HomeMy WebLinkAboutPermit File BLD-2019-0366 1204 6th Street City of Anacortes Invoice/Permit#: BLD-2019-0366
904 6th Street
w P.O.
, Box 547 Applied date: 06111/2019
Issue date: 06/11/2019
ter' Anacortes, WA 98221-0547
:-"AICIPV4P (360) 293-1901 Expire date: 12/07/2020
Job Address: 1204 6TH ST Permit Type: Mechanical Permit
ANACORTES WA 98221-1722 Project:
APN: P55396
Remarks: Install new ductless heat pump
Owner: URS & HARRIET KUHNLEIN Contractor: BARRON HEATING&A C
Address: 1204 6TH ST Address: 5100 PACIFIC HWY
ANACORTES WA 98221-1722 FERNDALE WA 98248-9080
Phone: Phone: (800) 328-7774
License#: BARROHA179D7
General Information: Fees:
#of Heat Pumps>3 <= 15 Hp 1 Mechanical Permit Fees 50.65
Total Calculated: 50.65
Deposits/Receipts: 0.00
Total Due: 50.65
_ —{ ' rap r rr -tl
1.04"1 -5 !L r- r_t rt.
i.. m r:, CO NI -•
rho ci 0 el-
C") n ,-r i-` I i to
(! rt ••a:! 0
.. l.... y ! m C, ..
0 Cr Cr 1
y. _r 0 r.a .71, to
R•• :33
z r7.. c3
.yt. rr .. 3
et. S c
++ `, Ill
1.5
3 !l. —{
E. t—r r•
:r*:. T. i Cl
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN]180 DA-YS`'O1� t!
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK COMMIFlNCE6: c-1
HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PFOVISIOICS
OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT,
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL T PROVISIONS OF ANY OTHER 6TATE`O t
LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �, tom.
, ra'r h'
r_r
n rn .n
SIGNA U E.OF OWNER OR WTH GENT ISSUED BY
PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
' BAN PLUMBING & MECHANICAL PERMIT APPLICATION
+ Mailing Address: P.O. Box 547,Anacortes, WA 98221�� Office Location: 904 6th Street,Anacortes WA 98821
4 ff
Phone: (360) 293-1901, Fax: (360)293-1938
PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADD ESS(Street,Suite#): Parcel(s)#:
r20� a 5fi PS53c16
Subdivision/Lot#:
i
1 6 Residential K Commercial El
APPLICANT: Phone: Fax:
Address(Street,Ci y,State,Zip):^ c1'Z-t j E-Mail,Addre I
333 E 13(ct_c_tc-` cArvi Q fl4-, V,e c.9, C,.�/t- 0ra[._/f -P® �-�v-1—,14_ Gott
PRO ERTY OWNER: Phone: Fax: J.
Address(Street,City,State,ZJp): E-Mail A dress:
120 (4 C c� A Gicc_c ar45, 1-v4 q iz - ( to 1 u c.v%"t Uo:0,ci P-i ct,I.C a 144
CONTACT PERSON: Phone: Li Fax:
Gc O t.-wc. ',—
Address(Street,City,State,Zip): E-Mail Address:
CONTRACTOR:* Phone: Fax:
sue( ArN4:c-cck-
Address(Street,City,State,Zip): E-Mail Address
Contractor's License# Exp.Date:
*All Contractors&subcontractors must have a valid City of ro55-11CL?I'3 OA ((—c— Za
Anacortes business license prior to doing work in the City. Business License#: Exp.Date:
Contact the City's Finance Department at(360)299-1968. Cot , (3 P 11
Is this work,associated with another project? Yes 0 Now If yes,specify:
PROPOSED WORK: //
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: L ,c,._ Owner 0 Agent ,(specify): I.vu/0-4-c✓f�
Signature: Date: 6 -(( (1
MECHANICAL:
Equipment Type: Appliance/Equipment Information(new and relocated): Total#:
Furnace: Gas#_Elec#_Other: # BTUs:<100k_>100k_Location(s)
Wall Heater: Gas#_Elec#_Other: # BTUs:<100k>100k_Location(s)
Air Handler: Gas#_Elec#_Other: # BTUs:<100k>100k_Location(s)
Water Heater: Gas# Elec# Other: # BTUs: <100k>100k Location(s)
A .I!nit/Boiler/
Gas#_Elec# (Other: # BTUs: <<100k, 100k-500k, 500k-
4H ueat Pmn Roof
Top nit(Circle 1Mil HP: <3, 5-30 Location(s)
selected):
Hydronic Heating: Gas#_Elec#_In-Floor_Wa11 Radiant Boiler BTUs: Location
Exhaust Fans Bath#_Kitchen# Laundry# Other: #
(single duct):
Fireplace/Insert: Gas#_Elec#_Other: # Location(s)
Stove/Range/Oven: Gas#_Elec#_Other:_# Location(s)
Range Hood: # Location(s)
Refrigeration Unit: Gas#_Elec#_Other:_# Location(s)
Outdoor BBQ: Gas#_Elec#_Other:_# Location(s)
Clothes Dryer&Duct: Gas#_Elec#_Other:_# Location(s)
Gas Piping: # Location(s)
Other: # Location(s)
# Location(s)
TOTAL OUTLETS:
PLUMBING FIXTURES:
Fixture Type(new and relocated): Total#: Fixture Type(new and relocated): Total#:
Water Closet(Toilet): Pressure Reduction Valve/Pressure Regulator:
Urinal: Backflow Prevention Device:
Sink(kitchen,laundry, lavatory,hand,bar,slop,
eye wash,etc.): Water Service Line:
Tub/Shower: Drinking Fountain:
Dishwasher: Clothes Washer:
Hose Bib: Hydronic Heat in: Floor ❑ Wall ❑
Water Heater Tankless? Yes ❑ No ❑ Grease Interceptor:
Floor Drain/Floor Sink: Water Piping:
Refrigerator water supply(for water/ice
Other:
dispenser):
TOTAL OUTLETS: TOTAL OUTLETS:
PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
�11
PLUMBING AND MECHANICAL PERMIT CHECKLIST
Mailing Address: P.O. Box 547, Anacortes, WA 98221
Office Location: 904 6t17 Street, Anacortes WA 98821
Phone: (360) 293-1901, Fax: (360) 293-1938
PROJECT ADDRESS: l 20 �o 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:
Fv o a
2 �.
et, co
SUBMITTAL REQUIREMENTS: 2. ; w
eD
n The number indicates the number of ?: p
<15 copies for submittal(if applicable).
2
E. Pi' u
n A� cIq
Plumbing&Mechanical Permit Application 1 1 1 1
Mechanical Plans 1
Structural Calculations 1
State Non-Residential Energy Code Compliance Form 1
Manufacturer's Specifications/Cut Sheets 1 1
Elevation View for Roof Mounted Equipment 1 1
Plumbing Plans 1
Listed &Tested Fire Stopping Assemblies 1
1. Handouts and Standard Details may be found on the City's website at www.cityofanacortes.org 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.