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a,.. nn.. , kaaltwa4 <br /> _ .vKrw.ra'-+�+cM`NrunA^ M4zu�Y�^+,.kl"�'S#3#k'?' WJr '''e^a�, 'qr 'ra`#ChaNt".''r:Szb°7.s"4a."4r°:iA1 '.4 <br /> 0 <br /> 51 FOR INSPECTIONS CALL: CITY OF ANACORTES PERMIT wti 77V V <br /> 293-1901 BUILDING PERMIT <br /> 24 Hrs. Notice Requested Site Address I t 3. Lsy w;L ' I <br /> -;. NAME (OR NAME OF BUSINESS) <br /> PLUMBING <br /> ▪:: x . <br /> w, MAILING ADDRESS <br /> • Na TYPE OF FIXTURE:9R 4ITEM FEE <br /> ' CITY TELEPHONE NUMBER Water Closet <br /> '▪i' 'Anncortei , 4;A 962111 :'9.; M.';G Bathtub 4! $ <br /> NAME - Lavatory ' <br /> b Shower <br /> 'E ADDRESS Kitchen Sink <br /> x <br /> Dishwasher <br /> vw <br /> CITY TELEPHONE NUMBER Laundry Tray <br /> Clothes Washer <br /> NAME Water Heater <br /> ' a ,' c)' 1 L+: PI.a:tt)a?q`.L' C'cstx:.c I, Urinal <br />' ADDRESS - Drinking Fountain . <br /> ''`' gI,:3I I .3.1t.to :=tro&..'t -Floor Sink or Drain • <br /> `r. CITY TELEPHONE NUMBER _ Slop Sink <br /> :,i O,13u.ts^.)t^(.t;. r W. ;38221 22' i9)..rf5, Water Piping <br /> :,�;�: STATE LICENSE NUMBER CITY LICENSE NUMBER <br /> • <br /> '"'` 10 Residential' 0-Non-Residential ' PERMIT $ , <br /> ❑ New 'D Add ❑Alter' '❑ Repair TOTAL FEE $ <br /> 0 Building ' JD:Plumbing :❑ Mechanical MECHANICAL <br /> ❑ Sign , ❑ Demolition ❑ Other .0 GAS ❑ OIL ❑ ELECT. ❑ OTHER <br /> ,: Legal Description of Property.or Tax Account Slumber ° <br /> '1 No, TYPE OF EQUIPMENT FEE <br /> Lot Block of ' <br /> i`'' . Air Cond. Unit $ <br /> `r " 3772 - Ei 5-1' O04/ - 00G-J • ' Refrigeration Unit— HP <br /> f Boiler— NI HP <br /> Forced Air System— BTU/KW <br /> Describe Work <br /> Floor Furnace . <br /> :4 t.ri lai l•iriti • Wall Heater <br /> _ • - Unit Heater <br /> - ' Clothes Dryer <br /> Occupancy Use Ventilation Fan <br /> ❑ Single Family Residence ' D:Multi-Family Residence Range Hood <br /> C. , ❑ Office , ❑ Retail ❑ Storage ❑Church Air Handling Unit— CFM <br /> ❑ Restaurant ❑ Other Pre-manufactured Stove or Firepiabe <br /> NOTICE 3. Gas Piping f�i^ <br /> This permit is issued by the Building Official and,ander the provisions • <br /> of he Uniform Building Code;shall expire by limitation and.become null , <br /> and void if the building,or work�authorized by such permit is not corn- PERMIT $ I 5 4Th • <br /> menced within 180 days fitimitthe date 8 t of permit issuance,or if the building TOTAL FEE $ I 0 <br /> ` or)kwork authorized by such,petnut is suspended or abandoned at any time <br /> e, after the work is commenced,for,a period of 180 days. <br /> Y',_ ° TOTAL FEES VALUATION FEE <br /> ?�,.} By affixing my signature i he'reby certify,that I am the owner of the ' <br /> property for which this permit'is issued or am an authorized represen- Building $ <br /> tative of the owner. . , Plan Check .. C) . a'?ii <br /> All provisions of laws and ordinances governing this type of work will Plumbing <br /> ` be;complied with whether specified herein or not,including routine calls Mechanical ( ;; i'p!t <br /> a,?; for inspections. Sign <br /> //r Demolition - <br /> ` t.;,: . :-,-t. - `f'f. !.,• .: fir'--;%"' Energy Surcharge <br /> i J Signature of Owner or Authorized Agenl` ;(Date) State Surcharge <br /> - - ' Other . <br /> ppp - _, Street Setback Side:Yard Setback RearVard�Setback. TOTAL $ 19 . 00 <br /> , Use Zone Occupancy Group Type of-Const. Conditions:' <br /> f Lot Area Vacant Site Dwelling Units <br /> -t <br /> ❑Yes ❑No • - <br /> a.', Fire Sprinklers Required No.of Stories Bedrooms Occupant Load 1 I <br /> ❑Yes .b No • <br /> Size of Bldg. Plans Checked By:' <br /> WHEN SIGNED!AND DATED:BELOW,THIS IS YOUR'PERMIT —) . <br /> Permission is hereby,gbden to,do thelabov"e,desirribed lark;according to the conditions <br /> .hereon and Accmdidg to the spprobect plaiiil mid'Specifications'pertaining therfo,subject to: <br /> compliance with the md'manma of the CITY 0 ACORTF.S. ' <br /> ?;t 3,?"2 /:'!0 _ <br /> Permit Issued Byr(?� wit,% . ' <br /> Building Official (Date);: «q <br /> ,i,;s. .tl ) t:rra: PERMIT Dill # Qtt <br />