HomeMy WebLinkAboutPermit File BLD-2019-0778 4804 Harbor View Place Y 0 City of Anacortes Invoice/Permit#: BLD-2019-0778
904 6th Street
'>4Applied date: 11/26/2019
P.O.Box 547 Issue date: 11/26/2019
Anacortes, WA 98221-0547
(360) 293-1901 Expire date: 05/24/2021
Job Address: 4804 HARBOR VIEW PL Permit Type: Mechanical Permit
ANACORTES WA 98221-4087 Project:
APN: P105271
Remarks: Replace natural gas furnace for the same.
Owner: ORVILLE& CAROL MORROW Contractor: WEST MECHANICAL INC.
Address: 4804 HARBOR VIEW PL Address: 4443 ALDRICH RD
ANACORTES WA 98221-4087 BELLINGHAM WA 98226
Phone: (360) 588-8166 Phone: (360) 734-7599
License#:
General Information: Fees:
# Forced Air Furnace <=100k 1 Mechanical Permit Fees 38.30
Total Calculated: 38.30
Deposits/Receipts: 0.00
Total Due: 38.30
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 E4MINED 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 NOTyRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR
LOCAL LAW REGULATING CONSTRICTION OR THE PERFORMANCE OF CONSTRUCTION.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUE1' -
Permits and Insp... - BLD-2019-0778 - 2019
019478-0005 Carla Br... 11/26/20'19 10:54AM
12573 - WEST MECHANICAL INC.
BLD-2010-0778 Mechanical Permit
Payment Amount: 38.30
Transaction Amount: 38.87
03FIN CC: ****** ***117 07
NOV 2 6 2019
II Y OF R ti ' ICE;,COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
f 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:
9€ON acbcrr View ?late PIoS271
Subdivision/Lot#: RESIDENTIAL COMMERCIAL 0
APPLICANT: Phone:
PO.Co,J .yeti 3a4 - 73H - 7 S'9 °I
Address(Street,City,State,Zip): Email Address:
`141y 3 A\ rre.tA Ra. S1c\ 511c.M 9e214 cearo". @wcSi-Pit ccl�at�.tcal. lvc�-
PROPERTY OWNER: Phone:
Coro\ l4orc-aw 3GtJ - S - $ 1GC.
Address(Street,City,State,Zip): Email Address:
y$OM \-1c.cbcr View 'lace CLoiMo crow @gcna1l . coM
CONTACT PERSON: Phone:
Sc tr e 3 ap p\rt.stA/4
Address(Street,City,State,Zip): Email Address:
CONTRACTOR:* Phone:
Wes'r N\ec.lncANicc- 366 - 73y -
Address(Street,City,State,Zip): Email Address:
tLiLI3 PRO r L le). PAN Pith, 14A- 91226 Aare; a wcSi- . Nei __
*All Contractors&subcontractors must have a valid City of Professional License#: Exp.Date:
Anacortes business license prior to doing work in the City. Business License#: Exp.Date:
Contact the City's Finance Department at(360)299-1968. �/C,U Z I a 6 3/3 t 20 Zo
Is this work,associated with another project? Yes 0 No L' If yes,specify:
PROPOSED WORK: 17-0.- aat 5.14 F,rw.a cc
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: A Owner ❑ Agent specify): CG.i4r4e-4z r
Signature: � Date: /t/ 2-5—,/
MECHANICAL:
Equipment Type: Appliance/Equipment Information(new and relocated): Total#:
Furnace: Gas#: !L Elec#: Other#: Location(s): 1
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#: Elec#: Other:#: Location(s):
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): #: Location(s):
Boiler: Gas#: Elec#: BTUs: Location(s):
Other: #: Location(s):
TOTAL MECHANICAL OUTLETS:
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 ❑ Wall ❑ Grease Interceptor:
Other: Other:
TOTAL PLUMBING FIXTURES:
G � PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
alL,r PLUMBING AND MECHANICAL PERMIT CHECKLIST
t�� w� Mailing Address: P.O. Box 547, Anacortes, WA 98221
` ?coR'� Office Location: 904 6t11 Street, Anacortes WA 98821
Phone: (360) 293-1901
PROJECT ADDRESS:
Plans shall be of sufficient clarity to indicate the location, nature, and extent of the work proposed, and
conform to the provisions of the adopted International Codes and City Ordinances.
PERMIT TYPE:
„0 c c n O
►z a rAE.. a EE.. r
p SUBMITTAL REQUIREMENTS:
n The number indicates the number of AD
copies for submittal(if applicable). 4 O
s ate, a ar
A g. ara cro
.
--
AD
Plumbing&Mechanical Permit Application 1 1 1 1
Mechanical Plans 1 0 0 0
Structural Calculations 1 0 0 0
State Non-Residential Energy Code Compliance Form 1 0 0 0
Manufacturer's Specifications/Cut Sheets 1 0 1 0
Elevation View for Roof Mounted Equipment 1 0 1 0
Plumbing Plans 0 0 1 0
Listed&Tested Fire Stopping Assemblies 0 0 1 0
Permit Fee ✓ ✓ ✓ ✓
Existing Floor Plan 2 2 2 2
New Floor Plan 2 2 2 2
NOTES:
1. Handouts and standard details may be found on the City's Planning, Community, &Economic
Development website 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.
3. If installing a backflow prevention device, it will need to pass test results of which will need to be
submitted to the city for review.
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https://wwvveskagitcounty.net/Assessor/Jmages/Photos/3157/2156192.jpg 11/25/2019