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HomeMy WebLinkAboutPermit File BLD-2019-0213 (2) 1905 Tweed Place 7-g („D - 02 _ Y. O PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT RESIDENTIAL BUILDING PERMIT APPLICATION 1,7 Mailing Address: P.O. Box 547, Anacortes, WA 98221 := 6 Office Location: 904 6th Street, Anacortes WA 98821 APR 152B19 Phone: (360) 293-1901 PLEASE REFER''TO TIORMSMIDThlaUILDING PERMIT CHECKLIST BELOW FOR SUBMITTAL REQUIREMENTS PROJECT ADPRESS..( ):Street,Suite*: PARCEL(S)#: I6/o �' Pe 04c..e Subdivision/Lot PROJECT VALUATION: $ ®v`0 APPLICANT: `/� Phone: Address(Stree City, State,Zip): /9 Email Address: � b'l� ku IM of wA. •Cv4.% PROPERT WNER: Phone: ,�. C 4 ✓V( 3C0-610- (?>c 36d - 7 -ef Address(Street,city, State,Zip): Email Address: 1410c. 'T%J ecr! (L. 5'6 CONTACT PE1 SQN: 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 Business License#: Exp.Date: the City's Finance Department at(360)299-1968. PROPOSED WORK: Gr — p 144245 PROPOSED NEW SQUARE FOOTAGE: Basement SQ': ❑ Finished Basement: ❑ Unfinished Basement 1'Floor SQ': G e/Carport SQ': 2'Floor SQ': e Covered Porch/Patio SQ': 5 j,S' r. Fire Sprinkler: ❑ Yes ❑ 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 acortes. ,L Print Name: c)e Cvyo V4 Owner fgV Agent E (specify): Signature: Date: Page 1 of 5 IMPERVIOUS SURFACE AREA: Existing Impervious SQ': ?U 3() New Impervious SQ': S.7, Total Disturbed Land/Soil SQ': Total Proposed: Cut: Fill: New hard surfaces (pervious&impervious) Land converted from native vegetation to lawn or landscaping SQ' Land converted from native vegetation to pasture SQ' MECHANICAL: Equipment Type: Appliance/Equipment Information(new and relocated): Total#: Furnace: Gas#: Elec#: BTU: Other#: Wall Heater: Gas#: Elec#: Other:#: Location(s): Gas Water Heater: #: Location(s): Heat Pump: Elec#: Other#: Air Conditioning: Elec#: Other#: Radiant/Hydronic Heating: Gas#: Elec#: Other: #: Location(s): Exhaust Fans: Bath#: Laundry#: Other: Range Hood: #: Location(s): Fireplace: Gas#: Elec#: Other:#: Location(s): Clothes Dryer&Duct: Gas#: Elec#: Other:#: Location(s): Stove/Range/Oven: Gas#: Elec#: Other:#: Location(s): Gas Piping/Outlet(s): #: Location(s): Boiler Gas#: Elec#: BTUs: Location(s): Other: #: Location(s): - 7 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? 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Ili ( F'1; ti � 1 l III , II it IlliiiII , Ill l ' ' I , 111.1 ; it 1111 It ; III I� _ �` l� V V # tj� >'� 'f} O ( ! l, i YI' I I, III II 1 , ' f , 1I IIIi , , , 1 II II 1 , ! , 1 , 1 1 I , 1 1 I I , t• ,7 I II 1 1 �� 11 tor !'1 I . I I l 1 1 1 1 I 1 , I , 1 ( � ,�3 � 1' lt i pitlli 1 ! 'it ' II JJ ' 1 {1IIM ',i} ll I' 11 lr 1� + ~Iirll' r ' 1 ' 1 f 1Il II Ieft: (; Vcr 1 ' ' , i � III 1 I ' f { i t ril 11 .11 .1 ' I l ill I ' 1 II j -' h <_� va O0., ' ' I Il l 1 111 t 11 i' 1, 4 1 , i I� II 111 l.- KeP ( I1 I adill I III ,, 0 1 8I Ii ., i 1 I; e v I . l II I , 11! I II illlil I + ? . , 1 i I , i , 1 . I -0 ' 1 ' II 11 I i 111 ' II • , I , I Jil ' Ip i 1 1 L r l I r 1 i ill I ciii �I ' I ' 1II » ' 11 �� I I ' ! �l ��l ' a ' [ 1 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. The drainage analysis/plan& TESC Plan shall comply with the 2012 Department of Ecology's Storuiwater Management Manual for Western Washington(as amended in December 2014). 4. For new single-family residential building permit applications, a non-refundable plan review deposit of$200.00 is required at time of application submittal per AMC 19.14.035 &IRC 108.1.1. 5. For remodels/alterations for existing single-family residences, a plan review fee of 65% of the permit's valuation is required at time of application submittal per AMC 19.14.035 & IRC R108.2.4(1). 6. Within 180-days of application submittal refunds are allowed up to maximum of 80% of plan review fee so long as no review has been performed by staff per AMC 19.14.035 &IRC R108.5. The applicant must initiate this refund request by submitting a signed letter to the Building Department. Page 4 of 5 STAFF DETERMNATION OF COMPLETENESS: Please note,that the subject building permit application will be reviewed by staff for completeness. All of the items above as listed in the "Residential Building Permit Checklist"need to be submitted at time of application submittal unless deemed unnecessary by staff. If staff deems the application incomplete,the applicant will be notified by mail and/or email as to what items and/or revisions are still needed. Additionally, if the application is deemed incomplete,the applicant will have 90-days to submit the requested information per AMC 19.20.130(B)(2)(b). If the requested items and/or revisions are not provided by the deadline [90-days],the application may be rejected by staff and returned to the applicant along with any unspent application fees per AMC 19.20.130(C)(3)(b). FOR STAFF USE ONLY—COMPLETENESS DETERMINATION: If deemed incomplete,what is the date it was deemed incomplete? If deemed incomplete,was it deemed as such at the counter,by letter, or email(Circle One)? If by letter or email,when was it mailed by USPS or emailed? If deemed incomplete at the counter,when was this checklist with items circled given to the applicant? If deemed incomplete,what is the 90-day deadline for resubmittal of requested items and/or revisions? If deemed incomplete,who deemed it as such? (Please include the letter/email in the file detailing what additional items or revisions are still needed). If the application is deemed complete, what is the date it was deemed complete&who deemed it as such? Page 5 of 5 A.'166sciet, n...4.4....271._ Cdeitc- W I -- sk , . v `7 �- f ----r 07-2/ ( si„._ d e 2 ell;C&,fl 1:7 (Ift?..V‘.C C liC Hera) . • • 4,-(...--Z" ./ e . . a- Yi Zt l...) C.- ) i iff• - ) /L � ( U �, 6. it.V i • to 0- Ivi-- e „cc,. 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