HomeMy WebLinkAboutPermit File 1309 16th Street (2) 1 Y C City of Anacortes Invoice/Permit#: BLD-2019-0065
904 6th Street
Applied date: 02/06/2019
P.O.Box 547 Issue date: 02/06/2019
Anacortes, WA 98221-0547
(360) 293-1901 Expire date: 08/04/2020
Job Address: 1309 16TH ST Permit Type: Single Family Alteration/Repair Permit
ANACORTES WA 98221-2226 Project:
APN:
Remarks: Replace existing windows and doors. Nothing else is included in this permit. No change in framing.
Owner: DEE ANDRICH Contractor: OWNER
Address: 1309 16TH ST Address:
ANACORTES WA 98221-2226
Phone: (360)420-0332 Phone:
License#:
General Information: Fees:
Building Valuation 5000 Building Permit Fee 111.25
Plan Review Fee 72.31
State Building Code Fee Resi 6.50
Total Calculated: 190.06
Deposits/Receipts: 0.00
Total Due: 190.06
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THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, QR:IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COME tENCF ... I
HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORkECT.ALL PI OVI$IO1IS
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-, JY OTHER STATE OR
LOCAL LAW EGULATING CONST CTION OR THE PERFORMANCE OF CONSTRUCTION.
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SIGNAT F OWNER OR AUTHORIZED AGENT ISSUED BY 'T , :45 ' iI
. 7f Y o PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
-n
r _ RESIDENTIAL BUILDING PERMIT APPLICATION
_ Mailing Address: P.O. Box 547, Anacortes, WA 98221
'�'� Office Location: 904 6th Street, Anacortes WA 98821
Phone: (360) 293-1901
PLEASE REFER TO THE RESIDENTIAL BUILDING PERMIT CHECKLIST BELOW FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS(Street,Suite#): PARCEL(S)#:
43
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Subdivision/Lot#: PROJECT VALUATION: $ ��
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APPLICANT: ) Phone: i
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Addr ss(Street,City, tate, p): c Email Address:
PROPERTY OWNER: Phone:
Address(Street,City, State,Zip): Email Address:
CONTACT PERSON: Phone:
Address(Street,City, State,Zip): Email Address:
LENDING AGENCY: Phone:
Address(Street,City, State,Zip): Email Address:
CONTRACTOR:* Phone:
(
Address(Street,City, State,Zip): Email Address:
Professional License#: Exp.Date:
*All Contractors&Subcontractors must have a valid City of
Anacortes business license prior to doing work in the City. Contact
the City's Finance Department at(360)299-1968. Business License#: Exp.Date:
PROPOSED WORK: zip,� .-7ci s i p v- t iJ c,.( QA s., T 5
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PROPOSED NEW SQUARE FOOTAGE:
Basement SQ': ❑ Finished Basement: ❑ Unfinished Basement
1'Floor SQ': Garage/Carport SQ':
2'Floor SQ': Deck/Covered Porch/Patio SQ':
Fire Sprinkler: E Yes E No Lot Area SQ':
I declare under penalty of perjury that the information I have provided on this form/application is true, correct, and
complete, and that I am the property owner or duly authorized agent of the property owner to submit a permit
application to the City of Anacortes. n(1
Print Nam ` ` (//\ k- �+`� Owne ] Agent .D pecify):
Signature: { Date: D lie/I c(
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