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HomeMy WebLinkAboutPermit File BLD-2019-0331 1717 25th-H Court 1'T - C City of Anacortes 904 6th Street Invoice/Permit#: BLD-2019-0331 Applied date: 05/22/2019 P.O.Box 547 Issue date: 05/22/2019 '•• Anacortes, WA 98221-0547 Expire date: 11/17/2020 Job Address: 1717 25TH H CT Permit Type: Reroof Single Family Residence ANACORTES WA 98221-3891 Project: APN: P103538 Remarks: Residential reroof, replace comp with comp. Owner: BRANDY CARR Contractor: SKAGIT ROOFING LLC Address: 1717 25TH H CT Address: 9672 FARM TO MARKET RD ANACORTES WA 98221-3891 BOW WA 98232-7223 Phone: (360) 708-2234 Phone: (360)428-1900 License#: General Information: Fees: Building Valuation 11700 Building Permit Fee 209.25 State Building Code Fee Resi 6.50 Total Calculated: 215.75 Deposits/Receipts: 0.00 Total Due: 215.75 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. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY Permits and Insp... - BLD-2019-0331 - 2019 019194-0013 Carla Br... 05122/2019 '10:00AM 11851 - SKAGIT ROOFING LLC BLD-2019-0331 Reroof Single Family Residence Payment Amount: 215.75 Transaction Amount: 215.75 03 F I N CC: ********-7402 PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT o�' RE-ROOF P7RMIT aPPILIICAT0©111 Mailing Address:P.O. Box 547,Anacortes, WA 98221 li Office Location: 904 6th Street,Anacortes WA 98821 Phone: (360)293-1901, Fax: (360)293-1938 PLEASE REFER TO THE RE-ROOF PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS RESIDENTIAL ,. COMMERCIAL 0 PROJECT ADDRESS(S rreet,Suite#): PARCEL(s)#: 7 Subdivision/Lot #: ' p " PROJECT VALUATION$ �• APPLICANT: Phone: Fax: ,. fey- -•. ,�s: -- .. ' .. Address(StreetCity,State,Zip):i�,� 4 ' � �,,�`�� 5��,; �� E-Mail Address: PROPERTY OWNER: Phone: Fax: Address(Street,City,State,Zip): ,., E-Mail Address: CONTACT PERSON: "'' Phone: [�t Fax: Address(Street,City,State,Zip): E-Mail Address: CONTRACTOR:* . Phone: Fax: Address(Street,City,State,Zip): E-Mail Address * Contractor's License# Exp.Date: All Contractors&subcontractors must have a valid City of Anacortes business license prior to doing work in the City. Business License#: Exp.Date: Contact the City's Finance Department at(360)299-1968. PROPOSED WORK: "fe. v^ �� ° p.ka TYPE OF ROOFING: NUMBER OF LAYERS: CLASS OF ROOFING: p A ❑ B ❑ C NUMBER OF SQUARES: 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 " ,: Owner 0 Agent 0 (specify): Signature. -_ - Date Page 1 of 2