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PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT <br /> PLUMBING & MECHANICAL PERMIT APPLICATION <br /> Vicapt43: Mailing Address:P.O. Box 547,Anacortes, WA 98221 <br /> Office Location: 904 6" Street,Anacortes WA 98821 <br /> Phone: (360) 293-1901 <br /> PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS <br /> PROJECT ADDRESS(Street,Suite#): PARCEL(S)#: _ PROJECT VALUATION: <br /> 1918 24th Street P57612 $5,000 <br /> Subdivision/Lot#: RESIDENTIAL El COMMERCIAL ❑ <br /> APPLICANT: Phone: <br /> Barron Heating 360-676-1131 <br /> Address(Street,City,State,Zip): Email Address: <br /> 5100 Pacific Highway Suite 103, Ferndale,WA 98248 amandaa@barronheating.com <br /> PROPERTY OWNER: Phone: <br /> Michelle Borlin 253-882-7573 <br /> Address(Street,City,State,Zip): Email Address: <br /> 1918 24th Street,Anacortes,WA 98221 N/A <br /> CONTACT PERSON: Phone: <br /> Barron Heating 360-676-1131 <br /> Address(Street,City,State,Zip): Email Address: <br /> 5100 Pacific Highway Suite 103,Ferndale,WA 98248 amandaa@barronheating.com <br /> CONTRACTOR:* Phone: <br /> Barron Heating 360-676-1131 <br /> Address(Street,City,State,Zip): Email Address: <br /> 5100 Pacific Highway Suite 103, Ferndale,WA 98248 amandaa@barronheating.com <br /> *All Contractors&subcontractors must have a valid City of Professional License#: Exp. 0: <br /> BARROHA179177 10/23/2022020 <br /> Anacortes business license prior to doing work in the City. Business License#: Exp.Date: <br /> Contact the City's Finance Department at(360)299-1968. 600-092-564 <br /> Is this work,associated with another project? Yes ❑ No El If yes,specify: <br /> PROPOSED WORK: Replace natural gas tankless water heater,like for like <br /> I declare under penalty of pet jury that the information I have provided on this form/application is true,correct,and <br /> complete,and that I am the property owner or duly authorized agent of the property owner to submit a permit <br /> application to the City of A.nacortes. <br /> Print Name; Amanda Allison Owner 0 Agent L (specify): Barron Heating <br /> Signature: .54(/‘<mi Date: 04/14/2020 <br />