HomeMy WebLinkAboutPermit File BLD-2019-0656 5512 Doon Way 6 City of Anacortes Invoice/Permit#: BLD-2019-0656
904 6th Street
Applied date: 10/07/2019
P.O.Box 547
""'� Issue date: 10/07/2019
0 Anacortes, WA 98221-0547 Expire date: 04/04/2021
'"- (360) 293-1901
Job Address: 5512 DOON WAY Permit Type: Mechanical Permit
ANACORTES WA 98221-2918 Project:
APN: P59656
Remarks: Install a new heat pump and replace furnace qith an air handler.
Owner: SCOTT ELY Contractor: FOSS HEATING AND COOLING
Address: 3607 35TH AVE WEST Address: 333 E BLACKBURN RD
SEATTLE WA 98199 MOUNT VERNON WA 98273-9006
Phone: (206) 618-5301 Phone: (360) 336-1517
License#:
General Information: Fees:
#of Heat Pumps <= 3 Hp 1 Mechanical Permit Fees 48.85
#OF AIR HANDLING UNITS<10000 1 Total Calculated: 48.85
Deposits/Receipts: 0.00
Total Due: 48.85
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 WHETFJ SPECIFIED HEREIN OR NOT, THE
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE-PRO ISIONS OF ANY OTHER STATE OR
LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SIGNATURE NE R AUTHORIZED AGENT ISSUE°:--BY'�
Permits and Insp... - BLD-2019-0656 - 2019
019401-0046 Carla Br... 10/07/2019 01 :25 P M
6033 - FOSS HEATING AND COOLING
BLD-2019-0656 Mechanical Permit
Payment Amount: 48.85
Transaction Amount: 48.85
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PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
PLUMBING & MECHANICAL PERMIT APPLICATION
, ';� i i i ( c ,,, : P.O. Box 547,Anacortes, WA 98221
' )P %, ri ke of ,. 904 6t1 Street,Anacortes WA 98821
Phone: ) 293-1901, Fax: (360) 293-1938
OCY044019 '
PLEASE REFER TO THE.PLUMBING'&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS JStreet,Suite#): Parcel(s)it: C-
5/2. 7° -` � ,..)6
Subdivision/Lot#:
Residential Commercial 0
APPLICANT: Phone: Fax:
Address(Street,City,State,Zip): E-Mail Addtes : f j_
3-3 3 , tr`?[is I qq11 j/. �,�tir rote, la/Al el -2 7.% 4101 ',-CCU,) J2 4le( G-aG 4i
PROPE TY OWNER: Phone: :
e, (v 2i( GIB 67 /
Address(Street,C'ty,State,Zip): i E-Mail Address:
P
CONTACT PERSON: n Phone: Fax:
ex
Address(Street, ity, State,�"ip): E-Mail Address:
CONTRACTOR:* // Phone: Fax:
Address(Street,City,State,Zi E-Mail Address
Contractor's License# Exp.Date:
All Contractors&subcontractors must have a valid City of F 5 f . 4.,1 ((_ r- z0
Anacortes business license prior to doing work in the City. Business License#: Exp.Date:
Contact the City's Finance Department at(360)299-1968. q (_ 2 o
Is this work,associated with another project? Yes El No 143 If yes,specify:
PROPOSED WORK: .,-
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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.
44.Print Name: 44'e"^�-- Owner 0 Agent (specify): i'r-
Signature: _7'1,-r'-- ----� -- Date: /e-`5 `/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:<1 00k>1 00k_Location(s)
Air Handler: Gas# Elec#Other: # BTUs:<100k>I00k_Location(s) f
Water Heater: Gas# Elec# Other: # BTUs:<100k>100k Location(s)
AC oiler
H Pump Roof Gas#_Elec#Other: # BTUs: <100k, 100k-500k, 500k-
Top ' 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#_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# Elec#_Other: # Location(s)
Gas Piping: # Location(s)
Other: # Location(s)
Location(s)
TOTAL OUTLETS: Z
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
PLUMBING AND MECHANICAL PERMIT CHECKLIST
Mailing Address:P.O. Box 547, Anacortes, WA 98221
Office Location:904 6th Street,Anacortes WA 98821
Phone: (360) 293-1901, Fax: (360) 293-1938
PROJECT ADDRESS: .55(Z- C'Z i f
Plans shall be of sufficient clarity to indicate the location,nature, and extent of the work proposed,and
confouut to the provisions of the adopted International Codes and City Ordinances.
PERMIT TX'PE:
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SUBMITTAL REOUIPE11 1VTS ^* r
Then .Fiber indicates.the.nut nber of L.) — 0
cope for submittal(%f tipplicabk).. �
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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.orc 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.