HomeMy WebLinkAboutPermit File BLD-2023-0098 1314 15th Street City of Anacortes Invoice/Permit#: BLD-2023-0098
904 6th Street
Applied date: 02/16/2023
P.O.Box 547
Issue date: 02/16/2023
Anacortes, WA 98221-0547
r. Expire date: 08/14/2024
Job Address: 1314 15TH ST Permit Type: Mechanical Permit
ANACORTES WA 98221-2213 Project:
APN: P55579
Remarks: Replace gas water heater for the same.
Owner: ADAM&ERIN BLACK Contractor: FOSS HEATING AND COOLING
Address: 1314 15TH ST Address: 333 E BLACKBURN RD
ANACORTES WA 98221-2213 MOUNT VERNON WA 98273-9006
Phone: (425)273-3005 Phone: (360)336-1517
- License#:
General Information: Fees:
#of Gas Water Heaters— 100k 1 Mechanical Permit Fees 38.20
Total Calculated: 38.20
Deposits/Receipts: 0.00
Total Due: 38.20
The issuance or granting of this permit shall not be construed to be a permit for, or approval of, any violation of this Code or any other ordinance or order of
the City, of any state or federal law, or of any order, proclamation, guidance advice or decision of the Governor of this State.To the extent the issuance or
granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or
federal law, or order, proclamation, guidance advice or decision of the Governor of this State, this permit shall not authorize such work and shall not be
valid. The building official is authorized to prevent occupancy or use of a structure where in violation of this Code, any other City ordinances of this
jurisdiction or any other ordinance or executive order of the City, or of any state or federal law, or of any order, proclamation,guidance advice or decision of
the Governor. The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect,
inaccurate or incomplete information, or in violation of any City ordinance, regulation or order, state or federal law, or any order, proclamation, guidance or
decision of the Governor.This permit becomes null and void if work or construction authorized is not commenced within 180 days or if construction work is
suspended or abandoned for a period of 180 days at any time after work is commenced. I have read and a in d this cation and know the same to
be true and correct.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED Y
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PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
Mailing Address: P.O. Box 547, Anacortes, WA 98221
Office Location: 904 61h Street, Anacortes WA 98821
�:. 4... . Phone: (360) 293-1901
PLUMBING & MECHANICAL PERMIT APPLICATION
Please complete all applicable information and submit to buildingpermit@cityofanacortes.org
PROPERTY INFORMATION
PROJECT ADDRESS ASSESSORS PARCEL NUMBER
1314 15th St. P55579
PROJECT VALUATION
RESIDENTIAL COMMERCIAL
PROPERTY OWNER OWNER PHONE
Adam Black 425-273-3005
OWNER ADDRESS OWNER EMAIL
1314 15th St. Anacortes, WA 98221 oreosheep@gmail.com
APPLICANT INFORMATION
PROPERTY OWNER CONTRACTOR OTHER:
NAME PHONE
Foss Heating and Cooling (360)336-1517
ADDRESS EMAIL
333 E. Blackburn "Rd. Ste. A Mt. Vernon, WA 98273 orders@fossheating.com
CONTRACTOR INFORMATION
NAME PHONE
Foss Heating and Cooling (360)336-1517
CONTRACTOR'S BUSINESS LICENSES* STATE LICENSE# EXPIRATION
*All Contractors & Subcontractors must have a valid FOSSHC1983QA 11/1/24
City of Anacortes business license prior to doing work UBI LICENSE# EXPIRATION
in the City. 602236031 9/30/23
ADDRESS(STREET,CITY,STATE,ZIP) EMAIL
333 E. Blackburn rd. Ste. A Mt. Vernon, WA 98273 orders@fossheating.com
PROJECT INFORMATION
DESCRIPTION OF PROPOSED WORK:
Replace natural gas water heater with like in kind.
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? F— YES X NO
If YES, provide the permit/application number:
Plumbing/Mechanical Permit Application
Updated December 2021 Page 1 of 3
MECHANICAL
APPLIANCE/EQUIPMENT INFORMATION (NEW AND RELOCATED)
EQUIPMENT TYPE Indicate the number of fixtures for each equipment type TOTAL
GAS ELECTRIC OTHER-Please specify COMMENT
Furnace
Wall Heater
Water Heater 1 1
Heat Pump
Air Conditioner/Handler
Radiant/Hydronic Heating
Exhaust Fans
Range Hood
Fireplace
Clothes Dryer& Duct
Stove/Range/Oven
Refrigeration Unit
Gas Piping/Outlet(s)
Boiler BTUs:
Other
TOTAL MECHANICAL OUTLETS 1
PLUMBING FIXTURES
FIXTURE TYPE (NEW AND RELOCATED) TOTAL FIXTURE TYPE(NEW AND RELOCATED) TOTAL
Toilets Refrigerator water supply
Kitchen Sink Pressure Reduction Valve/Regulator
Utility Sink Water Service Line
Tub Water Piping
Hand Sink Washing Machine
Shower Electric Water Heater:Tank-less? Yes❑ No❑
Dishwasher Backflow Prevention Device
Urinal Hose Bib
Floor Drain/Floor Sink Drinking Fountain
Hydronic Heat in: ❑Floor ❑Wall Grease Interceptor
Other-please specify:
TOTAL PLUMBING FIXTURES
Plumbing/Mechanical Permit Application
Updated December 2021 Page 2 of 3
PLUMBING & MECHANICAL PERMIT APPLICATION CHECKLIST
COMMERCIAL RESIDENTIAL
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O SUBMITTAL REQUIREMENTS = c = c T
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Plumbing& Mechanical Permit Application ✓ ✓ ✓ ✓
Mechanical Plans ✓
Structural Calculations ✓
State Non-Residential Energy Code Compliance Form ✓
Manufacturer's Specifications/Cut Sheets ✓ ✓ ✓
Plumbing Plans ✓
Listed &Tested Fire Stopping Assemblies ✓
Elevation View for Roof Mounted Equipment ✓ ✓
Existing Floor Plan ✓ ✓ ✓ ✓
New Floor Plan ✓ ✓ ✓ ✓
NOTE:
1. Handouts and standard details may be found on the City's Planning, Community, & Economic
Development website or can be obtained at city hall during normal business hours.
2. Plans, calculation, & reports prepared by state licensed architects or professional engineers must
be stamped and signed by the design professional.
3. If installing a backflow prevention device, it will need to pass test results of which will need to be
submitted to the city for review.
ACKNOWLEDGEMENTS & SIGNATURE
By affixing my signature hereto, I certify that I am the owner,or am acting as the Owner's authorized
agent, and that the application and documents contained with this submittal are complete and
accurate to the best of my knowledge and abilities.
2/16/23
SIGNATURE DATE
Plumbing/Mechanical Permit Application
Updated December 2021 Page 3 of 3