HomeMy WebLinkAboutBLD-2008-0465 - RE-ROOF RESIDENTIAL GZT ..O :T City of Anacortes Permit#: BLD-2008-0465
\ 6 904 6th Street Issue date: 09118/2008
P.O.Box 547
,�+; �T► `jam} Expire date: 09/18/2009
Anacortes, WA 98221-0547
Job Address: 1012 16TH ST Permit Type: Reroof Single Family Residence
ANACORTES WA 98221-2221 Project:
APN: P55140
Remarks: Tear off roofing, install OSB sheathing and comp shingles
Owner: KAREN MILLS Contractor:
Address: 1012 16TH ST Address:
ANACORTES WA 98221-2221
Phone: Phone:
License#:
General Information: Fees:
Building Valuation 7240 State Building Code Fee 4.50
Building Permit Fee 68.50
Total Calculated: 73.00
Deposits/Receipts: 0.00
Total Due: 73.06
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I
HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL
PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR
NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER
STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SIGN TURE OF OWNER OR AUTHORIZED AGENT ISS D BY
0,IT
o Residential Building Permit Application
Building Department
P.O. Box 547 Anacortes, WA 98221
Phone No.: 360-293-1901 FAX: 360.293.1938
SITE ADDRESS: t O t •Z t io'E S r
CONTRACTOR ®i p cant -Pt�ROJECT DESCRIPTION
Name Slj&NQ>tl R-0() 1=lv'� \eA.L O,FF
Address - l.'a Z' -{1rLF+'N 6A-"R_k-':a T- t2.j (A S T.ZtL-(- t I u- U S t9 y 1.S !=v L
City/State/Zip gtlw i.s- 01v2,34 14 W0GJv�J arj" t'�uN Solt Ni®i.ci
Phone q2 1 14ft/0 FAX
State License# ' VUC Exp tL a
PARCEL NUMBER n S I b
City of Anacortes License 1"
PROPERTY OWNER c ❑Applicant LEGAL DESCRIPTION
Name AaQ•C�ly 4�ilt-�7
Address
City/State/Zip A ry\C-4' Art Lw'� c)Z-Lf PROJECT VALUATION t9
Phone'Vt 3._L-L i i FAX
Number of Dwelling Units
E-Mail Address Number of Stories
Building Area:
0 Architect❑Designer ❑Engineer O Applicant 1"Floor s.f. 2nd Floor s.f.
Name 3`d Floor s.f. Basement s.f.
Address Garage s.f. Carport s.f.
City/State/Zip Deck s.f. Lot Area s.f.
Phone FAX
E-mail Address
CONTACT RJ-Applicant LENDER
LENDER INFORMATION MUST BE PROVIDED FOR PROJECTS OVER$5,000
Name J t lA 0 J =( IN VALUATION PER RCW.
Address Name
City/State/Zip Address
Phone FAX City/State/Zip
E-mail Address Phone No.
CONTINUED ON THE BACK
Residential Mechanical Fixtures
Fuel Type
❑ Natural Gas ❑ Electric ❑ Wood ❑ Propane Gas ❑ Other
Type of Equipment Number of Type of Equipment Number of
Fixtures Fixtures
Furnace<=100K BTU Clothes Dryer
Boilers/AC/Heat Pump as Water Heater
Gas Outlets Gas Fireplace
Ventilation Fans Fireplace Insert
Stove,Appliance Other Units
Range Hood
Residential Plumbing Fixtures
Type of Fixture Number of Type of Fixture Number of
Fixtures Fixtures
Toilet Clothes Washer
Bathtub Electric Water Heater
Shower Utility Sink
Dishwasher Hose Bibb
Hand Sink Water Piping
Kitchen Sink w/Dis osal Additional Fixtures
I HEREBY ACKNOWLEDGE IF HAVE READ THIS PERMIT APPLICANT AND STATE THE INFORMATION IS CORRECT,AND AGREE TO COMPLY
WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING ACITIVIES COVERED BY THIS PERMIT APPLICATION. WITH THIS PERMIT ALL
CONTRACTORS AND SUBCONTRACTORS SHALL HAVE A CURRENT WASHINGTON STATE CONTRACTORS LICENSE AND A CITY BUSINESS
LICENSE.STOP WORK ORDERS WILL BE ISSUED ON JOB SITES WHERE CONTRACTORS/SUBCONTRACTORS ARE WORKING WITHOUT
PROPER LI �NSE. o
Ll
AAPLICANT SIGNATURE DATE
1
Last Updated 11-29-05