HomeMy WebLinkAboutBLD-2019-0554 - WINDOWS/DOORS/SIDING NEW OR REPLACED City of Anacortes Invoice/Permit#: BLD-2019-0554
\ 904 6th Street
Applied date: 08/23/2019
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w'�ell P.O.Box547
; �� Issue date: 08/23/2019
Anacortes, WA 98221-0547
; r ^ - (360) 293-1901 Expire date: 02/18/2021
Job Address: 917 E AVE Permit Type: Single Family Alteration/Repair Permit
ANACORTES WA 98221-1400 Project:
APN: P56121
Remarks: Reside entire house.
Owner: LINDA MILLS AND NANCY CORNELL Contractor: ROBERT E. MILLER CONSTRUCTION
Address: 917 E AVE Address: 3520 COMMERCIAL AVE
ANACORTES WA 98221-1400 ANACORTES WA 98221-4229
Phone: Phone: (360)298-1113
License#:
General Information: Fees:
Building Valuation 8000 Building Permit Fee 153.25
Plan Review Fee 99.61
State Building Code Fee Resi 6.50
Total Calculated: 259.36
Deposits/Receipts: 0.00
Total Due: 259.36
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THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAY , P IFT
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMME ICppi-7.:1
HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVIIQNS-'
OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR RtOt�,"".i TF_1E
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER $TA 444;
LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. k `;'
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SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY o
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Y o PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
c_ ` RESIDENTIAL BUILDING PERMIT APPLICATION
Mailing Address: P.O. Box 547,Anacortes, WA 98221
y -q �+ Office Location: 904 6th Street, Anacortes WA 98821
Phone: (360)293-1901
PLEASE REFER TO THE RESIDENTIAL BUILDING PERMIT CHECKLIST BELOW FOR SUBMITTAL REQUIREMENTS
PROJE T ADDRESS(
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treet,Suite#): PARCEL(S)#:
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Subdivision/Lot#: PROJECT VALUATION: $
APPLIS4NTi Phone: /
Address(Street,City,State,Zip): Email Address:
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PROPERTY OWNER: Phone:
A/CI� -w -
Address(street,City,State,Zip): Email Address:
CONTACT PERSON: Phone:
Address(Street,City,State,Zip): Email Address:
LENDING AGENCY: Phone:
Address(Street,City,State,Zip): Email Address:
CONTRACTO Phone:
✓I� C 'T
Address(Stre 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: 4F_5")i)#_
PROPOSED NEW SQUARE FOOTAGE:
Basement SQ': ❑ Finished Basement: ❑ Unfinished Basement
1St Floor SQ': Garage/Carport SQ':
2'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 Anacortes. n,,�
Print Name: El J4f)l-l-£& Owner ❑ Agent 0 (specify):
Signature: - Date: r.°„,2 3, .2_0/ `7
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