HomeMy WebLinkAboutPermit File BLD-2019-0647 2417 Creekside Lane Y. 0 '` :. City of Anacortes Invoice/Permit#: BLD-2019-0647
904 6th Street Applied date: 10/04/2019
` " P.O.Box 547 Issue date: 10/04/2019
Anacortes, WA 98221-0547
Expire date: 04/01/2021
(360) 293-1901
Job Address: 2417 CREEKSIDE LN Permit Type: Mechanical Permit
ANACORTES WA 98221-2466 Project:
APN: P84000
Remarks: Install gas fireplace and piping to location.
Owner: STUART&GRETCHEN MCINDOE Contractor: BARRON HEATING &A C
Address: 2417 CREEKSIDE LN Address: 5100 PACIFIC HWY
ANACORTES WA 98221-2466 FERNDALE WA 98248-9080
Phone: (360) 755-6897 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-2019-0647 - 2019
019425-0068 Carla Br... 1 0/22/201 9 02:12PM
12532 - BARRON HEATING & A C
BLD-2019-0647 Mechanical Permit
Payment Amount: 38.90
Transaction Amount: 38.90
CHECK: 090322
PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
PLUMBING & MECHANICAL PERMIT APPLICATION
, 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:
2417 Creekside Lane P84000 - $4,854
Subdivision/Lot#: RESIDENTIAL El COMMERCIAL 0
APPLICANT: Phone:
Barron Heating 360-676-1131
Address(Street,City,State,Zip): Email Address:
5100 Pacific Highway Suite 103, Ferndale,WA 98248 kaylissad@barronheating.com
PROPERTY OWNER: Phone:
Gretchen Mcindoe 360-755-6897
Address(Street, City, State,Zip): Email Address:
2417 Creekside Lane,Anacortes,WA 98221 N/A
CONTACT PERSON: Phone:
Barron Heating 360-676-1131
Address(Street,City,State,Zip): Email Address:
5100 Pacific Highway Suite 103, Ferndale,WA 98248 kaylissad@barronheating.com
CONTRACTOR:* Phone:
Barron Heating 360-676-1131
Address(Street,City,State,Zip): Email Address:
5100 Pacific Highway Suite 103, Ferndale,WA 98248 kaylissad@barronheating.com
*All Contractors&subcontractors must have a valid City of Professional License#: Exp.Date:
BARROHA179D7 10/23/2020
Anacortes business license prior to doing work in the City. Business License#: Exp.Date:
Contact the City's Finance Department at(360)299-1968. 600-092-564 03/31/2020
Is this work,associated with another project? Yes 0 No El If yes,specify:
PROPOSED WORK: Install natural gas fireplace and gas piping to location
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: Kaylissa Dunmore Owner 0 Agent l (specify): Barron Heating
Signature: 011-br-A- Date: 10/02/2019
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#: I Elec#: Other:#: Location(s): MU
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): um
Boiler: Gas P. Elec#: BTUs: Location(s):Other: #: Location(s):
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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 0 No 0 Dishwasher: Backflow Prevention Device:Urinal: Hose Bib:Floor Drain/Floor Sink: Drinking Fountain:
Hydronic Heat in: Floor 0 Wall 0 _ Grease Interceptor:
Other: Other
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