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- . . . <br />• <br />' FOR INSPECTIONS CALL: CITY OF. ANACORTES 0 PERMIT ,a <br /> 293•I9o1 • BUILDING: PERMIT <br /> -`24 Hrs. Notice Requested Site Addressr~-n;• i I ti, <br /> NAME(OR NAME OF BUSINESS) f <br /> i PLUMBING <br /> Mr, Petal" ZiMmew ,r . <br /> MAILING ADDRESS ` <br /> No. TYPE OF FIXTURE QR ITEM FEE <br /> :fns3 t I tti 33 <br /> CITY TELEPHONE NUMBER' Water Closet. $',1 <br /> "4 Anacortei. WA 99221 , 29Z-'Otto ' Bathtub <br /> 'i k NAME ! ' Lavatory <br /> Shower <br /> ADDRESS Kitchen Sink' , <br /> vDishwasher' r• -. <br /> CITY TELEPHONE NUMBER Laundry Tray - <br /> • Clothes Washer - <br /> " NAME Water Heater <br /> Savage ft :'Pxt'a Urinal <br /> 2 ADDRESS Drinking Fountain <br /> e <br /> P.O., Bc.)r 367 -t Floor Sink or Drain <br /> (yak CITY TELEPHONE NUMBER Slop Sink <br /> -p Artacortao, WI 98221 293-24; 21, Water Piping <br /> STATE LICENSE NUMBER CITY LICENSE NUMBER <br /> SAVAGP 11943 PE 4344 '' <br /> 0 #esidential I ❑"Ion-Residential ' _ PERMIT $ <br /> ?I 0 New','--` ❑ Add ❑Alter . ❑'Repair TOTAL FEE $ <br /> ,. ❑ Eitild'ing ❑ Plumbing ❑ Mechanical MECHANICAL <br /> ❑ Sign 1 ❑ Demolition U Other ❑ GAS 0 OIL 0 ELECT. 0 OTHER <br /> Legal'D;escription of Property or Tax Account Number -' <br /> No. TYPE OF EQUIPMENT FEE <br /> Lot Block of <br /> ' Air Cond. Unit $ <br /> . Refrigeration Unit— HP <br /> _ Boiler— HP <br /> ,, Forced Air System— BTU/KW <br /> Decrrrtt 0Wfiork • Floor Furnace . . <br /> Wall Heater <br /> Unit Heater' <br /> Clothes Dryer .., <br /> ' Occupancy,.Use - Ventilation Fan , - <br /> 0 Single Family;Residence 0 Multi-Family Residence Range Hood <br /> 0 Office 0 Retail 0 Storage 0 Church , . A'ir',Handling-Unit— CFM <br /> s 0 Restaurant, 0 Other Pre-manufactured Stove or Fireplace <br /> NOTICE 1 Gas Piping <br /> This permit is issued by the Building Official and,under the provisions <br /> j of the Uniform Building Code,shall expire by limitatioi'and become null ' <br /> i and void if the building or work authorized!by,such permit is;not com- PERMIT $ <br /> "menced within 180 days from the'date of permit issuance,'or if the building <br /> , - TOTA'L'TEE $ <br /> z or work authorized by'such permit is'Suspended Or abandoned at any time <br /> after the work is commenced Mr a period of 180 days: TOTAL FEES - 1 %59 ryY pATION 2,FEFO <br /> By affixing my signature, I hereby certify that I am the owner of the ,Building $ 0 t)0 <br /> ' property for which this permit is issued or am an authorized represen- <br /> ', =tative of the owner. Plan Check ' <br /> ' ; -All provisions of laws and ordinances governing this-type of work will Plumbing , <br /> be complied with-whet�lier sp fled herein or not, including routine calls' Mechanical . <br /> i for inspeetrons.„' - # Sign <br /> / . ,,�' Demolition <br /> ;„.., , rr C" Energy Surcharge <br /> - Si wne or Authorized Agent 't(Date) State Surcharge <br /> 1 .. . . Other Sid ..''eu <br /> ' Street Setback Side Yard'Setback Rear Yeid:Setback - TOTAL $ <br /> i <br /> Use Zone Occupancy;Group Type of Const. Conditions: <br /> t. Lot Area Vacant Site Dwelling Units <br /> i- ❑Yes ❑No - <br /> Eire Sprinklers Required No. of Stories Bedrooms Occupant Load -:, <br /> E•]Yes El No <br /> Size of Bldg. Plans Checked By: <br /> . t <br /> WHEN SIGNED aD DATED--BELOW THIS IS YOUR PERMIT <br /> Permission is hereby given'tb do;the ibi;A desnibed work,&manaing;to the conditions t <br /> hereon and according'to'tbea'approyedap",lane`ind'speafiia'tionp,pertaimng'�therto,subject to <br /> ;compliance with the ordinances oVtlie=CITY;CF ANACORTES. ° /f d}uspr 91 <br /> �y2. <br /> .: 'f Permit Issued By Iu dui i ri r r arilt <br /> Building Official _(Date) .,!1',7,i <br /> Ir..' rOuvirri, 8$0 <br />