HomeMy WebLinkAboutWRIGHT AVE, 3208 y .._.
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�= �`� PERMIT CENTER e�t'�'t�' �
�U��ING� �
:• �� • Building Pernvt Application
Den1rtmen�or CommunitS�Develonmenl ' 28G-4c1� 5treet " ]3remerlon ' WA ' y�i337
(360) 473-5275 ' F:ix (360) �1�73-5278
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Site Address: 3ao8 !n/I�I�C-f`T �C�� ��'-��-�`-' ��3�a
CONTRACTOR: OWNER: �P4�q. L (�
Address: Address: ,3ao$ GJ -
Ci , State, Zi : Ci , State, Zi : ,8n-��e�� w� 9 b
License#& Ex . Date: Phone#: 3�vo �!S-g63
Contact Name: Authorized Agent Name:
Contact Phone#: Address:
Tax �D/Parcel #: ��"I3-o��}-ov3-�oc�b City, State, Zip:
Phone#:
What is the application for? (Please check onel
�NEW SINGLE-FAMILY RESIDENCE �COMMERCIAL REPAIR
�NEW DUPLEX �NEW MULTI-FAMILY
�NEW MANUFACTURED HOME Q TENANT IMPROVEMENT
�RESIDENTIAL REMODEL Q NEW GARAGE/CAR PORT •
�RESIDENTIAL ADDITION Q NEW ACCESSORY BUILDING
�RESIDENTIAL REPAIR Q NEW SIGN
�NEW COMMERCIAL 0 STRUCTURE DEMOLITION
�COMMERCIAL REMODEL �GRADING(Cubic Yards: )
�COMMERCIAL ADDITION �OTHER:
!S THlS PROPERTY W/THIN 200 FEET OF A SHORELINE? YES� NO f�]
Scope of work proposed: �^'� Sin�Ccr F�Mr� TU ���X
Square Footage: Dwelling: . Garage: Decks:
Valuation Plan Review Fee Permit Fee Surcharge Total Fees
a
3sc�..�� ( ,�� z• �-,� �O;� f� 3 P S/
Application for which no permit is issued within 180 days followmg the date of application shall expire by limitation,and plans and other data
submitted for review may thereafter be retumed to the applicant or destroyed by the buildmg 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 confrol 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 applicanl shall resubmit plans and pay a new plan review fee
�/1�a�.
Applican ' Signature Date
DATE ROUTED: August 23, 2004
3208 WRIGHT AVE, REMODEL OF A SFR INTO A
DUPLEX.
PERMIT # BB04 01267 .�
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Dcl�art�nent oI�Comrnunit�� Development ' `�86 - �l�tli Street � Bren�erlon *_ V�'A * y�337
(360) 4�73-�275 � P�u� (3G0) �1•7�i-�i27K
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Type of Fuel: Electric Gas Oil Propane
Occupancy: Residential Commercial
Site Address: 32� w'a-�C1KT tyr 'F�� 3a13'�`���3��b
CONTRACTOR: '' OWNER: Ra�� -
Address: Address: 3ve� w e�c� P��
Cit , State, Zip: Cit , State, Zi : '��� w� a&3�o
License # & Ex . Date: Phone #: 3(�,c► �IS -8�
Contact Phone #: Tax ID/Parcel #: 3°l�3-ooy- �'3-��
NO. TYPE OF EQUIPMENT NO. TYPE �F FIXTURE
RANGE � WATER CLOSET�-'�
WOOD/PELLET STOVE/GAS FIREPLACE BATHTUB
2, GAS FURNACE btu: ' LAVATORY (BATH SINK)/
CONVERSION BURNER btu: SHOWER
UNIT HEATER btu: �' KITCHEN SINK �
BOILER btu: ,'l, DISHWASHER +��
GAS PIPING •� LAUNDRY TRAY
EVAPORATION COOLERS btu: 2 CLOTHES WASHER •�s
A/C UNIT btu: ,2 WATER HEATER, �`
HEAT PUMP btu: URINAL
REHEAT BOX but: DRINKING FOUNTAIN
2, EXHAUST FANS �� � FLOOR SINK OR DRAIN
,2 RANGE HOOD(RESIDENTIAL)� � WATER PIPING 8�ALTERATION
RANGE HOOD(COMMERCIAL) GREASE TRAP/INTERCEPTOR
2. CLOTHERS DRYER HOSE BIBBS
INCINERATOR LAWN SPRINKLER SYSTEM
DUCT ALTERATION SWIMMlNG POOL
TANK TYPE: BLDG. SEWER: (MOBILE/MOVED HOME)
REFRIGERATION UNIT ROOF DRAINS
OTHER: OTHER:
OTHER: OTHER:
MECHANICAL FEES:
PLUMBING FEES:
TOTAL FEES:
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Appli nYs Sig ture Date
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Map Layout Page 1 of 1
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DISCLAIMER: Th�s map is intended for display purposes only and is not intended for
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[Click here to Print] � (�
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� � � CITY OF BREMERTON
� I ' DEPARTMENT OF COMMUNITY DEVELOPMENT Receipt Number� BDD0002044
I
� 286 Fourth St.Bremerton,WA 98337 .
� (360)473-5275 Fax:(360)473-5278
Receipt Date: 08120/2004 Cashier: PCONROY PayerlPayee Name: LOPEZ RAFAEL 8�APRIL K
Tran Original Fee Amount Fe
Permit# Fee Description Code Amount • Paid Balanc '
B604 01267 Plan Review Fee 1/4580 $319.96 $319.96 $0.00
Total: $319.96
Previous Payment History
Receipt# Receipt Date Fee Description Amount Paid Permit#
Payment Check Payment
Method Number Amount
CREDIT CARD $319.96
Total: $319.96
I
Page 1 of 1
DATE ROUTED: August 23, 2004
3208 WRIGHT AVE, REMODEL OF A SFR INTO A
DUPLEX.
PERMIT # BB04 01267
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BREMERT01�
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ENGINEERING DIVISION
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Department of Community Development
Current Planner,Robert J.Grumbach,AICP �
Te1360-473-5379
rgrumbach(dci.bremerton.we.ue Fax 360�73-5278
286 4th Street
iBremerton,WA 98337
August 27, 2004 ._._._..-.--------�-
_ Rafael Lopez
3208 Wright Avenue
Bremerton, WA 98310
RE: BUILDING PERMIT BB04-01267
Dear Mr. Lopez,
Your building permit has been reviewed for compliance with zoning requirements set
forth in Bremerton Municipal Code (BMC) Chapter 21.02 and clarification regarding the
alley access is required. The zoning code defines an alley as any public right-of-way or
thoroughfare between 10 and 30 feet wide, which affords a secondary means of access
to abutting properties primarily for service purposes.
A review of the assessor's map of your neighborhood shows your property is not located
next to any ally that is a public right-of-way. We need clarification if this is an alley or an
access easement. If it is an easement, you will need to provide documentation showing
� your legal right to use it. � �
Please note that a duplex structure requires four (4) off-street parking spaces. You can
have them in the backyard provide they are not located within any setback areas (5 feet
from the side property lines and 15 feet from the rear property line). Also, parking
spaces and driveways must be paved. A revision to your site plan is required to show
parking spaces that meet setback requirements. Additionally, indicate on your site plan
existing and proposed paving.
Please let me know if you have any questions (phone 473-5379).
Sincerely,
Robert J. Grumbach, AICP �
Current Planner
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Department of Community Development ��
Current Planner,Robert J.Grumbach,AICP �Te1;36' 0=.473=5379=���=-=��
rgrumhac h@ci.bremerton.wa.us
�Faz:360-4�73-5278,--: � ,.', '.:
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D •Bremerton,'•VVA,98337�'
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August 27, 2004 e��..P �2 20�� _.
�6�tIVlt6����
Rafael Lopez [f�1�9G0�
3208 Wright Avenue
Bremerton, WA 98310
RE: BUILDING PERMIT B604-01267
Dear Mr. Lopez,
Your building permit has been reviewed for compliance with zoning requirements set
forth in Bremerton Municipal Code (BMC) Chapter 21.02 and clarification regarding the .
alley access is required. The zoning code defines an alley ag any public right-of-way or
thoroughfare between 10 and 30 feet wide, which affords a secondary means of access
to abutting properties primarily for service purposes. �
A review of the assessor's map of your neighborhood shows your property is not located
next to any ally that is a public right-of-way. We need clarification if this is an alley or an
access easement. If it is an easement, you will need to provide documentation showing
your legal right to use it. .
Please note that a duplex structure requires four (4) ofF-street parking spaces. You can
have them in the backyard provide they are not located within any setbacic areas (5 feet
from the side property lines and 15 feet from the rear property line). Also, parking
spaces and driveways must be paved. A revision to your site plan is required to show
parking spaces that meet setback requirements. Additionally, indicate on your site plan '
existing and proposed paving.
Please let me know if you have any questions (phone 473-5379).
Sincerely,
I
Robert J. Grumbach, AICP .
Current Planner
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�� CITY OF BREMERTON PERMIT NUMBER �B OB 4 01267 �
° I DEPARTMENT OF COMMUNITY DEVELOPMENT DATE ISSUED: 09/21/2004
. � 286 Fourth St.Bremerton,WA 98337
(360)478-5275 Fax:(360)478-5278
�
ASSESSOR NUMBER: 3973-004-003-0006 ZONING: DR SITE ADDRESS: 3208 WRIGHT AVE
APPLICANT NAME: LOPEZ RAFAEL 8 APRIL K PHONE: (360)415-8635 ADDRESS: 3208 WRIGHT AVE,BREMERTON,WA 98310
OWNER NAME: LOPEZ RAFAEL 8 APRIL K PHONE: (360)415-8635 ADDRESS: 3208 WRIGHT AVE,BREMERTON,WA 98310
CONTRACTOR: SELF PHONE: (360)710-5081 ADDRESS:
LENDER NAME: PHONE: ADDRESS:
SUBMITTED: 08/20I2004 APP VED: 09/20/ 4 EXPIRATION: 03/20/2005 STATUS: ISSUED
_ . —..... ._�__........ _ �....---- --
VALUATION: $35,000.00 Residential Building Permlt w/MechanicallPlumbing
�— ---- -
Plan Review Fee $319.96 458o CONVERT A SFR TO A DUPLEX
Building Permit Sas2.25 22�� Building Code Edition: UBC: 1997
Mechanical Fixture Fee 5�s2 ao zz�s Occupancy Group:
State Surcharge $a.so o2ss Type of Construction:
Plumbing Fizture Fee $104.00 2213 Flood Zone:
TOTAL FEES: �— $1,113.51� Setbacks: (Front) (Side) (Rear) (Other)
Sanitation Method:
Number of Bedrooms:
Square Footage: Bid Price from Applicant 1 TOTAL
IInspection Requests Fire Inspections (360)473-5380
� DCD:Building Inspections (360)473-5870 H/D:Bremerton,Kitsap County Health District (360)337-5285
L&I:Department of Labor and Industries (360)415-4000 PW:Department of Public Works (360)473-5270
IThis permit shall become null and void if the budding or work described and authorized by this permit has not commenced within 180 days from the date of issuance,or if this bwlding or i
Iwork is suspended or abandoned at any time after the work is commenced for a period of 1 SO 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 speafied herein or not. The granting oi a permit does not presume to give authority to violate or cancel provisions of any State or local loaw 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 Contractors 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.
I have read,and agree to abide by the c it including all conditions of zoning,building codes,and State and Federal laws.
SIGNATURE OF OWNER OR
AGENT:
PRINTED NAME: DATE: �� "' � /
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.
1. (DCD-01) DCD: Prior to performing any renovation or demolition work, Puget Sound Clean Air Agency �G'
(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). �
2. (DCD-02) 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.lni.wa.gov/p-ts/asbestos/asbestos.htm. �L
3. (DCD-13) DCD: Driveways and parking areas must be paved.
4. (DCD-14) DCD: Approved Plans, Engineering,Site Plan, Permit,and Conditions,Shall remain on site �
� and be available for inspection. �
5. (DCD-20) Building Plan Review: �L �
1. Smoke Alarms-Shall be interconnected 110-volt battery backup,one in each bedroom, I
Page 1 of 3
� CITY OF BREMERTON PERMIT NUMBER BB04 01267
�� ° I � DATE ISSUED: 09/21/2004
S � DEPARTMENT OF COMMUNITY DEVELOPMENT �
—�
;.� .'0 286 Fourth St.Bremerton,WA 98337
(360)478-5275 Fax:(360)478-5278
ASSESSOR NUMBER: 3973-004-003-0006 ZONING: DR SITE ADDRESS: 3208 WRIGHT AVE
APPLICANT NAME: LOPEZ RAFAEL&APRIL K PHONE: (360)415-8635 ADDRESS: 3208 WRIGHT AVE,BREMERTON,WA 98310
OWNER NAME: LOPEZ RAFAEL 8 APRIL K PHONE: (360)415-8635 ADDRESS: 3208 WRIGHT AVE,BREMERTON,WA 98310
CONTRACTOR: SELF PHONE: (360)710-5081 ADDRESS:
LENDER NAME: PHONE: ()- ADDRESS:
SUBMITTED: 08/20/2004 APPROVED: 09/20/2004 EXPIRATION: 03/20/2005 STATUS: ISSUED
adjacent hall,and on every floor
2.C.F.M. Fan Rating-Bath and laundry 50 C.F.M.,range hood 100 C.F.M.,whole house fan
(2 bed 50-75)(3 bed 80-120)(4 bed 100-150)(5 bed 150-180)
4. Foundation Footings-1st floor foundation shall be 12"below undisturbed soil,2nd floor
foundations shall be 18"below undisturbed soil,the ground under the floor may be excavated
to the top of the footing and no lower.
3. Egress Windows-are required in basements in dwelling units and every sleeping room
below the 4th floor. Egress rescue windows shall have a minimum net clear opening of 5.7 sq
ft,a minimum of 24"clear height,and a minimum of 22"clear width.
4.All penetrations in 1-hour wall between units shall have a 1-hour fire rating
5.Code Compliance-All work in the City of Bremerton shall adhere to the following
2003 International Codes:
International Building Code
International Residential Code
International Existing Building Code
International Fire Code
International Mechanical Code
Uniform Plumbing Code
International Fuel Gas Code
1998 WA State Barrier Free Code
2001 WA State Energy Code
2000 WA State Ventilation Code
Check For All Washington State Amendments.
Check For Notes Ori Plan
6. (Project-Specific) DCD:Should access from the easement be denied in the future,a driveway shall be provided
from Wright Avenue.
MINIMUM INSPECTIONS REQUIRED
Inspection requests must be received by B:OOam 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.
Mechanical
Plumbing Rough-In
Framing
Insulation
Sheetrock Nailing
Driveway ,
Sewer Lateral
Final Inspection-Building
FIXTURE LIST
Qty Description Qty Descriptior
2 R-Water Closet and/or Urinal 2 R-Bath Fan and/or Exhaust Fan
2 R-Clothes Washing Machine 2 R-Natural Gas Furnace+/-Ducting
2 R-Dish Washer 2 R-Gas Water Heater Vent&Combustion Air
4 R-Sink(Lavatory,Kitchen,Mop or Bar Sink) 2 R-Clothes Dryer with Exhaust
2 R-Tub and/or Shower Unit 4 R-Gaspipe System LPG/NATL/OIL
2 R-Cook Stove with Exhaust
2 R-Range Hood
Page 2 of 3
�� . :
� CITY OF BREMERTON PERMIT NUMBER BB04 01267
� DEPARTMENT OF COMMUNITY DEVELOPMENT DATE ISSUED: 09/21/2004
, .�, 286 Fourth St.Bremerton,WA 98337
'" (360)478-5275 Fax:(360)478-5278
ASSESSOR NUMBER: 3973-004-003-0006 ZONING: DR SITE ADDRESS: 3208 WRIGHT AVE
APPLICANT NAME: LOPEZ RAFAEL&APRIL K PHONE: (360)415-8635 ADDRESS: 3208 WRIGHT AVE,BREMERTON,WA 98310
OWNER NAME: LOPEZ RAFAEL&APRIL K PHONE: (360)415-8635 ADDRESS: 3208 WRIGHT AVE,BREMERTON,WA 98310
CONTRACTOR: SELF PHONE: (360)710-5081 ADDRESS:
LENDER NAME: PHONE: O- ADDRESS:
SUBMITTED: 08/20/2004 APPROVED: 09/20/2004 EXPIRATION: 03/20/2005 STATUS: ISSUED
Page 3 of 3
CITY OF BREMERTON
I "� � Receipt Number: BDD0002158
DEPARTMENT OF COMMUNITY DEVELOPMENT
�
� 286 Fourth St.Bremerton,WA 98337
� (360)473-5275 Fax:(360)473-5278
Receipt Date: 09121l2004 Cashier: PCONROY Payer/Payee Name: LOPEZ RAFAEL 8�APRIL K
Tran Original Fee Amount Fe
Permit# Fee Description Code �� Paid Balanc
���^-�
6B04 01267 Building Permit � � 1$492.25 $0.00
BB04 01267 Mechanical Fixture Fee �' � � � $192.80 $0.00
BB04 01267 State Surcharge '�. `I $4.50 $0.00
6B04 01267 Plumbing Fixture Fee � � `104.00 $0.00
,' �
1 793.55
,
Previous Pa -
Receipt# Receipt Date Fee D � �ermit#
1
BDD0002044 OS/20/2004 Plan Review Fee � ��01267
� �
Payment Check Pa 1 1
Method Number A �
CREDIT CARD $79;1 `�,
Total: $793.
�
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Page 1 of 1
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Department of Community Development
�� - 286 Fourth Streei, Bremerlon, WA 9b337
(360) 473-�275; Fax: (360) 473-5278
website: www.ci.bremerton.wa.us
I •
C' ' •
I�ESID�NTIAL SITE PLAN QUESTIONNAIRE
The answers to this questionnaire assist the staff in reviewing one or two—unit residential building
permit. Please complete the form and submii it along with the buildin� permit. Providing complete
information will help ensure the tunely processing of your pernut.
APPLICANT INFORMATION:
NAME: ���- LoPc� - � �
ADDRESS: 3tio� w R�,��t-�T Ea�� .
CITY: $Q.r�r�F2-�vN STATE: W P� ZIP �$$�o
TELEPHONE: VJork: �'��•��l e Home/ Cell: `�}�5-�c�35
FROJECT I]VTFORMAT]ON:
l. Ta�Account Number: 3�13 — O� — OQ"�— �C)O�o
2. Site Address: 3 a-O Q� w(�.�MrZ- �3� q� �,(�,�o
GEl��RAL SITE INFORMA'I'ION:
3. Please check sewer service provided: � City of Bremerton
❑ Septic (contact Kitsap County Health.for letter of
acceptability)
4. Is the sii:e cl�aracterized as: Forest or Vegetation
Cleared
_�_Developed
5. Please check which soil types apply
ai the building site: ., ❑ Crystalline bedrock
� Sedimentary and foliated rock
❑ Sandy gravel and/or gravel �
❑ Sand, siliy sand, clayey sand, silty gravel and
clayey gravel .
❑ Clay, sandy clay, silty clay; clayey silt,
Resideniial Site Plan 1 of 3 Revision: June 20U4
� . �
.. .
. ,
it�SID�NTIAL D�V�LOPM�NT VVORKSH��T
1. Whai is the zoning designation: ��
2. VJhat is the area (square footage) of the lot? � ��O �1��
3. Please provide the following information. Zoning development requirements are found in Section
21.02.130, Figure 130 (Lot P�equirements) of ihe Bremerton Municipal Code (BMC). Uff-street
parlcing requiremenis are found in BMC Section 21.02.670. VJhen addin� to or replacing a.n
existin� structure, this information should reflect the entire site afl:er worlc is completed.
DESCRIPTION ZONING PROPOSED STAFF
REQUiREMENT REV�W*
FRONT YARD SETBACK � S 1'S�
REAR YARD SETBAC�** I S a'c��
SIDE YARD SETBACI� S � 7 �tv ��
SIDE YARD SETBACIL � ' JZ�/��
MA�,'IMCTM HEIGHT Mp� 3 0' t S �
LOT COVE�AGE**�` Mp,,� O`jo l�qo
NITMBER OF OFF-STP�EET � �
P�NG SPACES
* To be complei;ed by staff.
**Use this as the second front yard setback for comer lots and throu�h lots.
*����Lot Coverage is defined as that portion of a lot covered by the roof areas of ALL structures, but
not including driveways, vvalkways, patios and low open decks. A low open deck is defined as
rising 30 inches or less�above the fin_i.shed grade.
The applicant herby certifies that all of the above statements and the information contained in any
other transnuttals made herev��ith are true, and the applicant ael:rio��ledges that any action taken by
the City of Bremerton based in vvhole or in part on this application may be reversed if it develops
tbat any such statement or other information contained herein is false.
8 �o2v-o�`{
App �cant Si re - Date
Residential Site Plan 3 of 3 Re��ision: June 2004
,
BUIL RMj2'' SITE ADDRESS
_ . $ t�J � ll.�' �'1�
� /NSPECT/ON aet e Z ::
ROJECT D SC IPTION
CARD �� �e s . .
PROTECT THIS CARD FROM THE WEATHER
H u- � ' ' •
Building Plumbing echanical Fi e Alarm/Sprinkler ❑
DURING INSPECTIONS THE BUILDING PERMIT & APPROVED PLANS SHALL BE ON SITE
Permit # BB04 — � �t � p��� Oo [� �0�[�
�
For Inspections Call (360) 473- 5870 Approved Date Notes
Erosion Co�:trol In Place
1 St Fou�tdation Footing
FOUNDATION Fou�:dation walls
DO NOT' POUR CONCRETE Plun:bi»g Ground Work ,� ' � -
PRIOR TO APPROVAL In Slab Mec/ianical
Footing Ifisulation
2nd PLUMBING Rougla In /'�l5_0 /�I2Dy
MECHANICAL Duct/Vent /-/,2 �
GAS PIPE Support/Test/Meter set
3 rd Hold dow�z con�iections
Sl�ear Pa�zel�zaili�zg
F�ZAMING L&I Electrical Approved
If Isr �c 2"d are approved Ve�ztilation reqr�iren:ents �/2OL
Framin ,��'O �� �����y�
4th U�:der floor
walls /�P'6�
INSULATION ���t��
�_ c,
5th SHEETROCK ,� w�� ��-0`'�
- - 0 �P Mr,�
All of the 473 5870 L�' A
th B UILDING
�
6 above - -
FINAL Must be �
approved ----- - PR tZ>>"y�. 0 1� ����
Prior to �
final �
ALL FINAL INSPECTIONS COMPLETED /�
Occupancy Approval(Siirg/e Faneil��Residence O�:ZJ+) .
DO NOT OCCtiPY BLTILDING V��ITHOUT BUILDI G EPAR E1�T APPROVAL
PROTECT THIS C_9RD FROM T ,E 'EATHER
�
•� � � f
'�T . /� $ ��•.....-,-^ ----------------------- Receipt No. .� � � .�� �
,�,.����
l�l� `3���� • Fee ---••---•--------�------•---��---------••------ •--�--------'--••-••--•-•-•----•-•-------•--•--••-••---••. .
� UILDlNG �ERMIT .
CITY OF BREMERTON • BUILDING DEPARTMENT ,
,/�' F. E. IRISH,Building Inspector • ESsex 3-1411, Ext. 36 .
Owner's Value Bldg.Dept. Value DESCRIPTION: (/
a I-
� � '�f�d '�_ Lot Block Additions
Address on Job ---r-'1�-`�--------!t:-�_{...�_�-------------- ------------------------------------ Date -----�==---�--�---_---�-�--
Buildin a ---------------- and --�---------- stories ------------------------ basement. Lot ---------------- X ----------------
g ---------------- -
FrontYard ------------------------ Rear Yard -----------------------. Side Yard ------------------------ Garage ------------------------------
OccupancY --------------------=------------------------------------------------- --------------------------------- Zone.-----------------------------------------
Owner.__.�l2�'��------,r--------�Pti?�„���=�-------------------•
Address -------------------------------------------- Phone .----------------
Contractor -----D�,�----=-f�---:.,�.:.-'--:-�fin._.:_--'---------- Address -------------------------------------------- Phone ----------------- �
This permit is issued f or:
- � e �
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.. ----=-- �
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All auork to con f orm to all applicable building ordinances and amendments. Please note the f ollowing
special instructions and requirements.
DETACH HERE AND POST THIS SECTION ON 106
INSPECTION— Reinforcing steel must be inspectad after placing and befare cove�ing. FORMS shali be inspe�eted
and approved before pouring. All plumbing, wiring and the frame of all buildings must be inspected and appraved
before cove�ing. Wcad preservative to be used on all wood against masonry.Ventilate foundation and attic.Sepa-
� rate pe�mets requ�ired for plumbing, wiring and heating.See City Engineer before working on streets or sidewalks.
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Owner s Signature-----,-r�:,��,-----`�---------�....:��-,�-------- BY -
----------------------------------------------------------------------------
�f � Hit Authosized Agent
Building Inspector -------------------�---�-�-`-.-------=�~'-==--:.--=�------------------------
�
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