(360) 478-5275 Fax: (360) 478-5278
ASSESSOR NUMBER: 3964-000-112-0003 ZONING: DR
APPLICANT NAME: FITZGERALD JOHN DANIEL GENL PHONE:
OWNER NAME: FITZGERALD JOHN DANIEL GENL PHONE:
CONTRACTOR: GR WILSON & ASSOC PHONE: (360)275-3852
LENDER NAME: PHONE:
SUBMITTED: 04/23/2004 APPROVED:
SITE ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
ADDRESS:
219 APPLE ST
331 NE MCWILLIAMS CT
331 NE MCWILLIAMS CT
EXPIRATION:
11/03/2004
MINIMUM INSPECTIONS REQUIRED
Inspection requests must be received by 8:00am in order to be scheduled for same day. To request an inspection, please call (360) 478-5275 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
r;
i
5'BO~ 0/02.(
DK
'DL.S1"" I
PERMIT CENTER
Department of Community Development * 286 4th Street * Bremerton * W A * 98337
(360) 478-5275 * Fax (360) 478-5278
Building Permit Application
APPLICANT: ,~OWNER 0 CONTRACTOR 0 AUTHORIZED AGENT
Site Address 219/221 A Ie Street
Tax Account Number:
3964-000- 112-0003
OWNER Name: John & Violette Fitzgerald
Address: 331 NE McWilliams Ct
City, State, Zip Bremerton, W A, 98311
Phone #: (360) 377-9670
Authorized Agent Address:
City, State, Zip
Phone #: (
CONTRACTOR:
Address:
City, State, Zip
Phone #: (
License #
Contact Name:
. . Contact Phone #:
)
I Expir. Date:
(
)
)
Check the type of application for below:
o NEW SINGLE-FAMILY RESIDENCE 0 NEW COMMERCIAL
o NEW DUPLEX 0 COMMERCIAL REMODEL
o NEW MANUFACTURED HOME 0 COMMERCIAL ADDITION
o RESIDENTIAL REMODEL 0 COMMERCIAL REPAIR
o RESIDENTIAL ADDITION 0 NEW MULTI-FAMILY
o RESIDENTIAL REPAIR 0 TENANT IMPROVEMENT
IS THIS PROPERTY WITHIN 200 FEET OF A SHORELINE?
Scope of Work Proposed: Demolish Duplex
o NEW GARAGE/CAR PORT
o NEW ACCESSORY SLOG
o NEW SIGN
[gI STRUCTURE DEMOLITION
o GRADING (Cubic yards: _)
o OTHER
YES 0 NO [8J
Square Footage: Dwelling: 1440
Garage:
Valuation
Plan Review Fee
Permit Fee
~~Q.9
Decks:
Application for which no permit is issued within 180 days following the date of application shal expire by limitation,
plans and other data submitted for review may thereafter be returned to the applicant or destroye by the build in cia!.
The building official may extend the time for action by the applicant for a period not exceeding 18 quest by
the applicant showing the circumstances beyond the control of the applicant have prevented action from being taken. No
applicant shall be extended more than once. rder to r ew action on an application after expiration, the applicant
shall resubmit plans and pay a new plan revie ~ .
APPLICANT'S SIGNATURE:
DATE: +d~ ~
LEBO
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April 23, 2004
APPLICANT WILL HAVE SEWER CAP INSPECTION
ON OR AROUND MAY 5, AND WILL PAY FOR DEMO
SHORTLY AFTER.
Ma~ 05 04 03:27p
Encineering Division
360-478-53'98
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POS~::.~:::~~Oj:__ 7671 oa:~~~~~sll' ;:L-_
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APPLICANT [NFORMATiON
DATE: _1~..J2i11l q~l_ 1 :);.CC':'f
NAME' F;+-;,~:?,,r'; IA '1~:..4t\;),~ hi t:'II\'IJC':J ~,(h'\'e;:J\~ r PHONE'
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l~ MM 07 2004 L)
. 8REMERTON -'
SUlLDlNG DEPARTMENi
Billing Address: 33I",.~'7j6-lIt-tJl ///4J-11S
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. '1'- Owner/Agent: ~/~/#-~?7;..,/ r ~t...~r!6.1
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Accepted on behalfof Breme
By:
BREMERTON MUNICIPAL UTILITIES
3027 Olympus Drive
Hremerttlll, Wa 98110-4799
(36D}473-5270'UTILITY"SERV:ICE AGREEMENT
L;.EMERTON CITY TREASURER
08'54A1D
APR26 '2004
Work OrderNo.
'A:;7 ~ /, ,1'>;;-">14 -"'>fl
ReceiptNo"'~,'.,~-0~='1 lc?',.',
Ta lNo.
THANK.YOU
Legal Description:
SERVICE REQUIREMENTS: ..[ ]Water
SERVICE AREA: l~YCity
PLAN ATTACHED: [ ]
SERVICE CHARGES:
Connection/Inspection Fee: AMOUNT
Water Domestic.. ; .. ;.... .. ... Size $
Irrigation ...... ...... .Size ==-- $ . q.
Wastewater..........e.~.a.dl.....c:14pS.e;) $ 214. ,'0
Stormwater.. . .. . .. . . . ... . . . . ... .. .. . .. .. .. .. . .. . . . . :. .. .... $
q,gac)
Front Footage Fee:
Water......... ........... ............. ..................... ... $
Watewater.............. ................ -'......... ..... .'.t1.... $
Stormwater......... ......................................... $
~'~'~'
, . -- - ---'
- , ,.- , ,- .
~~l07:. .....
. 'BREMER10N , .
BUlLU\NGDEPARTME~I,.
General Facility Fee:
Water..........# of Units _ @$ $
Wastewater... # of Units ~ @ $$
Stormwater..# of Units ----.: @$ $
System Development Charges: '
Water... ................~. .. . ;;'~.. .;;~';;;;./;; ;,.. ;'....'.;;...;;; $.
Watewater.;.. .'....... ...,........., .."....... ,..,' .....,....".. $.
Stormwater."..........;.................. .'..;........;..... "$'
'''...,.'.i.,< .'.' .$
] Asphalt,J.] Concrete $
[ ] Yes [ ]No
County Road Permit: ..
Pavement Restoration Charge
Refund
Tapping Fee:.....
...........................'.....,.......................
.-- " -' -', .
"Other: .. . . . .. . . .. .. . . . . . . . . . . . . . '. . .. .. . . . . .. . . . .. . . . .. .. .. . .. .. , . . .. . . .. .. $
TOTAL:. ..'...... ...... ....... .'.......... ......... ...... ...... .'. ..'. '$ . ~l4..pl/-.O
--~~'.\;;,::~-:
1. Utility charges ,are theIesponsibility oftheowneuegardless of whether the propertyi'soc:F~pied by the
owner or tenant. Dnpaid>charge shal1lJecome a lien on the property serviced. ..x, ,,' " "",'
2. By this agreement, the undersigned owIler-acknowledges thatthe ownerassnmes :therisk !nidtheCity
disclaims responsibility fora1Lclaimsfordamageorjnjuryto personar property".
Name:'
.p-?!"- I fiL
.-t/~a eva."",
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Phone Number(
d-City: 6;~~.
Date:
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Zip: CJ ~-' II
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Municipal Utilities:
90 l.J I ec....
Date:
1/ -,2(p-oy
Completed By:
Date:
Original & Hard Copies; Accounting, Pink Copy: ' Engineering,., Blue Copy: ,Water.:, Yellow Copy: Customer
IN:5?ev~CO $- liPf'fbVCcP 5/0710f vuu.k-'~~
J
B [7IL.D L\,T G PE~~fIT
~_ 1Ii.I'~PECTION
"'t:i.o · ft ~RD
PROTECT THIS CARD FROM THE WEA THER
Building 0 Plulnbing 0 l\1echanical
DURING INsrECT10NS THE BUILDING I)ER1\1IT & A]>PROVED PLANS SHALL 1;[ ON Sl'I'E
Perll1it # ~ See ,~ocJe
?@~1f @ J{ ~0 ~u ~
For Inspections Call (360) 473- 5870
Approved Date
Notes
Erosion Control 111 Place
Foundation Footing
Foundation walls
Plumbing Ground Work
111 Slab A:1ech.anical
1 st
FO UJ\T]JA TIOJ\T
DO NOT POli'R CONCRETE
PRIOR TO APPROVAL
Footing Insulation
, 2nd
PLUA:lBLVG
MECHA1VICAL
GAS PIPE
Rough 111
Duct / Vent
Support / Test / A:1eter set
3rd
Hold down connections
. Shear Pallelnailillg
L&I Electrical Approved
Ventilation requirements.
Pramin1(
FRAA111VG
If 1st & 211d are approved
4th
IJ\TSULATION
Ullder-jloor
walls
ceiling
,
sth
6th
FI^~4L
SHEETROCK
All of the
above
Must be
approved
Prior to
final
BUILDLNG
rFATER Ai
473-5870
473-5927
Driveway 473-5270
Sewer 473-5270
473-5384/5385
ALL FI1\TAL L'VSPECTIOlvS COAfPLETED
DO ~OT OCCUpy B"UILDING \VITHOUT BUILDIl'-'G D .ill .M:E~ IT APPRO,TAL
OCClJ"PANCY VIOLATION IS A MISDEIv1EA...:c~OR - SE .;. T 305(d)
PROTECT THIS C4.RD FROM' THE Tr"EA THER
.
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.
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N9
40872
. 00
Fee $..______..u__mm{Qm.u:~m.u__..hm.________.....um_ Receipt No. __um/.9._/(.f__~im.mmmu__u._mu
BUILDING PERM IT
CITY OF BREMERTON BUILDING DEPARTMENT
F. E. IRISH, Building Inspector . ESsex 3-1411, Ext. 36
Owner's Value Bldg. Dept.
$ I) O(){J .
Value DESCRIPTION:
Lot
Block
Additions
Address on Job _'_:?t: 1..9.__:: __ __ ~ _~ L_ ___ u -?:?,,Iz.,ll ,.t:~",,~ ___ ___ u__ ___ __ ___ ___m_ __ _. _ ____ _._ __ ___ u Date _____.,$ :-::_ i?_ i~_2_C1.. __ u ____ _m_
Building _____u_.u__u_ x ______um_m_ and __uu__________ stories _u_____u__uuu_.____ basement. Lot _u__u_u__m_ x m_u___u_____
Front Yard _u._m_u___um__m Rear Yard Uu_m____mm__m_ Side Yard _____m_u__u__u__u_ Garage uu____m__m_m_m______
E::~~~~:~;~:::-:::~_~~~!~::;:-::::::::::::::::::::::-i~~:~::::::::::::-:::::::::~~~~:::::-::::::::-~f~:::::::::_~:_:::_::.
This permit is issued for: 7' .
'f} "f,!b>'-:r A "," ". /.
"'"'~(!,.~?::J:"{., .tf.?:~=_!~f:~:'!!!_::~_ _ ___ __::::__ ______,< Si~~~-~?f.:i::<__ ,_..~:~..:'f:::1;o:_A':_ __ __ __ !~~:?:t:'-"";j::""_4(J._ ____ ____ ___ _ ___ __ ___ ___ __ __ __ ___ ___ _ ___ ______ ___ _ _____
v I
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
INS.PECTION - Reinforcing steel must be i'nspected a,fte,r placing and be,fo,re c01vering. FORMS shaH be inspelCted
and appro'ved before pouri,ng. All p,lumbing, wiri'ng and the fra,me of all buildi'ngs must be i,nspeded and a'pproved
before cove,ring. Wood preservatiye to be used on all wood a,gainst masomy. Ventilate fo,undation and attic. Sepa-
ra,te permits re,qu'ired for plumbing, wiri'ng a,nd he,ating. See City Engineer before wo,rking on streets o,r sidewalks.
,/'
::::::::::::::::::::::::::::::: :~~;.:~;;;'~-~}::::::::::::: ~:::: ::~:;.~: ~t~::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
::::::::::::::::::::::::::: ;~?: :{r.~ l:: ~:: :_::l~{L:: }{}l- - - -: :,::::: ~,:?1-~::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
, . Ii ',' "-3f' // ""t 17 ': ' 'l~/ B
Owner s SlgnatiU,.t:et,;/__ ,-b".t,,..:-'?'luL-------:u,, :_____. y ___._u__u_____u__uu__u_m_m_mm_u__m_m___u__u__u____m__
l ~ /,;1 ,His Authorized Agent
Id /1. ;J.~' Ii ' "
Bui ing InsPU9!tor - - - - - __ s::::::_~ ~ _ _ _ k_: _ \,,~h~1'.~ ___ _ ___ u ___ _ _ _ _ _ u u u u __ __ _ u _ _u _ __ u u u _____
l By ___ _ __ _ _.I~?!:..._ ~ _ _ u __ u_ _ _ __ __ _ __ ___ u _ _ _ _ _ u ___ _ _ ___ u __ _ ___ _ u_ _ ___ _ u __ u _ _._ _ __
~DF
3 ~, - ~ D \J G tp.> = 1 \/I ~ T
City of Bremerton, Washington
Phone: (206) 478-5281
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2372
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OWNER'S VALUE BLDG. DEPT_ VALUE PLAN CHECK FEE
$ ~6;z.r;- $
RECEIPT NO_
PERMIT FEE
$ ;. '/ fZ5!
RECEIPT NO. DATE
, r
SITE ADDRESS I LOCATION 1}./1 ~ :2;l/ #/~~ e- Sr
OWNER'S NAME/?-5 ~~,..<.t'c? ADDRESS PHONE
~
CONTRACTOR /1bttPiI- ..f~~ /?~~d~ ~ATE CONTRACTOR'S L1C.#
~
ADDRESS PHONE
~ RESIDENCE 0 BUSINESS o OTHER 0 NEW ~ REPAIR 0 REMODEL 0 ADDITION 0 DEMOLISH
PLANNING I ZONING FIRE ZONE STORIES OCCUPANCY
THIS PERMIT ISSUED FOR: jVe(.,.U /7/J G- 7' d~a5
-'
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.
INSPECTIONS REQUIRED: Foundation 0 Framing 0 Plumbing 0 Electrical 0 Wallboard 0 FINAL ~
FOR INSPECTORS USE ONLY: REI NSPECTION:
NOT
TYPE OF INSPECTION DATE TIME APPROVED' APPROVED COMMENT DATE TIME APPROVED
FINAL INSPECTION APPROVED BY
Building Inspector
ISSUANCE OF OCCUPANCY CERTIFICATE REQUIRED BEFORE OCCUPYING BUILDING
OWNER'S SIGNATURE BY ___.Q ~n~~ ~~ ~.~W\~
Authorized Agent
BUILDING DEPT. 7?-!~~
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