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FOR INSPECTIONS CALL: MY OF ANACORTES PERMIT <br /> 2si3t90t BUILDING PERMIT <br /> • <br /> ' 24 Hrs. Notice,;Requelted Site Address i i .- 1 i p r, a t r.a.p L. ' <br /> NAME(OR'NAME°OF BUSINESS) <br /> <& M. raroriscdaatr$ >'Lt,MBINIP. <br /> MAILING ADDRESS , Na TYPE OF <br /> 1216 lltil 'St r pat OEiST Si'. <br /> CITY TELEPHONE NUMBER Water Closet $ <br /> Anacor 1.t3s, WA 98 21 . -,,._ 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 /> R&P Inv. Urinal <br /> ' se <br /> • iADDRESS Drinking Fountain <br /> G.CI, Bun. 431 Floor Sink or Drain <br /> CITY TELEPHONE NUMBER Slop Sink <br /> O Mnac:or tes, Wf* 98221 243-2235 Water Piping <br /> STATE LICENSE NUMBER CITY LICENSE NUMBER , <br /> RRINV**1O1JZ _ _ <br /> [''Resklentl$ D Non-Residential '. PERMIT $ <br /> ❑ New tJ Add ❑Ayer 0 Repair TOTAL FEE $ <br /> CI Building ' ❑Plumbing in Mechanical MECHANICAL <br /> ❑ Sign ❑ Demolition Q Other ❑ GAS ❑ OIL ❑ EI,ECI'. ❑ OTHER <br /> Legal Description of Property or Mix Account Number Na 'TYPE OF EQUIPMENT FEE <br /> j,�� Block of <br /> ,71 t-6.78-D1.#-0000 Air Cond. Unit $ <br /> Refrigeration Unit- HP <br /> Boiler- HP <br /> —Forced Air System- BTU/KW <br /> Describe Work Floor Furnace <br /> Add Garassie, Wall Heater <br /> Unit Heater <br /> Clothes Dryer <br /> ` Occupancy Use Ventilation Fan ' <br /> Il Single Family Residence ❑ Multi-Family Residence Range Hood ' <br /> ' '- ❑ Office ❑ Retail ❑Storage ❑Church Air Handling Unit- CFM . <br /> 0 Restaurant ❑ Other Pre-manufactured Stove or Fireplace <br /> NOTICE Gas Piping <br /> This permit is issued by the Building Official and,under the provisions <br /> of the Uniform Building Code,shall expire by limitatigh and become null _ <br /> and void if the building or work authorized by such,permit is not corn- ' PER$ET $ <br /> menced withirt:180 days from the date of permit issuance,or if the building itrrAL FEE $ <br /> or work authorized by such permit is suspended or abandoned at any time <br /> after the work is commenced for a period of l80 days. TOTAL FEES VALQATION FEE <br /> By affixing my signature, I hereby certify that I am the owner of the ' <br /> Building , jfj()-0,. <br /> r, $ P,z "AI <br /> property for which this permit is issued or am an authorized represen- plan Check <br /> ' trove of the owner. r, 16 <br /> All provisions of laws and ordinances governing thistype of work will Plumbing <br /> be complied with whether specified herein or not,including routine calls Mechanical <br /> for inspecti e. -,,.•^' -^ Sign ' <br /> 3 - <br /> � T..- + Demolition <br /> nergy Surcharge <br /> Signature of Owner or Authorized Agent (Date) State Surcharge u ",' <br /> 'w Other <br /> Street Setback Side Yard Setback Rear @rd:sailsck TOTAL $ <br /> e" r `iQ <br /> Use Zone occupancy Group Type of Cat. ' Conditions: <br /> Lot Area Vacant Sit Dwelling Units <br /> ❑Yet ❑No - <br /> Fire Sprinklers Required Na of Stories Bedrooms Occupant Load K is <br /> ❑Yes ❑No <br /> Size of Bldg. Plans Checked By: <br /> MTV SIGNED AVID mistWOW,1 lams rramsr <br /> Permi.ien'S kitty shin dq the;Owe deiaAbed work tais Sw to the condition <br /> hereon and ward*to tsappawed plans hod_padEatiaos pew therto,subject to <br /> compWoa with the adman-d the an-or ANACORI'FS. <br /> p� t rr`, <br /> Permit Issued By a i .,�' .'1 ilk), yy�e��a <br /> Building Official (Dot) 10 @ wet saws <br /> Lc1iir! Fr�ant uV 6a�wnr�Vl <br /> PERMIT <br />