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-'ate - -sc iK�'.NH>AY�b^F. :n.i., •. <br /> FOR INSPECTIONS CALL: CITY OF ANACORTES PERMIT ;;.;I 7543 <br /> 293-1901 BUILDING PERMIT <br /> 24 Hrs. Notice Requested Site Address <br /> 1401 H A e <br /> NAME (OR NAME OF BUSINESS) PLUMBING <br /> x .,err} C'rusbs <br /> MAILING ADDRESS No. TYPE OF FIXTURE OR ITEM FEE <br /> 21 S loth Street <br /> CITY TELEPHONE NUMBER Water Closet $ <br /> It . '\ t rnon, Fla. 336-5901 Bathtub <br /> NAME Lavatory <br /> b Shower <br /> ADDRESS Kitchen Sink <br /> U Dishwasher <br /> cc CITY TELEPHONE NUMBER Laundry Tray <br /> Clothes Washer <br /> NAME Water Heater <br /> xiies;tcuast Roofing , Inc . Urinal <br /> ADDRESS Drinking Fountain <br /> 114-I Bur 1ingtot, R1‘ :1 Floor Sink or Drain <br /> z CITY TELEPHONE NUMBER Slop Sink <br /> o• itirI i ❑gtott, Wa 7;7-'1000 Water Piping <br /> STATE LICENSE NUMBER CITY LICENSE NUMBER <br /> ti1.'S1'CkI110ri1l <br /> 0 Residential 0 Non-Residential PERMIT $ <br /> 0 New 0 Add O Alter Q Repair TOTAL FEE $ <br /> O Building 0 Plumbing 0 Mechanical MECHANICAL <br /> ❑ Sign 0 Demolition 0 Other 0 GAS 0 OIL 0 ELECT. 0 OTHER <br /> Legal Description of Property or Tax Account Number ° <br /> No. TYPE OF EQUIPMENT FEE <br /> Lot Block of <br /> '171101-;"1)100066 Air Cond. Unit $ <br /> • , Refrigeration Unit— HP <br /> Boiler— HP <br /> Forced Air System— BTU/KW <br /> Describe Work • Floor Furnace <br /> R.9_Po,,f Wall Heater <br /> Unit Heater <br /> Clothes Dryer <br /> Occupancy Use Ventilation Fan <br /> O Single Family Residence 0 Multi-Family Residence Range Hood <br /> O Office 0 Retail 0 Storage 0 Church Air Handling Unit— CFM <br /> ❑ Restaurant 0 Other Pre-manufactured Stove or Fireplace <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 <br /> 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 TOTAL 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 /> By affixing my signature, I hereby certify that I am the owner of the <br /> property for which this permit is issued or ant an authorized represen- Building 1 , 1 Ofl - 00 $ -15 . 00 <br /> tative of the owner. Plan Check 0, 00 <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 <br /> for inspections. Sign <br /> Demolition <br />, Energy Surcharge <br /> Signature of Owner or Ausariied Agent (Date) State Surcharge <br /> Street Setback Side Yard Samaek Rear Yard Setback Other n t a t e <:u nc 1'a r g e TOTAL $ 'rt-- c o <br /> d - r,0 <br /> Use Zone Occupancy Group 'type of Const. Conditions: - <br /> kt1 <br /> Lot Area Vacant Site Dwelling Units <br /> _❑Yes ❑No . <br /> Fire Sprinklers Required No.of Stories Bedrooms Occupant Load <br /> ❑Yes 'O No ' <br /> Size of Bldg. Plans Checked By: <br /> WTI SIGNED AND DAIED BELOW,TEN S YOUR PERMIT <br /> Permission is hereby given to do the above described work according to the conditions - <br /> hereon and according to the approved plans specifications pertaining thefts,subject to - <br /> compliance with the ordinances of the OF ANACORTES. <br /> Permit Issued Byt �jy //ae,ey 1 /2 9/8 9 <br /> Building official (Dale) <br /> Eli, in Frank PERMIT 1 t,^� e7 y43 <br /> � t e <br />