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FOR INSPECTIONS CALL: 0 CITY OF ANACORTES 0 PERMIT N41 8597 <br /> 293-1901 BUILDING PERMIT <br /> 24 Hrs. Notice Requested Site Address) A 1 4 tf.w,,nr1, .a,.: <br /> ' NAME (OR NAME OF BUSINESS) PLUMBING <br /> Go rel .T nhngon <br /> MAILING ADDRESS No. TYPE OF FIXTURE OR ITEM FEE <br /> i# 1313 Broadview <br /> CITY TELEPHONE NUMBER Water Closet $ <br /> f Anacortes, WA 98221 293-11176 Bathtub <br /> NAME Lavatory <br /> a Shower <br /> •• ADDRESS Kitchen Sink <br /> (a - Dishwasher <br /> • CITY TELEPHONE NUMBER Laundry Tray <br /> Clothes Washer <br /> • NAME Water Heater <br /> a Commercial Heating Urinal <br /> ADDRESS Drinking Fountain <br /> • 329 E. Blackburn Rd. Floor Sink or Drain . <br /> •z CITY TELEPHONE NUMBER Slop Sink <br /> u Mt. Vernon, WA 98273 428-5636 Water Piping <br /> STATE LICENSE NUMBER CITY LICENSE NUMBER ' <br /> COMMEHA 116R6 <br /> 0 Residential ❑ Non-Residential PERMIT $ <br /> ❑ New ❑ Add ❑Alter ❑ Repair TOTAL FEE $ <br /> 0 Building 0 Plumbing [ Mechanical MECIIA14ICAL <br /> . ❑ Sign 0 Demolition U Other C'j GAS 0 OIL ❑ ELECT. 0 OTHER <br /> Legal Description 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 /> I Boiler— HP 9,00 <br /> • Forced Air System— BTU/KW <br /> DeunsbrteiWok ping and gas furnace remove Floor Furnace <br /> • oil furnace. Wall Heater <br /> Unit Heater <br /> Clothes Dryer <br /> Oc9ppancy Use Ventilation Fan <br /> ❑ Single Family Residence 0 Multi-Family Residence Range Hood <br /> ❑ Office 0 Retail ❑ Storage 0 Church Air Handling Unit— CFM <br /> ❑ Restaurant 0 Other 1 Pre-manufactured Stove or Fireplace 3.00 <br /> NOTICE Gas Piping <br /> This permit is issued by the Building Official and,under the provisions <br /> of the Uniform Building Code,shall expire by limitation and become null 15.00 <br /> . 'and void if the building or work authorized by such permit is not com- PERMIT $ 27.00 <br /> menced within 180 days from the date of permit issuance,.or if the building TO 'AL FEE $ <br /> or work authorized by such permit is suspended or abandoned at any time <br /> after the work is commenced for a period of 180 days. TOTAL FEES VALUATION FEE <br /> k By affixing my signature, I hereby certify that I am the owner of the Building $ 0.30 <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 27.00 <br /> be complied with whether specified herein or not,including routine calls Mechanical <br /> for inspections. Sign <br /> l ' fi / Demolition <br /> /t d , f,:.. ''Z1; / Energy Surcharge <br /> Signature of Owner br AAudio' t (D.mT State Surcharge 27 .00 <br /> Street Setback Side Yard Setback Rear Yard Setback Other <br /> TOTAL $ <br />' the Zone Occupancy Group 'Type of Conn. Conditions: <br /> Lot Area Want Site Dwelling Units - <br /> ❑Yes ❑No <br />' Fire Sprinklers Required No. of Stories Bedrooms Occupant Load <br /> ❑Yes ❑No <br /> lire of Bldg. Plans Checked By: <br /> WHEN SIGNED AND DATED BELOW,DEW IS YOUR PERM <br /> Peniieapl is hereby given to do the aboye.desalb d work,acdording to the=edlUom <br /> hereon and weeding to the approved plardind epedg*Uom pertifoittg tierto,subject to <br /> compliance with the a=manes.el the CITY OF ANACORTES. U 3/19/91 <br /> Permit Issued By R,iwiri Frill nk , <br /> Building Official (Date) <br /> ... PERMIT Itr <br /> 807 . <br />