HomeMy WebLinkAboutPermit File BLD-2019-0488 1315 Portalis Court Y. .C3 : City of Anacortes Invoice/Permit#: BLD-2019-0488
904 6th Street
�""'" P.O.Box 547 Applied date: 07/29/2019
WA 98221-0547 Issue date: 07/29/2019
U�r' Anacortes,
:' Expire date: 01/24/2021
"1"j (360) 293 1901
Job Address: 1315 PORTALIS CT Permit Type: Mechanical Permit
ANACORTES WA 98221-4049 Project:
APN: P122182
Remarks: Replace furnace like for like. Install new heat pump.
Owner: SHARYLEE BARNES Contractor: FOSS HEATING AND COOLING
Address: 1315 PORTALIS CT Address: 333 E BLACKBURN RD
ANACORTES WA 98221-4049 MOUNT VERNON WA 98273-9006
Phone: (360) 982-2885 Phone: (360) 336-1517
License#:
General Information: Fees:
# Forced Air Furnace<=100k 1 Mechanical Permit Fees 53.00
#of Heat Pumps<=3 Hp 1 Total Calculated: 53.00
Deposits/Receipts: 0.00
Total Due: 53.00
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 WHETH ECIFIED HEREIN OR NOT, THE
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE- ROVI ONS OF ANY OTHER STATE OR
LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SIG ATURE OF'OWNE OR7�t7'F RIZED AGENT ISSU D BY ��
Permits and Insp... e BLD-2019-0488 - 2019
019292-0050 Erin Wil... 07/30/2019 11 :33AM
6033 - FOSS HEATING AND COOLING
BLD-2019-0488 Mechanical Permit
Payment Amount: 53.00
Transaction Amount: 53.00
03FIN CC: ±****1:.y`yy3971
PLANNING, COMMUNITY, &. ECONOMIC DEVELOPMENT DEPARTMENT
PLUMBING & MECHANICAL PERMIT APPLLCATION
Mailing_Address: P.a Box 547, Anacortes, WA 98221
Office Location: 90.4 6th Street, Anacortes WA 98821
,,...i.,..i..„-, Phone: (360) 293-1901, Fax: (360) 293-1938 ,
PLEASE REFER TO THE PLUMBING & MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street Suite #): Parcel(s) #:
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Subdivision/Lot#:
Residential ASV- Commercial El
APPLICANT: (-----, r Phone: Fax:
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Address;.,,§treet, City, State, Zip): ' --) (6-'a 7,7 E-Mail.Address: _ 1
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PRAPERTY 9WNERL)
Phone: Fax:
Address (Street City, State Zip): E-Mail Address:
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CONTACT PERSON: Phone: Fax:
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Address (Street, City, State, Zip): E-Mail Address:
CONTRACTOR:* 4
Phone: Fax:
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Address(Street, City, State, Zip): i E-Mail Address
Contractor's License # .Exp. Date:
*.A.11 Contractors & subcontractors must have a valid City of
905.5-t-i-ci.. clif 3 OA tk
Anacortes business license prior to doing work in the City. Business License # Exp. Date:
Contact the City'S Finance Department at(360) 299-1968. o a i elt—rel*— fi
Is this work, associated with another project'? Yes 0 No la If yes, specify:
PROPOSED WORK:
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I declare under penalty of perjury that the information I have provided on this foim/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 Ana.cortes.
Print Name ..4 L L--ct,k,..-...e.,t.„„.„ „.....,____
Owner 0 Agent kr (specify): -1----- ---,;;;-‘,„
Signature: . `-------- Date: 7— z----c-f — I
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MECHANICAL:
Equipment Type: Appliance/Equipment Information(new and relocated): Total#:
Furnace: Gas# /Elea# Other: # BTUs:<100k >100k Location(s)
Wall Heater: Gas#_Elec#_Other: # BTUs:<1O0k>100k_Location(s)
Air Handler: Gas# Elec#AOther: # BTUs:<100k>J_00k_Location(s)
Water Heater: Gas# Elec# Other: # BTUs:<100k>100k Location(s)
/Boiler/
r Heat Porn Roof Gas#_E1ec-#_I Other: # BTUs: <1OOk, 100k-500k, 500k-
op Unit(Circle IMil HP: <3, 3-.15,_15-30 Location(s) 4-lc
selected):
Hydronic Heating: Gas#_Elec#_In-Floor_ Wall Radiant Boiler BTUs: Location
Exhaust Fans Bath## Kitchen# Laundry/#_Other:
(single duct):
Fireplace/Insert: Gas# Elec# Other: # Location(s)
Stove/Range/Oven: Gas# E1ec#_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#_Elect#_Other:_# Location(s)
Gas Piping: # Location(s)
Other: # Location(s)
# Location(s)
TOTAL OUTLETS: "L
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, Water Service Line:
eye wash,etc.):
Tub/Shower: Drinking-Fountain:
Dishwasher: Clothes Washer:
Hose Bib: Hydronic Heat in: Floor ❑ Wall .D
Water Heater Tankless? Yes C7 No D Grease Interceptor:
Floor Drain/Floor Sink: Water Piping:
Refrigerator water supply(for water/ice Other
dispenser):
TOTAL OUTLETS:: TOTAL OUTLETS: