HomeMy WebLinkAboutBERTHA AVE., 322 �J
BUILDING PERMIT 322 BERTHA AVE
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I NSPECTION Demobs,
CARD
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Building ❑ Plumbing Mechanical Alarm /Sprinkler
This Placard must be posted on o ne b uil d ing a t Permit & "Approved" plans must be at the sit
Permit # BB 11 00089 POST ON SITE
Call the following Agency Telephone Numbers for inspectio - Propertylines shall be properly identified and marked before
Budding Department Inspections Call (360) 473 -5870 foundation footing inspection Setbacks are measured to the
WATER - Public Works - Water (360) 473 - 5927 finished wall structure
- Reinspection fee may be assessed if inspection has been
PW - Public Works - Engineering (360) 473 -5270 requested when not ready or corrections are not completed
HEALTH - Kitsap Co Health District (360) 337 -5285 - Permit a pproved plans, engineering, and inspection card shall
Fire - Fire Department (360) 473 -5394 be on site during construction or Reinspection Fee maybe
L &I - Dept of Labor and Industry (360) 415 -4000 assessed
Inspection Approved Date - Notes
Final Inspection - Building
FINAL BUILDING (360) 473 - 5870
All of the above must be approved IPA 9.22y/
Occupancy approval for SFR only - Commercial
structures require a separate Certificate of Occupancy
DO NOT OCCUPY BUILDING WITHOUT BUILDING DEPARTMENTAPPROVAL
PROTECT THIS CARD FROM THE WEATHER
PE IT CENTER
RESIDENTIAL
. Building Permit Application
Denartinent of Commwnty Dexelonment * 345 - 6th Street. Swte 600 * Bremerton * WA * 98337 -1873
(360) 473 -5275 * Fax (360) 473-5278 * www ci bremerton.wa us
Apphcant: 7 , 0 � Cl wnc ru ; ��' " ue Contiactoi - "� ° � Authonz ed,Agent s _ , .
Site Address 3 a a �� �-e� 64 pt/,o
To apply for a property address, contact Public Works at (360) 473.5270
CONTRACTOR: V M o tv S PLu E - 1 1 00V OWNER: s) iu r4 ft W
Address j o N.0 6X ITZ 0 .4 Address I Q 3 On A C) &T W40 1
City, State Zip .2 - 4 - 9 Z7 ' City,State,Zip j6AA*KeA_T V IT
License#&E Date rM C i4 C 4.4 hone # 366 /
Contact Name *XfL W A4ULE 11 Authorized Agent Name:
Contact Phone # '3 4E
Email address 4NXZ ± M C ity , State Zi
Tax ID /Parcel #: Z / - 3 -it - OZ Phone #. ( )
❑ Sewer Septic Email address
Whafli -'the application for, ? °(Please,check)' , ,` , New Construction,' 7i erabbn - Addition
❑ NEW SINGLE - FAMILY RESIDENCE ❑ RESIDENTIAL REBUILD
❑ NEW DUPLEX ❑ RESIDENTIAL ADDITION
❑ NEW MANUFACTURED HOME ❑ RESIDENTIAL REPAIR
❑ NEW GARAGEICARPORT ❑ NEW ACCESSORY BUILDING
DEMOLITION sf Interior sf Exterior** sf Foundation Wall" Roof / Section
** Separate demolition permit and fees required
Contact Public Works for sewer cap permit (473 -5270) Sewer must be capped pnor to demolition permit issuance
❑ OTHER
IS THIS PROPERTY WITHIN 200 FEET OF SHORELINE? YES❑ NO� y �
Sco a of work propo d �P/ktO�.�P fr�J� -i? S% S � �� - • Ca'1i/✓lQ�/�
a.-tAd LL .g_
Square Footage Building 1st Floo Basement 5 - 7 5 , — Garage : 1st Floor
2nd Floor Other 2nd Floor
Deck(s):
Valuation Plan Review Fee Permit Fee Surcharge Total Fees
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 budding official The budding official may extend the bme
for action by the applicant for a period not exceeding 180 days on request by the applicant, showing that circumstances beyond the control of
the applicant have prevented action from being taken No applicant shall be extended more than once In order to renew action on an
application fter expiration, the applicant shall resubmit plans and pay a new plan review fee o - ca 02 I 1
- Sig ture (Print) Date
Rev Oct 2008 (Continued on back)
RESIDENTIAL SITE PLAN QUESTIONNAIRE
1 Site Address
2 Are any areas being developed on the site within 200 feet of the shorehne9 Yes / No
NOTE: If yes, please fill out a Shoreline Permit Submittal Checklist (WAC 173 -27 -180)
CRITICAL AREA CHECKLIST:
3 Slope is calculated by dividing the vertical Check all that apply to the site and areas within 200 feet of the
distance by the horizontal distance and then site
multiplying the result by 100 Example
Flat less than 5 -feet elevation change over entire site
Rolling slopes on site generally less than 15%
Vertical a
Distance = 20' Billy slopes present on site of more than 15% and
less than 30 %.,
Horizontal Steep grades of greater tho 30% present on site
Distance = 100'
Vertical 20 feet Other (please describe) 4.
Horizontal 100 feet =.2 X 100 = 20% slope
4 Does the site or properties within 200 feet of the site contain areas of standing water, creek or an area
where water flows across the ground surface? Yes / No
5 Is there an apparent wetland present on the site or on properties within 200 feet of the site? Yes / No
RESIDENTIAL DEVELOPMENT WORKSHEET:
6 What is the amount of grading proposed (in cubic yards), not including foundation area
Fill amount Cut amount Total grading
NOTE: Grading over 50 cubic yards requires a separate permit
Will the grading material be unported or exported Yes / No
7 Please provide the following information The setbacks are measured from the finished exterior wall
of a structure to the lot line, not from the foundation Accurately represent your setbacks on site plan
DESCRIPTION PROPOSED
Front yard setback *Use this as the second front yard setback
Rear yard setback* for corner lots and through lots
Side yard setback
Side yard setback * *Development Coverage is defined as
Maxi num height that portion of a lot covered by unpervious
Development coverage" surface areas of all structures, and
Number of off - street impervious paved areas, such as
p arking spaces driveways and walkways
•
Residential Questionnaire Revision October 2008
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VJTSA
HE SCOTT �. LINDQUIST, MD, MPH, DIRECTOR
345 6TH STREET, SUITE 300
D 1 5 T R g C 7 ! BREMERTON, WA 98337 -1866
(360) 337 -5235
Certification for Use or s iaaioate Memo9
Abandonment Of Existing Tank u e only
A. SITE INFORMATION
Ste Address - Street Ity 23P COOS' Assessor T Account Number
B. CONTRACTOR INFORMATION (KCHD ertified Personnel)
CertNtedCOatpany Photo Num r
Mk 1- AA, C o ass n 7; oN
C. TANK CERTIFICATION (Check all fields that apply) c
TANK t - CERTIFICATION FOR: ❑ USE &ABANDONMENT
Tank Type V p T P Comments
Tank Size T -S (� gallons '(
Compartments. gone f7 Two f '
Baffles) condition verified as in good condition? [:j Yes ® NIA
1
Does the Tank have a minimum of 6" of cover? ®,Yes E] No
Risers have been Installed to grade (required) Yes
Tank has been tested and certified as water tight on Date
TANK 2- CERTIFICATICNFOR: ❑ USE ❑ ABANDONMENT
Tank Type Comments
Tank Size gallons
Compartments F� One F Two
Baffle(s) condition verified as in good condition? [:] Yes NIA i
i
Does the Tank have a minimum of 6" of cover? Yes No N
f
Risers have been installed to grade (required) Yes p
Tank has been tested and certified as water tight o i Date
D. ACKNOWLEDGEMENT & SIGNATUR
I certify that (1) the information contained in this tank certificetic n is true and accurate to the best of my knowledge (2 ) he tank has been tested to be water tight and in
good wor king dltion or that (3) the tank has abandoned per requirements of the Ketsap County Health Destnct
42AA p W �. _ d��lQ4 t/ 3 //
Signature Name Printed Date
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Kitsap County Assessor's Building Data Page 1 of 2
Building Data
Tax Account No Process No Situs Address
152401 -3- 119 -2002 1148501 11322 BERTHA AVE
Details Bldg 1 of 1
Year Built 11936
Quality & Low Rambler If Mobile Home click here for details
Type
Roof Material lComp sh to 235#
ExtWall Type lWood siding
Sq Footage
Floor Area Living Area
Basement * 575 0 * Could be basement or lower level
garage
Lower Level 10 0
Above Ground 1759 759
Total 11334 759
Porch/Deck 136
Detached
Garage
Attached
Garage
Attributes
Bedroom(s) 2 Fireplace(s) Yes
Half Bath(s) 10 Sewer N Full Bath(s) 11 Water ly
Heat Source jElectric baseboard
Other
Improvements ICNPY, WDDK
Imp (Cont) 11
Land Desc R -10 (City of Bremerton) ,
Land (Cont) ,
Land (Cont)
* Could be basement or lower level garage
** May include wood, gas, or pellet stove
http //kcwppub2 co kitsap wa us /pls /ilisw /online_lis_mfo _pkg building_data 2/3/2011
CITY OF BREMERTON PERMIT NUMBER BB11 00089
DEPARTMENT OF COMMUNITY DEVELOPMENT DATE ISSUED 02/03/2011
` 345 - 6th Street Bremerton WA 98337
(360) 473 -5275 Fax (360) 473 -5278
ASSESSOR NUMBER 152401 -3 119 -2002 ZONING R10 SITE ADDRESS 322 BERTHAAVE
APPLICANT NAME SANDERS RONALD L PHONE ADDRESS 1943 GREGORY ST NO 1 BREMERTON WA 98337
OWNER NAME SANDERS RONALD L PHONE ADDRESS 1943 GREGORY ST NO 1 BREMERTON WA 98337
CONTRACTOR M & M CONSTRUCTION PHONE (360) 732 -7777 ADDRESS 3389 WEST VALLEY RD 98325
LENDER NAME PHONE ADDRESS
SUBMITTED 02/03/2011 APPROVED 02/03/2011 EXPIRATION 08/02/2011 STATUS ISSUED
VALUATION Demolition Permit
Demolition Fee $5600 2218 Demolish SFR
State Surcharge $450 0236 Building Code Edition
TOTAL FEES $6050 Occupancy Group
Type of Construction
Flood Zone
Setbacks
Sanitation Method
Number of Bedrooms
Inspection Requests FIRE Fire Inspections (360) 473 -5394
DCD Building Inspections (360) 473 -5870 HEALTH Kitsap County Health District (360) 337 -5285
L &I Department of Labor and Industries (360) 415 -4000 PW &U Public Works - Engineering (360) 473 -5270
This permit shall become null and void if the described work authorized by this permit has not commenced within 180 days from the date of issuance or if the work is suspended or abandoned
at anytime 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 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 budding 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 conditions of this permit 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 -11) DCD Once demolition work has begun, It must be completed and ready for inspection
within 60 days All demolition debris shall be properly transported to, and disposed of
within an approved solid waste facility The property shall be left In a clean, safe condition, `
protected from erosion Demolition approval does not constitute approval for any other
work, Including site development work
10 (DCD -02) 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
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
Page 1 of 3
CITY OF BREMERTON PERMIT NUMBER BB11 00089
DEPARTMENT OF COMMUNITY DEVELOPMENT DATE ISSUED 02/03/2011
345 - 6th Street Bremerton WA 98337
3 (360) 473 -5275 Fax (360) 473 -5278
ASSESSOR NUMBER 152401 -3 119 -2002 ZONING R10 SITE ADDRESS 322 BERTHAAVE
APPLICANT NAME SANDERS RONALD L PHONE ADDRESS 1943 GREGORY ST NO 1 BREMERTON WA 98337
OWNER NAME SANDERS RONALD L PHONE ADDRESS 1943 GREGORY ST NO 1 BREMERTON WA 98337
CONTRACTOR M & M CONSTRUCTION PHONE (360) 732 -7777 ADDRESS 3389 WEST VALLEY RD 98325
LENDER NAME PHONE ADDRESS
SUBMITTED 02/03/2011 APPROVED 02/03/2011 EXPIRATION 08/0212011 STATUS ISSUED
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 Ini wa gov /p -ts /asbestos /asbestos htm n) f f
10 (DCD -50) Final Inspection Required All building permits shall have a final Inspection performed and
approved by the City of Bremerton Department of Community Development prior to permit
expiration The failure to request a final Inspection or failure to obtain final approval prior to
expiration may require a reactivation fee, or a new permit application if more than a year
has passed with no activity
11 (DCD- DEM01) IBC SECTION 3308 TEMPORARY USE OF STREETS, ALLEYS AND PUBLIC PROPERTY
3308 1 Storage and handling of materials The temporary use of streets or public property
for the storage or handling of materials or of equipment required for construction or
demolition, and the protection provided to the public shall comply with the provisions of the
authority having jurisdiction and this chapter
3308 1 1 Obstructions Construction materials and equipment shall not be placed or stored
so as to obstruct access to fire hydrants, standpipes, fire or police alarm boxes, catch
basins or manholes, nor shall such material or equipment be located within 20 feet (6096
mm) of a street intersection, or placed so as to obstruct normal observations of traffic
signals or to hinder the use of public transit loading platforms
3308 2 Utility fixtures Building materials, fences, sheds or any obstruction of any kind shall
not be placed so as to obstruct free approach to any fire hydrant, fire department
connection, utility pole, manhole, fire alarm box or catch basin, or so as to Interfere with the
passage of water in the gutter Protection against damage shall be provided to such utility
fixtures during the progress of the work, but sight of them shall not be obstructed
A Right -of -Way permit Is required if any work is to be conducted in the right -of -way,
including the placement of any dumpsters In the right -of -way
12 (DCD- DEMO2) IBC 3301 2 Storage and placement Construction equipment and materials shall be stored 4V
and placed so as not to endanger the public, the workers or adjoining property for the
duration of the construction project
IBC 3302 2 Manner of removal Waste materials shall be removed in a manner which
prevents injury or damage to persons, adjoining properties and public rights -of -way
IBC SECTION 3307 PROTECTION OF ADJOINING PROPERTY
3307 1 Protection required Adjoining public and private property shall be protected from
damage during construction, remodeling and demolition work Protection must be provided
for footings, foundations, party walls, chimneys, skylights and roofs Provisions shall be
made to controlwater runoff and erosion during construction or demolition activities The
person making or causing an excavation to be made shall provide written notice to the
owners of adjoining buildings advising them that the excavation is to be made and that the
adjoining buildings should be protected Said notification shall be delivered not less than
10 days prior to the scheduled starting date of the excavation
Page 2 of 3
CITY OF BREMERTON PERMIT NUMBER B131 00089
DEPARTMENT OF COMMUNITY DEVELOPMENT DATE ISSUED 02/03/2011
345 - 6th Street Bremerton WA 98337
(360) 473 -5275 Fax (360) 473 -5278
ASSESSOR NUMBER 152401 -3 119 2002 ZONING R10 SITE ADDRESS 322 BERTHA AVE
APPLICANT NAME SANDERS RONALD L PHONE ADDRESS 1943 GREGORY ST NO 1 BREMERTON WA 98337
OWNER NAME SANDERS RONALD L PHONE ADDRESS 1943 GREGORY ST NO 1 BREMERTON WA 98337
CONTRACTOR M & M CONSTRUCTION PHONE (360) 732 -7777 ADDRESS 3389 WEST VALLEY RD 98325
LENDER NAME PHONE ADDRESS
SUBMITTED 02/03/2011 APPROVED 02/03/2011 EXPIRATION 08/02/2011 STATUS ISSUED
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 To register for on -line inspection access, visit the City's website at www a bremerton wa us
Final Inspection - Building
Page 3 of 3
..
BRBMERTON BWIDING DBPARTMENT
Inspection Report
Scope of work: ADDITION
Ad""': BERTHA, 322
OWner: BOOTH
Contractor: N.A.
Permit Nmnber: 15138
Phone: 479-8069
Phone:
Inspeaion cud/approved plans on site
Footings: ftlCIaind me! plaament
Footings: ftlCIaind width 8[ depth
Bearing soil (soils anaIysi. if app6cable)
COMMENTS:
FOUNDATION
Setbacb
Walls: ftlCIuired .me) plaament
Walls: requind size
Special inspect<< (when app6cable)
FOOTINGS APPROVED:
~A
WAUSAPPROVED:
/ 2-- ~ Z) ~ B
COMMENTS:
deanncle to earth
60e
u.inmet....
uiRd
10'
APPROVED:
~/14- 3 /~l>-11
"
COMMENTS:
UNDER FLOOR/FOUNDATION INSlrrATIO~P~VED: ..;-
WAll. INSUlATION APPROVED:: ff ''-/'/L ~G INSUlATION APPROVED:
~
MECIUNICAL
ted
hearth
COMMENTS:____
GAS PIPING APPROVED:
______FURNACEAPPROVED:
OTHERAPPLIANCESAPPROVED:________
DWV 8[ water piping under test
DWV: proper sizing
DWV & w:ata' piping: proper support
Vent termination
Water supply: proper sizing
Water heater: garevalvc: on cold w:ater supply
Water heater reliefvalve drain to outside
R-I0 pad under w:ater beater when required
Grease lin tors: where uind
uind
COMMENTS:
~ "'-;Y ~ T-/f--1'Y ~
PLUMBING GROUNDWORKAPPROVED:___
~$-'L
PLUMBING ROUGH-IN APPROVED____ ..J 1 ,
, /?~A,c
Proper faao:ning: nails -7" o.Co Iwrii. plane
Proper futening:_12" o.c:. h.oriz. pIane(1I2")
Proper fasreniing:saews-16" o.co vert. plane (112")
P faso:ni 12" o.Co b.oriz. lane (5/8")
P faso:ni :saews-16"0.Co vert. 1ane(5/8")
Area & aration w:aDs
Usable s ace under stain (5/8" uind)
Cotridors
.BBET.OCI
I
nails-8" o.Co vertical plane
_12" o.c;.laoftz. pIane(1I2") 24" o.c;. framing
saews-12" o.co vert. pIane(1I2")-24" o.Co framing
saews-12" o.c. horiz. pIane(5/8")-24" o.Co framing
saews-12" o.Co horiz. pIane(5/8")-24" o,c. framing
Draftstops where requind
Waterboard where requind (not on cei6ng)
COMMENTS:____
~
SHEETROCK APPROVED: CYl{~ Y } q I q,.Lj
<~
Energy code requirements met, exhaust fans
GarageJdwdling door &elf dosing soHd core
Handrails & guardrails. as requind
Exit signs when m(uirc:d
Oa:apant load. posted when app6cable
Wood siding to earth separation (6")
Radon monitOl' when m(uind
PINAL
Plumbing 8[ med1anical
Smoke d.etecton where required
Fire ratings maintained
EmergaKy lighting when requirc:d
Building wc::atbertight
Building address posted.
COMMENTS:
~~ 1t[~lJi
i#a_
FINAL APPROVED:
~14v 5,11Js-1
-.....----.....--:.----
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Application Date
:l.ssue Dafe
Assessor Acct i
Site Location
Owne.r - Last Name
- Street
-City
- Phone
y . Tenant's. Name.
'~}}gent' s Name
,~rchitect's Name
\ (X] Bui Iding
.[ ] Mechanical:
[X] Plumbing
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~~==,===~='======'===='=~=~===='=z==~==,~='============
12/07/1993
12/20/1993 .
152401-3-120-2609
322 BERTHA
BOOTH
322 BERTHA
. BREMERTON
(206) 479-8069
Application Number 93AP07169
perml. t Number . 15138
Project Group
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First. GERALD
Mt
State WA Zip 98310
Phone(206)
Phone(206)
[ ) Grading
[ ] Move Building
( ] Mobile Home
( ] Sign
[ ] Burning
[ ] Land Clear
[ ] Paving
[ ] Underground
[ ] Demolition
~-_.~~----~-~--~~-~~---~-------_._-----------------~'---~-'-----'-----~--,-
B~ilding Contractor:
Work will be completed by owner.
Nature of Work:
~ x 25 addition to existing home.
APPROVED pr..ANS ANDSITEPr..AN MUST REMAIN ON SITE A.ND
AVAI LABI.E FOR INSPECTION.
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BUilding Valuat.f.on
----~.~--,-~~-~-------.---~--'-~----~~--~-~---~------~~~----_._----~~------
Census Tract
COl.mcil District
..Consfruction
Type
Residence [X] Zoning Foundation [X]
Business [) Type Framing [Xl
. other [] Insulation [X]
New ( Jpl umbing [X]
Repair [] Status Mechanical [ ]
Remodel [] Code Wallboard [X]
Addition [ ] 6 Final [X]
;:~:f ;:d.;;~~.?' --- -- --- - - - -- -- -;;;;~;~d -;; ~-1~'- - -- - -- -" - --"
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$10000.00
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'"INSPECTION REP;ORT
I have thisctay'inspected this structure and these premises and have found'the following violations
of City, County,and/or State laws governing same:
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You are hereby notified that no more work shall be covered ~o~,t!le$~'premi$e$ ~nti[Jh~C:~bove
~~'ON~; CR;;:~V;;" Thi;O"i-;~ ::Em51,J?f' re-inspecti~ . ..' ,-
INSPECTOR FOR BUILDING DEPT.
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Fee $_mf.____-==::______ mmm_mmmm_mm_mm.mu Receipt No. ._!'..t::.__:=__mmm________.,__hm_m.
BUILDING PERMIT
CITY OF BREMERTO'N BUILDIING DEPARTMENT
Owner's Value Bldg. Dept.
Value DESCRIPTION:
F, E. IRISH, Building Inspecto: . ESsex 3-1411, Exf, 36
$"",( 00 0 lot Block Additions
..., :d ,::::;;. "-J: " .."
Address on Job _~.:~.:":'.~__n.:!_~:_~-:_m~~'~_-::'m_____.n_...mnn_..mm__....m__.mm.m _m_ Da _____f._::::.._(.:f_mu___m196.t.'l.
Building u__.n."....m x _m._mmm+ and mUn_.m.n. stories __n_mn_m.m_._n. bas . Lot o.n_mm'm. X um.____n.m
Front Yard o.__.mnm__nm_m Rea~ Yard __._mm___m____m_ Side Yard n__________n___m___. Garage .mnnU___m._._mm______
I
Occupancy _"'_ _. __ _._ _.. __ _. _ _ _._ __. __ _._..l. 00_ _. 00.. n_'n 0. _u.n.. .u.unn n...u nOn __un 00 ._. ..00_.0. 0000.. Zone h. ___ 0000 '_00' _0000.00._. nO. 000000_'00'_
Owner .~-<t'_~__a:<:~k<'~f:~"'-_....mmmn_n_._n Address n._.m.mnmnmu.u___.mn.mm. Phonenn_._mmn_
I
Contractor __. n. n' 00"_ _ _.._..._ _._ n' __:.__ _.. __ n 00 _. h_ _ _ h .__ _. _......00.. Address _ 00 _ 00 _00 00 n. 00 _. _ __. _00 00 _0. nO. ___ n n.u Phone_ n _00 _..._ _ _ ___
T1;.is. permit is issued for: !
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All work to conform to all hpplicable building ordinances and amendments. Please note the following
special instructions and requir~ments.
DETACH HERE AND POST THIS SECTION ON JOB
INSPECTION - Reinforcing ste~1 must be inspected after placing and before covering, FORMS shall be inspected
and approved before pouring, All plumbing, wiring and the frame o,f all buildings must be inspected and approved
before covering. Wood preservative to be used on all wood against masonry. Ventilate foundation and attic. Sepa-
rate permits required for plumbing, wiring and heating. See City Engineer before working on streets or sidewalks,
.~ ,
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.. - - ---- ----Oo- __ ___ __ __ _____ _____ __ _____ __ ____ __ __ - _:_ - - ___ __ __ __ __ __ _______ - - __ _____ _____ - - - - - - _________..__ ____ ___ __ ___ _________ __ __ __ ______ ____ ____________________ ________ _____
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nuu uu _0. 00 00_ n_n _._ nnn_ 0000 _. _ n _00 __ _n 'I" _ 00 _ _ __ _ _ _ __ __' _ _ _,. _ _. _ _ 00 _ _ n_ _ ._. n_ n _ _ _ 00"_ 00 00 _nn_.nn. _. _. n n 00 _. __. _._ n _._ _n _.u.. u, 00_ nU. o._n 00 n __ 00__
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Owner' s Signature __ .n. n n __. __ n.j u_. u_ _ __ __ n 0. __. n_ U U 00 .u___._ _. 00 _ By U _ .__ _ n. nn __. _.. n __. n 00 __. _ n.. n _nn_. _.. n.n.n _. nn _. n n. _ _ _ _ __
! His Authorized Agent
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Building Inspecto r n _m_ m n'" n u __. __._.m.m o.mm_ ___ _u __ m u. um m. ___ Un _. ___ _ U_ _n...
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y " _.. - u __ _ _ _ _ _ _ _. _ _ _ _ _ _ _ u __u _ _ _ _ _._ _ _ _ _. _._. _. _ _ _ _ _ _ _. _ _ _. _ _ _ _ _. _.. _. _ _. _ _ _.. __ _.. _...