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HomeMy WebLinkAboutPermit File BLD-2019-0376 520 4th Street (2) ?LD - — /'3 6 A Y �� (� �' `�i E OMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT "lam'' ' ENTIAL BALDING PERMIT APPLICATION 1 y -I JUN 14 9019 ailing Address:P.O. Box 547,Anacortes, WA 98221 \I:l c O- Office Location: 904 6th Street,Anacortes WA 98821 Phone: (360) 293-1901 CITY OF ANACORTES PLEASE REFER TO THE RESIDENTIAL BUILDING PERMIT CHECKLIST BELOW FOR SUBMITTAL REQUIREMENTS PRO CT ADDRESS(Street,Suite#): PARCEL(S)#: 1/1 Subdivision/Lot#: 1•�- PROJECT VALUATION: $ ,@ , 4,"S /4, APPLICANT:� LAC 1 ( k jç Phon?: a y Address(Street,City,State,Zi •, Email Address: , .1 I 44 , 1 PROPERTY OWNER: ++ Phone: V L41' Qekaa ( Address(Street,City,State,Zip): Email Address: CONTA T PERSON• , / Phone: i. JA( e ' I Address(Street,City,State,Zip): Email Address: LENDING AGENCY: Phone: Address(Street,City,State,Zip): Email Address: CONTRACTOR:* A,,,),,,-,.,, CO, +' AJr'' Phone: N 5456634 ee<_ Address(Street,City,State,Zip): Email Address: Professional License#: Exp.Date: *All Contractors&Subcontractors must have a valid City of - f Anacortes business license prior to doing work in the City. Contact �' �+e the City's Finance Department at(360)299-1968. Business License#: Exp.Date: PROPOSED WORK: 1 , .' e A$V d a i.i l„ 6 PROPOSED NEW SQUARE FOOTAGE: Basement SQ': ❑ Finished Basement: ❑ Unfinished Basement 1St Floor SQ': Garage/Carport SQ': 2nd Floor SQ': Deck/Covered Porch/Patio SQ': 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 of co es. i Print Name: i Owner 0 Agent fi (s ecify). . Signature: _Date: 40C/1 7 C, tot Page lof5 0 R'. ti \t:' 't- JuN 1 41019 CITY OF ANACORTES P N 11 G-8t BUILD! r. DEPT: CITY OF ANACUHim APPROVED PLAN PERMIT it: r ZOIQ-a-7 ,# ._ . u - ADDRES 520 4 is I C APPROV°`D BY: E ' 1 SUBJECT 0 FIELD INSPECTION. APPROVE P 0., 111110 SHALL N BE ALTERED WITHOUT AUTO Z' 0 rim r ., . 1111111 lir ., t' to , • - ._. _.. _..„, • . ,i, I dir 1 ,-,--. F- . . 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