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F.OR-I,NQ,PECTIO.NSCALL: ,;CITY OF ,ANAC,ORTE$`_ PERMIT ` !, 2 '' <br /> 293-1901 BUILDING PERMIT <br /> 24 Hrs. Notice-Requested Site Address01° 11t,1't Street <br /> • <br /> NAME':I(OR NAME OF BUSINESS) <br /> Pav -iVerflP PLUMBING <br /> MAILING`ADDRESS <br /> Na TYPE OF FIXTURE OR ITEM FEE y <br /> <°t31O i,tt t-Strt L i, <br /> CITY' 'J TELEPHONE NUMBER Water Closet " $ s, <br /> Aitiltitoilititee, WA 48221 293-5694 Bathtub ' <br /> NAME;,. Lavatory <br /> - - 'Shower <br /> ADDRESS, • Kitchen Sink <br /> - -Diahwasher <br /> CITY TELEPHONE NUMBER, ' ,Laundry Tray - <br /> H , , Clothes Washer . , <br /> NAIVE ' - Water Heater <br /> l': i y sH es Halting Urinal <br /> ADAItEs8 _ � • , Drinking Fountain <br /> -9H i W i 'I ttwllI�'ood, Lane Floor Sink or Drain -' <br /> CITY TELEPHONENUMBER Slop Sink <br /> g: r tac`�rtes, WA 98221 2€ 3-8843 Water Piping <br /> S];ATE LICENSE NUMBER CITY LICENSE NUMBER" - <br /> 00'040 4SIS8M 344 H • <br /> 0 Reaidentid ❑Vcn-Residential ' , PERMIT $ . <br /> ❑f NeW', "'❑Add ❑Alter '0-Repair TOTAL FEE $ <br /> 1 Oi Btl(Iding 0 Plumbing it: Mechanical MECHANICAL <br /> q Sign - 0 Demolition ❑,Other 3E] GAS ❑ OIL ❑'_ELECT. ❑ OTHER <br /> Legal Descriptioi of Propetty or,Ta c.4ccourit Ntimbert,, r.'' ' " No. "'4y';,,i' "TYPE";OF?EOI)IWI t FEE <br /> Lot i Block of <br /> Air Cond. Unit $ <br /> - Refrigeration Unit— HP <br /> Boiler— <br /> Forced Air System— BTU/KW <br /> Describe Work ,Floor Furnace - <br /> Oss, Pit9inn - - -Wall Heater, ' ' <br /> Unit Heater <br /> Clothes Dryer , <br /> Occu <br /> Pency.Use - <br /> n Vetilation Fan - <br /> ' ,p Single Family Residence 0 Multi-Family'Residence Range'Hood <br /> O Office " I] Retail 0 Storage ' ❑-Church Air Handling Unit— -CFM <br /> 0, Reatautant U] Other Pre-manufactured Stove or Fireplace ' <br /> 7 NOTICE 1 Gas Piping S JU <br /> This permit is issued by the Building Official and,under the provisions - <br /> ofthe�'Uniform Building Code,shall expire by limitation and become null - - <br /> and-vo�id if the building or work authorized by such-.permit-is,not com- ' , - _PERMIT $- 16-''O , <br /> mencd within 180'days from the date of permit issuanee,or if the_building TOTAL FEE " $ , 18* Jtd : " <br /> or,work,authorized by such permit is suspended or abandoned at any time " - ,jl <br /> after die work if commenced for a period of 180 days. TOTAL FEES VALUATION FEE • <br /> By ,affixing my signature, I hereby certify that I ant the owner of the - <br /> property for which this permit is issued or am an authorized represen- Building , $ " 'A <br /> tative,of the owner. Plan Check .O•"U _ <br /> tb' <br /> .All provisions of laws and ordinances governing this;,type of work will Plumbing_ <br /> • beiicomplied with whether specified herein or not,inclpding routine calls Mechanical 1#,,8W t,�{' :'t <br /> for inspections. '- Sign <br /> t .' i'` •�q�� Demolition - - - ' <br /> 4�"`t �l� 4� Die, ' s' }� ,""' Energy Surcharge' - ",, <br /> Sig'I mots M liar or Amho Agent . - '(Date) State Surcharge <br /> ' Street Setback Side Yard Setback ' Rear'Ya dSetback Other 'I - <br /> TOOL $ t 8,t!£t j <br /> Use zone Occupancy Group Type or Const Conditions: <br /> Lot Area Vacant Site Dwelling Units - - <br /> ❑Yes ❑No - . <br /> Fire Sprinklers Required No. of Stories Bedrooms Occupant Load <br /> ❑yes ❑No „ <br /> Size of Bldg. Plans Checked_By: - " <br /> WHEN:SIGNED AND-DATEDiBELOW,THIS IS YOUR PERIIDT <br /> Penmiedon u hereby'given to do the lib W derbed wale,aegwding to the conditions ' <br /> 'f gi lit- Ul io`e <br /> hmeon and aapdtrig W thehhPProved Dlaro and hate pertaining Gterto,subject W . i - <br /> compliance with th'enkninms of the cm OF ANACORTES. ,. <br /> ' 08/18/92 - ' <br /> Permit Issued By. f r1,t`.,zwAt vJ - 4 ..J ies/ SI—, - I .' - T <br /> ' Building'Ofcial (Date) - <br /> Edwin Frsnk <br /> 'PERMIT . - 'V..' 9832 ''' <br />