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0 0 <br /> FOR INSPECTIONS CALL: CITY OF ANACORTES PERMIT -04.1 $fl7 <br /> 293-1901 BUILDING PERMIT <br /> 24 Hrs. Notice Requested Site Address 1105 10th Street <br /> NAME(OR NAME OF BUSINESS) PLUMBING <br /> Douglas 4 Susan Tibbles , <br /> MAILING ADDRESS 1105 10th Street No. TYPE OF FIXTURE OR ITEM FEE <br /> CITY TELEPHONE NUMBER Water Closet $ <br /> Anacortes, WA 9822' Bathtub ' <br /> NAME Lavatory ' <br /> Shower <br /> ADDRESS Kitchen Sink • , <br /> Dishwasher <br /> CITY TELEPHONE NUMBER Laundry Tray <br /> Clothes Washer <br /> NAME Water Heater <br /> Jorgensen Home Improvements Urinal <br /> r ADDRESS Drinking Fountain <br /> 550 Mercer Suite 115 Floor Sink or Drain <br /> CITY TELEPHONE NUMBER Slop Sink <br /> ' 0 Seattle, WA 98109 283-8200 Water Piping <br /> STATE LICENSE NUMBER CITY LICENSE NUMBER . <br /> JORQEH 1181 M9 <br /> I' ❑'Itesireie l i 0 Non-Residential PERMIT S <br /> QTIeiv f Add ❑ Alter El Repair TOTAL FEE S <br /> ❑tuilding 7 Plumbing C] Mechanical MECHANICAL <br /> ❑ Sign ❑ Demolition 0 Other ❑ GAS ❑ OIL ❑ ELECT. ❑ OTHER <br /> Legal Description okf Propertyl 'Ri <br /> x x Account Number3-4 No. TYPE OF EQUIPMENT FEE <br /> 1.. Lur i g i na i tO nacortes Air Cond. Unit S <br /> 3772-058-004-0004 Refrigeration Unit— HP <br /> Boiler— HP <br /> Forced Air System— BTU/KW <br /> Describe Work - Floor Furnace <br /> New roof and vinyl siding Wall Heater <br /> Unit Heater <br /> Clothes Dryer ' <br /> i I1I Occupancy Use Ventilation Fan <br /> L Single Family Residence ❑ Multi-Family Residence Range Hood <br /> O Office ❑ Retail 0 Storage ❑Church Air Handling Unit— CFM <br /> ❑ Restaurant ❑Other Pre-manufactured Stove or Fireplace <br /> NOTICE Gas Piping <br /> 1 - This permit is issued by the Building Official and,under the provisions <br /> of the Uniform Building Code,shall expire by limitatiorf and become null <br /> J and void if the building or work authorized by such permit is not com- PERMIT S <br /> Merced within 180 days from the date of permit issuance,or if the building TOTAh FEE S <br /> or work authorized by such permit is suspended or abandoned at any lime 4- A ' <br /> I i atter the work is commenced for a period of 180 days. TOTAL FEES VALUATION FEE <br /> By affixing my signature, I hereby certify that I am the owner of the Building 18,000.UG $ 1 29.00 <br /> Property for which this permit is issued or am an authorized represen- 0.00 <br /> It�I'tive of the owner. Plan Check <br /> All provisions of laws and ordinances governing this type of work will Plumbing <br /> complied with whether specified herein or not,including routine calls Mechanical <br /> r inspections. Sign <br /> Demolition <br /> Energy Surcharge <br /> Signature of Owner or Authorized Agent ;(Date) State Surcharge 4.50 <br /> ' stria SaMck S Ya ide rd aclr Rear YardY Setback Other ErrAt $ 133. 50 <br /> use zone occupancy Group Type of coast. Conditions: <br /> ' Lot Area Vacua Site Melling((nib <br /> OYes ❑No <br /> ' Eke Sprinklers Required Na.of Stories Bedrooms.Occupat Load <br /> ' OYa ❑No <br /> Size of Bldg. Plans Checked By; <br /> WHEN SIGNED AND DATED ,THIS IS YOUR PERMIT <br /> hereon <br /> �armed above vomit to the sbjec to <br /> - 4o�a pwtNdng tkerW subject W <br /> sampan—with the ordinance's of the CITY Op'ANikCORTEB. <br /> 07/31/'J1 <br /> Permit Issued Byt a j g% d 2 JtJyy�,l ' n' „ ' S,......_ , <br /> liudtng oiFcia ' (Dale) <br /> Edwin Franc <br /> PERMIT $r $7 <br />