HomeMy WebLinkAboutPermit File BLD-2019-0167 2501 Creekside Lane ZT G Cityof Anacortes
Invoice/Permit#: BLD-2019-0167
904 6th Street
Applied date: 03/27/2019
P.O.Box 547 Issue date: 03/28/2019
0 Anacortes, WA 98221-0547 Expire date: 09/23/2020
:_., 4_`- (360) 293-1901
Job Address: 2501 CREEKSIDE LN Permit Type: Mechanical Permit
ANACORTES WA 98221-2459 Project:
APN: P83999
Remarks: install gas insert to existing gas piping.
Owner: MARY MCCLUNG Contractor: CRAFT STOVE INSTL OF MV WA LLC
Address: 2501 CREEKSIDE LN Address: 900 W DIVISION ST
ANACORTES WA 98221-2459 MOUNT VERNON WA 98273-3226
Phone: (206)409-3575 Phone: (360)336-3532
License#:
General Information: Fees:
#of Gas Fireplace 1 Mechanical Permit Fees 34.15
Total Calculated: 34.15
Deposits/Receipts: 0.00
Total Due: 34.15
r r.} ,- ,fr,
.. 0
tl t ••' i i R,
U rt ..•L)
I, I
,.-... ,-, Q ;a i ci
F} � os. za i_i,
--I f."} --a
•, U?
.• m w i
h+• H II]
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DiVS,. O 1
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCE .It
HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PRfih SIZ PC
OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR`TNG '_'H
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHERESTATE.?O_,
LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ) -r
r-,
a _�
+: c r r.)
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSU Y n n �'
3 tit
Ceist
Y 00 PLANNING,COMMUNITY,&ECONOMIC DEVELOPMENT DEPARTMENT
t PLUMBING as MECHANICAL PERMIT' APPLICZAUMN
ypw7 Mailing Address:P.O.Box 547,Anacortes, WA 98221
vlea
ca Office Location:904 6th Street,Anacortes WA 98821
Phone: (360)293-1901
PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDR S(Street,Si},it #): PARCEL(S)#: PROJECT VALUATION:
SrO 1 &PCX,r--c 4_e.. S i d..c° ,c
Subdivision/Lot#:
RESIDENTIAL ❑ COMMERCIAL ❑
APPLICANT: Phone:
C(G't 1 -!- 5+o 0--336- 3 2
�3Co
Address(Street,City,State,Zip): Email Address:
1(1) ( r\ 1-'W. 'k von \A A c__r l- s-k-DJd'S W CIS k C
PROPERTY OWNER: Phone:
PAo x' M COQ`�� 204- L uci-35-15
Address(Street,City,State,Zip): Email Address:
2Se 1 c sad Lr A w'&LO4cSS VJ c a Fs2.21
CONTACT PERSON: Phone: •
e-rn SOUS 3(D U 33C0--2 3 2-
Address(Street,City,State,Zip): Email Address:
DU VU , VV-. Ve- ntx\ ti1A rk- --4-s uves+,,_x)sh@coMcas+: !let
CONTRACTOR:* Phone:
C ct c- S- i 1 r \l&* -r\ toD-33co--7S32
Address(Street,City,State,Zip): Email Address:
00 WLDD gist Ve}rODC\\/\; t 73 CXa 4-slDca\iac tca f a6-1-
*All Contractors&subcontractors must have a valid City of Professional License# Ex Date:
Anacortes business license prior to doing work in the City. `s �� �3
Contact the City's Finance Department at(360)299-1968. Business License#: Exp.Date:
Is this work,associated with another project? Yes ❑ No ►': If yes,specify:
PROPOSED WORK: I ems- - \\ 43CAS (\seek has s ex;sfi`►�
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.
Print Name: (.AN - S6U&n-- Owner ❑ Agent 1 specify): ,Aatfl't Yl
Signature: Date: 3 261 t 'I
MECHANICAL:
Equipment Type: Appliance/Equipment Information(new and relocated): Total#:
Furnace: Gas#: Elec#: Other#: Location(s):
Wall Heater: Gas#: Elec#: Other:#: Location(s):
Gas Water Heater: #: Location(s):
Heat Pump: Elec#: Other#: Location(s):
Air Conditioner/Handler: Elec#: Other:#: Location(s):
Radiant/Hydronic Heating: Gas#: Elec#: Other:#: Location(s):
Exhaust Fans: Bath#: Laundry#: Kitchen#: Other#:
Range Hood: #: Type 1 or 2(Circle which one) Location(s):
Fireplace: Gas#: t Elec#: Other:#: Location(s): I i Nit 03
Clothes Dryer&Duct: Gas#: Elec#: Other:#: Location(s):
Stove/Range/Oven: Gas#: Elec#: Other:#: Location(s):
Refrigeration Unit: Elec#: Other:#: Location(s):
Gas Piping/Outlet(s): #: Location(s):
Boiler: Gas#: Elec#: BTUs: Location(s):
Other: #: Location(s):
TOTAL:Mdikadaii,F*CHANICAL OUTLETS: 1
PLUMBING FIXTURES:
Fixture Type (new and relocated): Total#: Fixture Type(new and relocated): Total#:
Water Closet(Toilet): Refrigerator water supply(for water/ice dispenser):
Kitchen Sink: Pressure Reduction Valve/Pressure Regulator:
Utility Sink: Water Service Line:
Tub: Water Piping:
Hand Sink: Clothes Washer:
Shower: Electric Water Heater: Tank-less? Yes 0 No❑
Dishwasher: Backflow Prevention Device:
Urinal: Hose Bib:
Floor Drain/Floor Sink: Drinking Fountain:
Hydronic Heat in: Floor ❑ Wall ❑ Grease Interceptor:
Other: Other:
TOTAL PLUMBING FIXTURES:
E
Ake
Y O�, PLANNING,COMMUNITY,&ECONOMIC DEVELOPMENT DEPARTMENT
1 ! 1171UMBING AND MECHANIC o E PERMIT CMECKLL11ST
17+14:10e, Mailing Address:P.O.Box 547,Anacortes, WA 98221
coR, Office Location:904 6 Street,Anacortes WA 98821
Phone: (360)293-1901
PROJECT ADDRESS: 25 v ( CX•eeks j e_ L n AM_CDEt S
Plans shall be of sufficient clarity to indicate the location,nature,and extent of the work proposed,and
conform to the provisions of the adopted International Codes and City Ordinances.
PERMIT TYPE:
II b c . c O
0.1
. B ,....
., I ..
0 SUBMITTAL REQUIREMENTS:
I
The number indicates the number of 5 *CIO
copies for submittal(if applicable). AD
4CD
AD
c) b
cip
IV
AD
E. '
o
Plumbing&Mechanical Permit Application 1 1 1 1
Mechanical Plans 1 0 0 0
Structural Calculations 1 0 0 0
State Non-Residential Energy Code Compliance Form 1 0 0 0
Manufacturer's Specifications/Cut Sheets 1 0 1 0
Elevation View for Roof Mounted Equipment 1 0 1 0
Plumbing Plans 0 0 1 0
Listed&Tested Fire Stopping Assemblies 0 0 1 0
Permit Fee ✓ ✓ ✓ ✓
Existing Floor Plan 2 2 2 2
New Floor Plan 2 2 2 2
NOTES:
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.