HomeMy WebLinkAboutPermit File BLD-2019-0440 5612 Sugarloaf Street City of Anacortes Invoice/Permit#: BLD-2019-0440
904 6th Street
Applied date: 07/12/2019
`!r"01 !' P.O.Box 547 Issue date: 07/12/2019
• Cl ;' Anacortes, WA 98221-0547
(360) 293-1901 Expire date: 01/07/2021
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Job Address: 5612 SUGARLOAF ST Permit Type: Mechanical Permit
ANACORTES WA 98221-2964 Project:
APN: P59084
Remarks: Replace gas water heater in crawlspace.
Owner: GAGE JOHN L Contractor: FAST WATER HEATER COMPANY
Address: 5612 SUGARLOAF ST Address: 11715 N CREEK PKWY S
ANACORTES WA 98221-2964 BOTHELL WA 98011-8807
Phone: Phone: (425) 636-7084
License#: FASTWWH948BC
General Information: Fees:
#of Gas Water Heaters<= 100k 1 Mechanical Permit Fees 38.20
Total Calculated: 38.20
Deposits/Receipts: 0.00
Total Due: 38.20
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THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR h!F
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMME�N Bb. 61
HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL Ft OVIdtOr
OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OF NQ�r;= l;E
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS NY OTHER-tS'$,,TE OR
LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. -. 4,,
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SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED
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PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT iiit
PLUMBING & MECHANICAL PERMIT APPLICATION
i' Mailing Address:P.O. Box 547, Anacortes, WA 98221
kk`` Office Location: 904 6th Street, Anacortes WA 98821
Phone: (360) 293-1901, Fax: (360) 293-1938
PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS(Street,Suite#): l Parcel(s)#: • cALl
12. Su •r 1 oaf S 1-i '1Y11CtCor�-es, voi.4,1
Subdivision/Lot#: ;�.�
Residential !, ', Commercial ❑
APPLICANT: Fax:
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r' Address(Street, City, State,Zip): E-Mail Address:
yV i t3 S-rU (kul G 'Y"
P OPE+RTY OWNER: P one: Fax:
Jr)r 1112 690-'1-v-5co�C�
Addre Street,City,State, ip • RnaCbr46aj'��{ E-Mail Address:
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CONTACT PERSON: k Phone: Fax:
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Address(Street, City,State,Zip)" E-Mail Address:
f Phone: Fax
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Address(Street,City, State,Zip): E-Mail Addr9s,s,
11115 l` cY i✓K() v '4C i 1j ' 'fir i,t i ii\1;A-13O i I r- 'vr a-5(giliS'1at ku,- 'i r, C O
Contractor's License# Exp.Date:
*All Contractors& subcontractors must have a valid City of , `-C)
Anacortes business license prior to doing work in the City. usiness License J#: Exp.Date: a
Contact the City's Finance Department at(360)299-1968. ) rD_S i.25— t, 1 -1 3
Is this work, associated with another project? Yes ❑ NO If yes, specify:
PROPOSED WORK:
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I declare under penalty of perjury that the information I have provided on this faun/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 th- r;f,,of Anacortes.
Print Name: _ / N(Y-" C\54-- Co A O1 nd Owner ❑ ge�t (specify):
Signature:A Date: lo
I
.515
MECHANICAL:
Equipment Type: Appliance/Equipment Informatio i (new and relocated): Total #:
Furnace: Gas# Elec# Other: # BTUs:<100k_>10Ok Locations)
Wall Heater: Gas# Elec# Other: # BTUs:<100k>l0Oi Location(s)
Air Handler: Gas#Elec# Other: # BTUs:<100k>100k Location(s)
(GEiec# Other: # BTUs: <100k>100k Locations) p �Water Heater: r� �t�'•'�S � i�)
AC Unit/Boiler/
Heat Pump/ Roof Gas# Eiec# Other: # BTUs: <lOOk, 100k-500k, 500k-
Top Unit(Circle 1Mil HP: <3, 3-15,_15-30 Location(s)
selected):
Hydronic Heating: Gas# Elec# In-Floor Wall Radiant Boiler BTUs: Location
Exhaust Fans Bath# Kitchen# Laundry# Other: #
(single duct):
Fireplace/Insert: Gas# Eiec# 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:
PLL 4IBING FIXTURES:
{ Fixture Type(new and relocated): Total#: Fixture Type(new and relocated): Total#:
Water Closet(Toilet): Pressure Reduction Valve/Pressure Regulator:
Urinal:
Bacldlow 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 0 Wall 0
icWater Heater Tankless? Yes 0 No ❑ ( Grease Interceptor:
Floor Drain/Floor Sink: Water Piping:
Refrigerator water supply(for water/ice
dispenser): Other:
TOTAL OUTLETS: TOTAL OUTLETS: