HomeMy WebLinkAboutPermit File BLD-2019-0186 5214 Doon Way • 0 City of Anacortes Invoice/Permit#: BLD-2019-0186
904 6th Street
Applied date: 04/05/2019
P.O.Box 547
Issue date: 04/05/2019
►�' Anacortes, WA 98221-0547
(360) 293-1901 Expire date: 10/01/2020
Job Address: 5214 DOON WAY Permit Type: Mechanical Permit
ANACORTES WA 98221-2912 Project:
APN: P60068
Remarks: Replace 50 gallon 40k Btu gas water heater in exterior utility room like for like
Owner: BOND JOHN D Contractor: TRI COUNTY PLMBG ANACORTES LLC
Address: 5214 DOON WAY Address: 1004 COMMERCIAL AVE
PMB#1101
• ANACORTES WA 98221-2912 ANACORTES WA 98221
Phone: Phone: (360)420-5753
License#: TRICOCP838M7
General Information: Fees:
#of Gas Water Heaters 1 Mechanical Permit Fees 34.15
Total Calculated: 34.15
Deposits/Receipts: 0.00
Total Due: 34.15
CO ,-•• CD -0
I11 IU rv, 0: 1,3 F+
'1• --'•' CD -..I •-t'
.1 1, I I
L 7 ,-I' 'J.J 0
C.
•«c CO
rt. —1"
+•t •, .i• CO I
iH tip. r--, co
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN ;180 DAYS,,7..O IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS;COMMENCEQ
HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROV.SLO
OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR 101, THE
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS ANY OTHER, TM-
LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. `o
C. I
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED 1
(Pffe 1E01171
1 APR 0'5 21119
PLANNING COMMUNITY &ECONOMIC DEVELOPMENT DEPARTMENT
TY OF ANACBING & MECHANICAL 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 PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS(Str ,Suite# : PARCEL(S)#: PROJECT VALUATION:
Subdivision/Lot#: RESIDENTIAL COMMERCIAL ❑
APPLICANT: Phone:
Address(Street, City, State,Zip): Email Address:
PROPERTY OWNER: Phone:
J� t� CO v 0 3 U 't ZO 12t C,
Address(Street,City, State,Zip): Email Address:
CONTACT PERSON: Phone:
Address(Street, City,State,Zip): Email Address:
CONTRACTOR:* Phone: ,
-at.:iv;1 g_ �- 7 3J3
Address(Street,City, State,Zip): Email Address:
Professional L, ceR,se# Exp.Date:
*All Contractors&subcontractors must have a valid City of f " I _c_ 7.
Anacortes business license prior to doing work in the City. I v
Business License#: Exp.Date:
Contact the City's Finance Department at(360)299-1968. J—
Is this work, associated with another project? Yes E No D If yes, specify:
PROPOSED WORK: n 1091&_ j p L' ( L 9,2 J) j11t
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 Anacortes.
Print Name: C of'f Owner D Agent ❑ (specify):
Signature: Date:
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): Li 0 iLo—
ie
Heat Pump: Elec#: Other#: Location(s): L�"'�. C ��y (
Air Conditioner/Handler: Elec#: Other:#: Location(s): It
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#: Elec#: Other:#: Location(s):
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 MECHANICAL OUTLETS; � '
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 0
Dishwasher: Backflow Prevention Device:
Urinal: Hose Bib:
Floor Drain/Floor Sink: Drinking Fountain:
Hydronic Heat in: Floor ❑ Wall 0 Grease Interceptor:
Other: Other:
TOTAL PLUMBING FIXTURES:
t r Y o PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
PLUMBING AND MECHANICAL PERMIT CHECKLIST
,��;.. " Mailing Address: P.O. Box 547, Anacortes, WA 98221
rt. Office Location: 904 6th Street, Anacortes WA 98821
Phone: (360) 293-1901
PROJECT ADDRESS:
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:
a 4. a 4- ..
a PO -m
SU MITTAL REQUIREMENTS: g 5- n rD
n The number indicates the number of A.E
copies for:submittal(if applicable). d
cb
ci a a as
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 Foiui 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.