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' Y C} City of Anacortes <br /> Invoice/Permit#: BLD-2016-1171 <br /> 904 6th Street <br /> Applied date: 04/06/2016 <br /> P.O.Box 547 Issue date: 04/06/2016 <br /> Anacortes, WA 98221-0547 <br /> Expire date: 10/03/2017 <br /> .11 <br /> Job Address: 2003 12TH ST Permit Type: Reroof Single Family Residence <br /> ANACORTES WA 98221-2005 Project: <br /> APN: P57147 <br /> Remarks: Residential reroof <br /> Owner: TOM BROOKS Contractor: MT. BAKER ROOFING <br /> Address: 2003 12TH ST Address: 3950 HOME RD <br /> • <br /> ANACORTES WA 98221-2005 BELLINGHAM WA 98226-9147 <br /> Phone: Phone: (360) 733-0191 <br /> License#: MTBAKRI055ML <br /> General Information: Fees: <br /> Building Valuation 4585 Building Permit Fee 111.25 <br /> State Building Code Fee 4.50 <br /> Total Calculated: 115.75 <br /> Deposits/Receipts: 0.00 <br /> Total Due: 115.75 <br /> fry •i; <br /> I i I m I''.j I't,. i I} .-•. <br /> ; ICI <br /> • I•.r 1.L <br /> IT.. ', <br /> 0 an ^:; ,i. III <br /> it. Int n <br /> --1 ::•Ii m <br /> -1- Im1 <br /> n+. C. ::{1 . <br /> THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS; <br /> CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMqNCP.J' I;I; <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 IIbT, <br /> GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE;qP, . <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. : <br /> I:�t I:_n it. CI <br /> SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY <br /> ch. <br /> I-I <br /> It' <br />