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PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT <br />` Mailing Address: P.O. Box 547, Anacortes, WA 98221 <br />Office Location: 904 51 Street, Anacortes WA 98821 <br />Phone: 360 293-1901 <br />,CM <br />•R:' r r ' • .• ON <br />1. PROPERTY INFORMATION <br />Project Address(Street, Suite <br />'a � or <br />Assessor Parcel Number: z I <br />J a <br />Subdivision/Lot #: <br />Zoning Designation: <br />Lot area (size): i 7 ft. <br />t sq. <br />2. TYPE OF PROJECT <br />❑ New SFR ❑ New Accessory Dwelling Unit: ❑ Deck/porch (new/repair) <br />❑ New Duplex ❑ Attached to Primary Unit ❑ Interior remodel <br />❑ Detached from Primary Unit <br />❑ New Addition to SFR ❑ Garage, carport or accessory building ❑ Fence or retaining wall <br />or duplex (new/repair) <br />Z Other: F%C15A t AA) oA.- xviet,, tA0.C1, <br />Project Summary: VNS Lr(U— <br />fS iak+DVA <br />o� <br />�- 5110Nkc�"s 46 lv� h-}- <br />�c <br />Project Valuation: $ <br />3. PROPERTY OWNER INFORMATION <br />Name: ,� <br />Phone: <br />Address (Street, City, State, Zip): <br />Email Address: <br />4. CONTRACTOR INFORMATION <br />Name:* 'r <br />hone%L5 5g3 yrJoi�P <br />A ll�f andl gas{afo4io+t <br />Contractor's Business Licens s <br />State License #: <br />�t <br />City License #:/ <br />6 a <br />'All Contractors & Subcontractors must have a valid City <br />Expiration Date: <br />Expiration Date: <br />03 <br />of Anacortes business license prior to doing work in the <br />City. ; or V4'1# ,I <br />P o anal <br />Address (Street, City, State, Zip): <br />Email Address: <br />5. CONTACT PERSON <br />Select one person the city will contact for anything <br />El Applicant 0Property Owner ❑Contractor <br />related to this project: <br />❑ Other list below <br />Name: ', <br />Phone <br />(7 <br />Address (Street, City, State, Zip): <br />Email i ddress: <br />ea <br />q 8aae <br />Res. Building Permit Application Submittal Checklist <br />Updated October 10, 2019 <br />Page 5 of 18 <br />