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Site Address:
(360) 473-5275
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1101,
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Building Permit Application
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473-5278 * �vww.ci.bremerton.wa.us
To apply for a property address, contact Public Works at (360) 473-5270
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❑ Sewer
❑ Septic
Email address:
What its the ap Iicatlon�oi Tease: chec%)
c New Construction ❑
Alteratton'❑"Addition
❑ NEW COMMERCIAL
❑ COMMERCIAL REMODEL
❑ COMMERCIAL ADDITION
❑ COMMERCIAL REPAIR
❑ NEW MULTI -FAMILY
❑ DEMOLITION Interior
❑ TENANT IMPROVEMENT WITH WORK
❑ TENANT IMPROVEMENT WITHOUT WORK
❑ NEW SIGN
❑ GRADING (Cubic Yards: )
❑ REROOF
Exterior** Foundation Wall** Roof /Section**
** Separate demolition permit and fees required.
Public Works for sewer cap permit (473-5270 . Sewer must be capped prior to demolition permit issuance.
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IS IS PROPERTY WITHIN 200 FEET OF A SHORELINE? YEs ❑] , NO (I all C
dy Scope of work proposed. �`1 v 7 7 �� �cj z f`/� j
Square Footage: Building: _ � ��C,� Construction Type:
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 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,fronAeinp taken. No applicant shall be extended more than once. In order to renew action on an application
after expira >i, e p icant shall Os bmit Maas and pay a new plan review fee.
Applicant's j t nature
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Rev. July 2008