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Y <br /> 1 4 City of Anacortes Invoice/Permit#: BLD-2019-0114 <br /> 904 6th Street Applied date: 03/06/2019 <br /> P.O.Box 547 Issue date: 03/06/2019 <br /> Anacortes, WA 98221-0547"a Expire date: 09/01/2020 <br /> (360) 293-1901 <br /> OW <br /> Job Address: 1207 17TH ST Permit Type: Mechanical Permit <br /> ANACORTES WA 98221-2354 Project: <br /> APN: P55482 <br /> Remarks: T-off gas line at the meter by the house and run new gas line to the ADU (building permit BLD-2018-0753)for the gas <br /> furnace and water heater. <br /> Owner: ROBERT RICHARD Contractor: OWNER <br /> Address: 1207 17TH ST Address: <br /> ANACORTES WA 98221-2354 <br /> Phone: (360) 707-1234 Phone: <br /> License#: <br /> General Information: Fees: <br /> #of Gas Piping 3 Mechanical Permit Fees 28.25 <br /> Total Calculated: 28.25 <br /> Deposits/Receipts: 0.00 <br /> Total Due: 28.25 <br /> o <br /> �•� -" .A. r t\1 N fit• <br /> 1l .Y. r1 Y•_ •y:1 <br /> H =1 a I <br /> n .-r I I <br /> = rt •+C' wi <br /> 743 <br /> } 0 r-. mrnCI. <br /> = m <br /> ,rt -1 <br /> J .. iR <br /> c ,4 :ell <br /> n .•. n. . <br /> CO I <br /> - , cn <br /> THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIC180 DA 'S, OIL; IF <br /> CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK I; a COMMFICEE;L; ;4; <br /> HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS!: <br /> OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR-RIOT, rtHt <br /> GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIO ANY OTHER;S_TATBt::I)IR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. . <br /> .r it 4, CD <br /> • <br /> �LL <br /> SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY 1 <br /> -1 <br /> 1 IA <br />