HomeMy WebLinkAboutPermit File BLD-2019-0652 2101 Creekside Circle . " 7 4:, City of Anacortes Invoice/Permit#: BLD-2019-0652
• 904 6th Street
Applied date: 10/04/2019
`!� P.O.Box 547 Issue date: 10/04/2019
t:P' 0. Anacortes, WA 98221-0547 Expire date: 04/01/2021
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Job Address: 2101 CREEKSIDE CIR Permit Type: Mechanical Permit
ANACORTES WA 98221-2461 Project:
APN: P84015
Remarks: Install a natural gas fireplace with new gas piping.
Owner: GERD&JUNE KRAUSE&JOSSY Contractor: BARRON HEATING &A C
Address: 2101 CREEKSIDE CIR Address: 5100 PACIFIC HWY
ANACORTES WA 98221-2461 FERNDALE WA 98248-9080
Phone: (206)271-3955 Phone: (360) 676-1131
License#:
General Information: Fees:
#of Gas Fireplace 1 Mechanical Permit Fees 38.90
#of Gas Piping 1 Total Calculated: 38.90
Deposits/Receipts: 0.00
Total Due: 38.90
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 WHETHER SPECIFIED HEREIN OR NOT, THE
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY
Permits and Insp...-BLD-2019-0652-2019
019425-0065 Carla Br... 10/22/2019 02:05PM
12532- BARRON HEATING&A C
BLD-2019-0652 Mechanical Permit
Payment Amount: 38.90
Transaction Amount: 38.90
CHECK:090313
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a x _ &ECONOMIC DEVELOPMENT DEPARTMENT
PLANNING, COMMUNITY,
16 PLUMBING & MECHANICAL PERMIT APPLICATION
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Mailing Address: P.O. Box 547, Anacortes, WA 98221
` Office Location: 904 6th Street,Anacortes WA 98821
Phone: (360) 293-1901
PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS(Street,Suite#): PARCEL(S)#: PROJECT VALUATION:
2101 Creekside Circle P84015 $6,050
Subdivision/Lot#:
RESIDENTIAL El COMMERCIAL 0
APPLICANT: Phone:
Barron Heating 360-676-1131
Address Street,City, State Zip): Email Address:
5100 Pacific Highway#103, Ferndale,WA 98248 kaylissad@barronheating.com
PROPERTY OWNER: Phone:
June Jossy&Gerd Krause 206-271-3955
Address(Street,City, State,Zip): Email Address:
2101 Creekside Circle,Anacortes,WA 98221 N/A
CONTACT PERSON: Phone:
Barron Heating 360-676-1131
Address(Street,City, State,Zip): Email Address:
5100 Pacific Highway#103, Ferndale,WA 98248 kaylissad@barronheating.com
CONTRACTOR:* Phone:
Barron Heating 360-676-1131
Address(Street,City, State,Zip): Email Address:
5100 Pacific Highway#103, Ferndale,WA 98248 kaylissad@barronheating.com
*All Contractors&subcontractors must have a valid City of Professional License#: Exp.Date:
Anacortes business license prior to doing work in the City. ►�Business
Pe DDi1 sss License##: Exp.D Da3�
a9-0 te:
Contact the City's Finance Department at(360)299-1968. (p�v —0.9 13 10-6
Is this work,associated with another project? Yes 0 No IN If yes,specify:
PROPOSED WORK: Install natural gas fireplace
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.
Print Name: haul 0610 Owner ❑ gent s ecif c?4ltfi
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Signature: Y ,t Date: /3U i 1�
MECHANICAL:
Equipment Type: Appliance/Equipment Information(new and relocated): Total#:
Furnace: Gas#: Elec#: Other#: Location(s):Wall Heater: Gas#: Elec#: Other:#: Location(s):Gas Water Heater: #: Location(s):
Heat Pump: Elec#: Other#: Location(s):
Air Conditioner/Handler: Elec#: Other:#: Location(s):Radiant/Hydronic Heating: Gas#: Elec#: Other:#: Location(s):
Exhaust Fans: Bath#: Laundry#: Kitchen#: Other#:Range Hood: #: Type 1 or 2(Circle which one) Location(s):Fireplace: Gas#: 1 Elec#: Other: #: Location(s): 1
Clothes Dryer&Duct: Gas#: Elec#: Other:#: Location(s):
Stove/Range/Oven: Gas#: Elec#: Other:#: Location(s):
Refrigeration Unit: Elec#: Other:#: Location(s):
Gas Piping/Outlet(s): #: 1 Location(s): 1
Boiler: Gas#: Elec#: BTUs: Location(s):
Other: #: Location(s):
PLUMBING FIXTURES:
Fixture Type(new and relocated): Total#: Fixture Type(new and relocated): Total#:
Water Closet(Toilet): Refrigerator water supply(for water/ice dispenser):Kitchen Sink: Pressure Reduction Valve/Pressure Regulator:Utility Sink: Water Service Line:Tub: Water Piping:
Hand Sink: Clothes Washer:
Shower: Electric Water Heater: Tank-less? Yes ❑ No ❑Dishwasher: Backflow Prevention Device:Urinal: Hose Bib:
Floor Drain/Floor Sink: Drinking Fountain:Hydronic Heat in: Floor 0 Wall ❑ _ Grease Interceptor:
Other: Other: