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CITY OF BREMERTON DEPARTMENT OF COMMUNITY DEVELOPMENT PERMIT NUMBER DATE ISSUED: g~m~t?QQ~;~;ililiiiiII 286 Fourth St. Bremerton, WA 98337 (360) 478-5275 Fax: (360) 478-5278 ASSESSOR NUMBER: APPLICANT NAME: OWNER NAME: CONTRACTOR: LENDER NAME: 3806-005-016-0001 GIDNEY CHONG S & CRISTINA M GIDNEY CHONG S & CRISTINA M HIJ FIRE & SAFE SUBMITTED: 05/06/2004 VALUATION: $2,000.00 $69.25 2211 $45.01 4580 $4.50 0236 Building Permit Plan Review Fee State Surcharge TOTAL FEES: Inspection Requests DCD: Building Inspections L&I: Department of Labor and Industries ZONING: CD SITE ADDRESS: 104 N CALLOW AVE PHONE: ADDRESS: 104 N CALLOW AVE PHONE: ADDRESS: 104 N CALLOW AVE PHONE: (206)353-9123 ADDRESS: PO BOX 5853 PHONE: \ ) ADDRESS: APPROVE~\ \ EXPIRATION: 11/14/2004 FIRE SUPPRESSION SYSTEM FOR TYPE I RANGE HOOD FOR GYO GYO RESTAURANT Building Code Edition: Occupancy Group: Type of Construction: Flood Zone: Setbacks: Sanitation Method: Number of Bedrooms: Square Footage: 1 TOTAL (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. Bid Price from Applicant (360) 473-5870 (360) 415-4000 Fire Inspections HID: Bremerton, Kitsap County Health District PW: Department of Public Works his permit including all conditions of zoning, building codes, and State and Federal laws. PRINTED NAME: ~.-o CON IONS City of Bremerton's ap oval of this application pertains only to the City's regulatory jurisdiction, and thus compliance with City \ regulations does not ne essarily ensure compliance with federal or state laws. 1. 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). 2. DCD: For more information, please contact Clean Air Agency through their web site at www.c1eanair.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. 3. Fire: Fire protection systems must comply with UFC, NFPA, UBC and BMC standards. 4. Fire: Type I hood required to meet UL300 standards. Suppression system shall be interfaced with fire alarm system to provide monitoring. Hood must be tested prior to final inspection approval. K-class fire extinguisher required. 5. All testing as required, prior to using 6. Install a class K extinguisher near stove 7. For testing appointment contact (360)473-5385 Page 1 of 2 '- CITY OF BREMERTON DEPARTMENT OF COMMUNITY DEVELOPMENT PERMIT NUMBER DATE ISSUED: 286 Fourth SI. Bremerton, WA 98337 (360) 478-5275 Fax: (360) 478-5278 ASSESSOR NUMBER: 3806-005-016-0001 ZONING: CD APPLICANT NAME: GIDNEY CHONG S & CRISTINA M PHONE: OWNER NAME: GIDNEY CHONG S & CRISTINA M PHONE: CONTRACTOR: HIJ FIRE & SAFE PHONE: (206)353-9123 LENDER NAME: PHONE: SUBMITTED: 05/06/2004 APPROVED: SITE ADDRESS: ADDRESS: ADDRESS: ADDRESS: ADDRESS: 104 N CALLOW AVE 104 N CALLOW AVE 104 N CALLOW AVE PO BOX 5853 EXPIRATION: 11/14/2004 8, Cross Connection: A cross connection (source of potential contamination to domestic water supply) inspection is required prior to issuance of a Certificate of Occupancy, Contact Earl Varner-at (360) 473-5927 to request an inspection, C 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. Cross Connection Control Final Inspection - Fire Page 2 of 2 -1WICiI GUARD. fC: IIE------ L. :,' L_.... The WetChemical Fire Suppression System 3-22 Cylinder Sizing After finding how many nozzles of each type are required for a system. the sum of all- the nozzle flow numbers is used to determine the number and size of the cylinders required. in accordance with the cylinder flow number _~ limits given below. - Table 3-30 Cylinder Flow Number Limits '.' - Ma~iml,lm F.loW Numbers of CyJinders " . ,,' '. ,:' Cylinder -:... ;., ~:. - :c', . . . Row.Nurn.ber . . . . RG-4GT or RG-4GS (15 L)(Long or Short 1 Cylinder 2 Cylinders 3 Cylinders 4 Cylinders :';"f.~R~G: RG-1.25G(4.7L) 4 Single Cylinder Only - (Cannot Manifold) 12 24 Can Manifold · 36 Up to 4 Cylinders 48 fij} ~ @ (g 0 W(g Jru In1 MAY 0 6 2004 ~ BREMERTON BUfLDlNG r)J:'Ol\PT'~Iit:~I'" .Only like cylinders can be manifolded (ie. four RG-4GS, two RG-SG.) The system can be actuated through vartous controls. in accordance with Table 3-4. To actuate a single cylinder system. use either the Mechanical or Electric Control Head or the A+ Control Box with pressure operated actuator. To actuate two or three cylinders. use either one or two Tandem Control Heads and a Mechanical or Electric Control Head or the A+ Control Box with 1-3 Pressure Operated Actuator(s). To actuate from 1 to 5 cylinders. the A+ Control Box with Pressure Operated Actuator(s) must be used. For applications requiring 5-10 cylinders the BMCS-l nitrogen releasing system is recommended. Larger systems. 10-100 cylinders. the BMCS-7 nitrogen releasing system is the recommended means of cylinder actuation. For complete details of the BMCS-l and BMCS- 7 systems. refer to each respective manuals. PIN B900002 and PIN B9000003. - Table 3-4. Actuation Controls Mechanical or Electric Tandem A+Control System Size Control Head Control Head Box BMCS-1 BMCS-7 '1 Cylinder .t .t 2 Cylinders .t. ,/ .t... 3 Cylinders .t.. .t .t... 4 Cylinders .t.. .t .t... 5 Cylinders .t.. .t .t... , 5.10 Cylinders .t.. .t... 10+ Cylinders .t"" .t... ./... .. o Requires both a mechanical or electric control head and tandem control head .. Requires a mechanical or electric control head and multiple tandem control heads ".BMCS s'eries requires a mechnica'.or electric control head to actuate. U.L.1. Ex 2458 3-22 Manual Part No. 9127100 (9/97) Badger Fire Protecllon The Wet Chemical Fire Suppression System . flAtlCE ellARD. 3-21 Nozzle Summary \.! Table 3-2. Nozzle Summary \'~>.:..;"~'f:"i1;. .~ . . . Perimeter '~. . Diameter .... ;.,i .,.'J~';: ,,:;:'Nozzlel... ,X".f. . ~ ~"..l'>::;;:, <!~~\-&," ~ .;..". ~ - -.. . M ;," """".. ~" ?r,;~:':,:.f'(...~~"f'"~l"~q)} <'''';' ; ,_ t' ., ~ tt~d"i}"';' . >" ~. -. . . . Max. ax. t~ngth. '-:"'; ~.'\:,I7IQw,No. Duct iJ ..:'. ~ ,~ .;,;. 50"(165.1 em) 15.91" (39 em) Unlimited. ADP/1 """:0'0"; '25A'c' M \""'~~I'I"~'cm" .. J\~'\";O""lrm'''itea"1''iJ:~1~~'A''RiiT2'~ ,:....v,4i,!.L,.:~_.:,:d[f -';.--,._.,:<,:1!;:,-"..,~-1.': _&t~;~~t:-,__ :-~, ~~""~""'~-. -_~~L.-;:.,:g1.:.,~"',._",:,"',._,._,:,;:""'~~\y~:~\~,~,~,~.-,L,.,,>:M ..... ...,'~' .,'i...... .:' " L th ' . W'dth .' ", ~.;.f<ll-.'" N' II ,;,c. h",.'t~,..-.. #:./ - ,';" -, , . eng. 'I I . " ','" <. "",,'t. ~11: ozz e , . '';,'.~. >'~ J"f'(::::''!.JfYf'_~ ".1<'l "I p. ' . .! ~ " . \'. .."'" 'til '.~~"" _, ~-... _:;: . azard ; :1, z,'."; "". 4~. ::. '. -. Max.' Max.: - Filters~' ,:':l:~.~:.. _ flow 'No. - - " < , , ~;? ~ Plenum 10' (3.0 m) 4' (1.2 m) "V" 8ank or Single ADP /1 ,:.:: :_-,:~,;.,;,.:..:. ~:::.-.':"..,.''- . HazardSize ~ Nozzle Height tI!ltes..: .,~.,,'::.-~ozzlel _ Hazard., ","'" .:" ':" , : -:. -". '. Inches/cm t. Inches/em Incnes/cni . -' .: . Flow-?: ' ~ . ~ ' . .. . '" < ,. Four-BumerRange 28 X 28 (71 x 71) 201042(5210107) wilhin 9(23) rad. \ of mid point. ..' B /1 ~iCO<ll[~g~~9~f~~"BIII.11tl~ifjlii~!f~'!~:{~~)~~Q:(1jI~il:w\i~1It:~~i33tri1.~lll1t"1IZ~W!2!illi.l~l~~~G;'i~n Single Val Deep Fal Fryer (Drip Boardsrto6 [2.5to18]) 18 X 18 (46 x 46) 271045 (6910114) 45010900 F/2 ~j"il~I~~V~1!"iRi~Iary2~~~I,~9Wf[~~~J~r~~~>>.!grtll~i~1l&~Jl~~~1l!:11J~jili;11,';%N;ii?t1~:rtQn~~tl~~11~t~Q]~C:ffi~lrll'1!i'1im?:;f~::i;';;:!ll~1Il0EiIi;! Split Vat Deep Fal Fryer 14 x 15 (36 x 38) 27 (69) t045 (117) 45010900 .' F/2 ~~.iI~pI~pl[~jli{xi~{fgig[9~mili;'[~j;'[tEI1Sfril1jlli\:;;!~1~1!1(q~!i~}Jlll.1;!}'1\I~'%~~~J~~JJ2~271[~li~~'~1I~~~R~iTj~~ii~;:;mi~QEll~;1IllrJ[{1~;f;~ Woks 141028 (3610 71) Dia. within 2 (5) 3108 of mid Pumice Rock (Lava, Ceramic) Charbroiler 22X23(56x58) 24(61)1048(122) 45010900; 2 Layers.of rock F/2 Electric GaSL~ Mesquite Charbroiler (Chips;wood. Logs) ""30X2f(is-xlfij" 24(61)1048(122) 45010900 GRW /1 ,;::>;L:g!(~.1i~~{L~!;1~li';~;t[~~[6~~~12!)%;)l~':''iIgflrtflJI',](Tj:;'[j nu24(SiTto'48(l22) -. 45010900; ---- 10 (25) Fuel deplh DM / 3 Tilt Skillet and Braising Pan 24 x 24 (61 x 61) 27.5 in (70 em) 10 46 in (117 cm) wilhin perimeler .' F /2 . , ~oZzle; . -. . No' ~ ",' Ji- ..., . , I' . ~ . ) ; ':',Iitentification . -. - . No' , . ADP(Appliance-Duct-Plenum) 81~~OO11 1 GRW(Gas Radiant-Wok) . 8120013 1 '. 0~1[~:<!!i[Q!li~I}ar.i;l~i1Z~~^lt;;)!J~~!Itiii'i't}J[~!;'~~J]jJi!2J~li[bJt]!1if.l1J11111!i;Ji OM (Mesquite) 81~~OO15 3 U.l.I. Ex 2458 3.21 Manual Part No, 9127100 (9i97) Badger Fire Protection Wet Chemical Instruction Manual AD-5 Designing for Larger Duct Protection \j Ducts 50 to 100 inches in perimeter: TwoADPnozzles. P/NB120011. pointing in the same direction are required for protection of ducts with perimeters greater than 50 inches and less than or equal to 100 inches. Ducts can be of unlimited length (See Figure AD-5). For other option of ducts up to 75 perimeter inches (See Figure AD-7 on page AD 1-9. Note: All Range Guard systems are listed by UL for use with the exhaust fan either on or off when the system Is discharged. . & .. .. DUCT Y \ HOOD x ~~J;C. Y2 X., · \ .. ~X x Y2x . " ~ Maximum Diameter: 31.83 inches Il . NOZZLES TO BE ALONG ONE CENTERLINE AT THE \4 POINTS. NOZZLES TO BE 0" TO 6" UP FROM ENTRANCE OF VERTICAL DUCT Maximum Diagonal: 11.78 inches Maximum Diagonal: 11.78 inches TYP. (2)"ADP NOZZLES. B120011 SQUARE RECTANGULAR ROUND Ct. ~ :ftL"~.:~NOZZLE It.- _J_ ~l .. DUCT ENTRANCE / . ~ OF VERTICAL DUCT I - --r- AIM POINT _ _ _ _ ~ OF HORIZONTAL DUCT 2 10 4 inches nozzle lip 10 duel hip ADP NOZZLE VERTICAL/HORIZONTAL DUCT Figure AD-5. Duct Protection Using Two ADP Nozzles, PIN 8120011 U.L.1. Ex 2458 AD1-7 December, 1997 Wet Chemical Instruction Manual AD-2 Designing for Plenum Protection \~ A single ADP nozzle (PIN B120011) will protect a single filter or "V" filter bank plenum with the follow- ing maxiIr.um dimensions: Plenum Length Plenum Width 10 Feet (3.0 m) 4 Feet (1.2 m) When no filters are present. the nozzle protecting the plenum is used to discharge the wet chemical on the underside of the hood. In this case. the hood may not exceed a length of 10 ft. (3.0 m) or a width of 4 ft. (1.2 m). A plenum with either a single filter bank or 'V" filter bank and a length of 10 ft. (3.0 m) or less may be protected by one ADP nozzle. The nozzle shall be located atone end of the plenum. Longer plenums may be similarly protected with a single ADP nozzle being used for each 10 ft. (3.0 m) of plenum length and each 4 ft. (1.2 m) of plenum width. ADP nozzles may be used in combinations (see Figure AD-2). Multiples may be installed facing in the same direction. and I or at the ends of the plenum pointing in. Each nozzle shall provide a maximum of 10 feet of coverage. ADP nozzles must be centrally located in the plenum with their discharge directed along the length of the plenum and located in relation to the filters as-shown in Figure AD-2. Note: All Range Guard systems are listed by UL for use with the exhaust fan either on or off when the system Is discharged. 4 FT. (1.2 M) PLENUM WIDTH NOZZLE LOCATED AT EITHER END OF PLENUM LENGTH AIMED DOWN' LENGTH OF PLENUM :'--20 FEET 1 I 10 I 10 ! P. <1 ACCEPTABLE NOZZLE POSmONS FOR MULTIPLE NOZZLES ADP NOZZLE 1 FLOW NUMBER . 113 W(. I I t ,. 01-' . H .~'b _.J j-w-+i SINGLE BANK FILTER COVEFtAGE %H1_ T H .:& "V" FILTER BANK COveRAGE Figure AD.2. Plenum Protection Nozzle PIN 8120011 U.L.!. Ex 2458 AD1-4 December, 1997 The Wet Chemical Fire Suppression System RANQ GlIARD. 3-5 Deep Vat Fryer ,and Griddle l. SINGLE VAT DEEP FAT FRl'ER WITH DRIP BOARDS One F nozzle or Plenum nozzle will protect one Single Vat Deep Fat Fryetwith a maximum hazard area 0[)8" x 18" (46 emx 46 ern) and an appliance area i8~ x 23" (46 em x 58 em) for fryers with a drip board. The nozzle is located at an angle of 45 degrees or more from the horizontal. It shall not be more than 45"(114 em) nor less than 27" (69 em) from the top of the appliance and aimed at the midpoint of the hazard area. The nozzle can be outside the perimeter of the appliance. (Hazard Area 18" x 18" (46 em x 46 em) - See Figure 3- 7) 48" 122an) Max Top 01 Appliance AIM PT.- 3' Radius from lilt Midpoint of HIZanI AtN Figure 3-8. Griddle - Flat Cooking Surface SPLIT VAT DEEP FAT FRYER One F nozzle or Plenum nozzle will protect a Split Vat Deep Fat Fryer with a split vat hazard area maxi- mum of 14" x 15" (36 em x 38 em) without drip board and 14" x 21" (36 em x 53 em) with a drip board. The nozzle is located at an angle of 45 degrees or more from the horizontal. It shall not be more than 45" (114 em) nor less than 27" (69 em) from the top of the appliance and aimed at the midpoint of the hazard area. The nozzle can be outside the perimeter of the appliance. (Hazard Area 14" x 15" (36 em x 38 em) - See figure 3-9) U.L.I. Ex 2458 AN F NOZZLE MAY BE LOCATED ANYWHERE WITHIN THE GRID DIAGONAL FROM AIM POINT 18" ,- (46 em) . MAX" tI Figure 3-7. Single Vat Deep Fat Fryer GRIDDLE - FIAT COOKING SURFACE One ADP nozzle will protect one griddl~ (with or without raised ribs) with a maximum hazard area of 30" x 42" (76 em x 107 em). The nozzle is located at any point on "the perimeter of the appllance and aimed at a point 3" (7.6 em) from the midpoint of the hazard area. It shall not be more than 48" (122 em) nor less than 13" (33 em) above the edge of the appli- ance perimeter. Positioning the nozzle directly over the appllance is not acceptable. (See figure 3~8.) AN F OR PLENUM NOZZLE MAY BE LOCATED ANYWHERE WITHIN THE GRID DIAGONAL FROM AIM POINT 45" (114 em) MAX" AIM POINT: MIDPOINT OF HAZARD CENTERED ON DIVIDER ~ 21" (114 em) INTERIOR OVERALL \ .1 Figure 3-9. Split Vat Deep Fat Fryer 3-5 Manual Part No. 9127100.(9/97) Badger Fire Protection ,~ GIIAAD. The Wet Chemical Fire Suppression System . 3-10 Upright Broiler jSalamander Broiler Upright Broiler One ADP I10zzlewill protect a broiler compartment with maximum internal horizontal dimensions of 30-1/4" x 34" (77 cm x 86 CII1); The nozzle Is located within the top 4" (10 cm) of space in the broiler compartment (see figure 3-17). It is ciimed tlirbugh the grill toward the center of the grease drain-off opening. Nozzles are commonly mounted on upright broilers near the front opening and directed inside the broiler. t. BROILER TO') 4" (10cm)- MAX t FRONT (BROILER DOOR REMOVED) _aHAUST DUCT NOTE: Dimensions shown are inside broiler compart- ment. +- ADP nozzle should be mounted on the perimeter of the broiler top (Shaded area). It should be directed through the grill toward the center of the grease drain-off opening. Nozzle discharge shall not be obstructed by any struc- tural part of the broiler. R.SIDE WOKS Figure 3-17. ADP Nozzle Installation for Upright Broilers One GRW nozzle will protect one wok: WOK Min. / Max. Diameter - 14" to 28" (36 to 72 cm) WOK Min./ Max. Depth - 3" to 8" (8 to 20cm) The nozzle is to be located directly over the center of the\vok aimed at the center and is allowed a 2" (5 cm) deviation from the center. It shall be not more than 56" (1,42 cm) nor less than 35" (89 cm) from the inside bottom of the wok being protected. (See figure 3-18) t 3S"(B9cm) MIN -, ! 3"(Bcmj to B"(20cm) DEPTH 1 56"(142cm) MAX. + U.L.I. Ex 2458 2" MAX. OFFSET ONE GRW NOZZLE MAY BE LOCATED ANYWHERE WITHIN THE SHADED AREA AIMED AT CENTER OF WOK. NOTE: ONE NOZZLE IS REQUIRED .. ,F.OR EACH WOK 14"(36em) to 2S"(71 em) DIA. . CENTER OF HAZARD AREA 'AT BASE OF WOK M Figure 3-18. WOK Nozzle Installation 3-10 Manual Part No. 9127100 (9/97) Badger Fire Protection I I r\OOD /5/ DUCT IS''x.2o'' RANGE GUARD 6 GALLON WET SYSTEM 1/2" EMT /S' UL 300 W6KoO ~~~nw~ MAY 0 6 2004 BREMERTON I I I ~,r I r @ ~l I , . -frY .. I I , 'PI' I o - /6'L> < 816'1 Fil<yER ( ') @t '3 f I " Ip. I I .If" I r 00 MANUAL PULL STATION FRYn< RICE COO~ HIJ .wanlS Jf. 9/l!, Fire & Safety PO BOX 58531 TUKwtLA, WA 98138 (425)445-3473 HIJ-FIRE c FIRE SUPPRESSION SYSTEM BUSINESS NAME BUSINESS LOCATION GBoq- O} 04-3 U~""'" ~~\;~' i,. :" L__.p'c/ IT CENTER FILe r=- I RC. CL-c. Department of Community Developtuent ::- 286 4th Street ::. Bremerton ::. ';;Y/ A ::- 98337 (360) 478-5275 ::- Fax (360) 478-5278 Building Permit Application APPLICANT: OWNER Address: City, State, Zip Phone #: ( ) Authorized Agent Address: Contact Phone #: City, State, Zip Phone #: ,( @ ) Check the type of application for below: o NEW SINGLE-FAMILY RESIDENCE D NEW COMMERCIAL o NEW DUPLEX D COMMERCIAL REMODEL o NEW MANUFACTURED HOME D COMMERCIAL ADDITION o RESIDENTIAL REMODEL D COMMERCIAL REPAIR o RESIDENTIAL ADDITION D NEW MULTI-FAMILY o RESIDENTIAL REPAIR D TENANT IMPROVEMENT IS THIS PROPERTY WITHIN 200 FEET OF A SHORELINJ;? ~: ,~,1A1 .' 2004 BREMERTON NEW GARAGGffitl!3'fNG'@Ef5ARTMENi NEW ACCESSORY SLOG NEW SIGN STRUCTURE DEMOLITION GRADING (Cubic yards: _ ) .oTHER NO D Scope of Work Proposed: SQ9are Footage: Dwelling: ," Garage: Decks: Valuation " / ~()~..--J j. . . \. Application for/~Gh no pfr>4?tPs ~~tdt~t180 days following the date of application shall expire by:mitation, 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 on . In order ,to renew action on an application after expiration, the applicant shall resubmit plans and pay a new plawrev' w fee. ;::. APPLICANT'S SIGNATU Total Fees 76 -"...., DATE: .s'--6 --0 K ,/ ~P~Uu ~ GBof- !ilr;- ~-O (L 1',<,' I 'I _.....,....1'..'"'" :/i: O) C)4-3 ."..:~ ~ ~ a w ~a' ERl\1IT CENTER II MAY 11 ZQO'4 .' .."' De artment of Communi ~evelo ment -,- 286 4tl -eet.,- Bremerton .,- '''\i/A''- 98337 f-- \ 6ufdt ~ ~~rfJM75 ::- Fax (360) 478-5278 . , ,,' II ... OEPARTMENT Building Permit Application APPLICANT: OWNER Address: City, State, Zip Phone #: ( Authorized Agent Address: ) Surcharge Cjc95 , C) A I' t' f /h,i h ' {)lJ, D l? 0 /d ' . Vth' ''?180 d f II ' th d t f I' t' h' II 'b "~ . " pp IcaIQn.,.,.9f-'w IC no permll IS Issue ,WI if1 ays 0 oWing e a e 0 app Ica Ion s a expire y 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 0:: ' In order to renew action on an application after expiration, the applicant shall resubmit plans and pay a new plc;..n/rev'~w fee, " Contact Phone #: City, State, Zip Phone #: Check the type of application for below: D NEW SINGLE-FAMILY RESIDENCE D NEW DUPLEX D t"JEW MANUFACTURED HOME D RESIDENTIAL REMODEL D RESIDENTIAL ADDITION D RESIDENTIAL REPAIR o NEW COMMERCIAL o COMMERCIAL REMODEL o COMMERCIAL ADDITION o COMMERCIAL REPAIR o NEW MULTI-FAMILY o TENANT IMPROVEMENT Scope of Work Proposed: Sq[jare Footage: Dwelling: Garage: Valuation Plan Review Fee Permit Fee ./ / APPLICANT'S SIGNATU '. ~ ( /01 u ) .~l<\ 1 \,' Z004 8REMERTON NEW GARAGg{ltLkllfNG'B~ARTMEf\1r NEW ACCESSORY BLDG NEW SIGN STRUCTUREDEMOUTION GRADING (Cubic yards: _ ) OTHER NO 0 Decks: Total Fees '76 DATE: ,S-r- 6' ~ 0 k' .../ CITY OF BREMERTON DEPARTMENT OF COMMUNITY DEVELOPMENT Receipt Number: B0~(j0016~'i ~.......;.r.i:.iilliIII\J 286 Fourth St Bremerton, WA 98337 (360) 473-5275 Fax: (360) 473-5278 Total: $ 69.25 $ 4.50 $ 73.75 $0.00 $0.00 BB04 01043 BB04 01043 Building Permit State Surcharge 1/2211 1/0236 $ 69.25 $4.50 [e,,,i6a~PaYm.~'~'i.. h'l:hh"~~~e"~'~~cfSti6 B000001604 05/06/2004 Plan Review Fee $45.01 BB0401043 CHECK 2131 Total: Page 1 of 1 CITY OF BREMERTON DEPARTMENT OF COMMUNITY DEVELOPMENT Receipt Number: 286 Fourth St. Bremerton, WA 98337 (360) 473-5275 Fax: (360) 473-5278 051g~1209~i" ,'" -J%&. ~;~';-'" ,~';~::,-_ - ..,,::ii;i:-, ',. ,~:~- - _~:~:~ -:~~~ paye'rlpayee"Name:< . HIJ'ijIRE.&:SAFE;ry sri' . ... ..' . ... '.' ... ...d',8, '::Ii 880401043 114580 Plan Review Fee ,~:r:~XiOu~~.~..~~nt..~.ist9,~' . ,:1f,; $eeD~scriptipn . ~Paym.Emt i',Mettlod m.w' CHECK eheck "'ii N~mbe,;jii 2121 $ 45.01 $ 45.01 Total: $ 45.01 Total: ,.,.....'.".".'." ........"...'.'.".','" )~/' -"",' ",'" ,,~Am()Hrt ;;; P~id 0~~ c" $ 45.01 $ 45.01 $0.00 Page 1 of 1