HomeMy WebLinkAboutBLD-2019-0759 - RESIDENTIAL INTERIOR ONLY REMODEL -8-T Y. '`r City of Anacortes Invoice/Permit#: BLD-2019-0759
904 6th Street
Applied date: 11/18/2019
P.O.Box 547 Issue date: 11/20/2019
s"''% �01 Anacortes, WA 98221-0547
Expire date: 05/18/2021
Cril
:1 co ` .',
(360) 293-1901
Job Address: 1010 0 AVE Permit Type: Single Family Alteration/Repair Permit
ANACORTES WA 98221-1956 Project:
APN:
Remarks: Full gut remodel of existing house and garage
Owner: BILL MENDUM Contractor: OWNER
Address: PO BOX 1656 Address:
ANACORTES WA 98221-6656
Phone: (360)293-6396 Phone:
License#:
General Information: Fees:
#of Ventilation Fans 1 Building Permit Fee 432.15
Building Valuation 28500 Plan Review Fee 280.90
#of Range Hoods 1 State Building Code Fee Resi 6.50
#of Clothes Dryers 1 Mechanical Permit Fees 44.80
#of Showers 1 Plumbing Permit Fee 62.00
#of Clothes Washers 1 Total Calculated: 826.35
of Kitchen Sinks 1 Deposits/Receipts: 280.90
#of Lavatories 1
#of Water Closets 1 Total Due: 545.45
#of Water Piping 1
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 ISSU D BY
Permits and Insp... - BLD-2019-0759 - 2019
01 9474-01 1 6 Carla Br... 11/22/2019 02:34PM
7601 - BILL MENDUM
BLD-2019-0759 Single Family Alteration/Repair Permit
Payment Amount: 545.45
Transaction Amount: 545.45
CHECK: 01252
PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
RESIDENTIAL BUILDING PERMIT APPLIcA�'�"ION , ,;,x; }•
Mailing Address:P.O. Box 547,Anacortes, WA 9821r '
Office Location: 904 6th Street,Anacortes WA 9882E
T- A Phone: (360)293-1901 11 , NOV 18 2019
PLEASE REFER TO THE RESIDENTIAL BUILDING PERMIT CHECKLIST BELOW FOR SUBMITTALYREkg1E S
PROJECT ADDRESS(Street Suite#): PARCEL(S)#:
1 O o 'O" An2kz-flQi
Subdivision/Lot#: PROJECT VALUATION: $�� Soo
APPLICANT: Phone:
Address(Street,City,State,Zip): Email Address:
P.. , ]�0 1 o 5 ' �}-�.��c�r�-�S iMZ tw\r r r�SC�o t Pt- ��1 �a v�
PROPERTY O Phone:
Address(Street,City,State,Zip): Email Address:
CONTACT RSON: Phone:
Address(Street,City,State,Zip): Email Address:
LENDING AGENCY: Phone:
Address(Street,City,State,Zip): Email Address:
CONTRACTOR:* Phone:
Address(Street,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. el
PROPOSED WORK: ��tl"�O C 2 .Jp d zti-r\4-,,
PROPOSED NEW SQUARE FOOTAGE:
Basement SQ': 41 ❑ Finished Basement ❑ Unfinished Basement
1st Floor SQ': Q Garage/Carport SQ':
2'Floor SQ': Q Deck/Covered Porch/Patio SQ':
Fire Sprinkler: ❑ Yes - No Lot Area SQ': 60,6 CS
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: : J l k +f - Owner Agent ❑ (specify):
Signature: Date: 1 1 \ 1
Page 1 of 5
IMPERVIOUS SURFACE AREA:
Existing Impervious SQ': 214 a New Impervious SQ': Z9-C
Total Disturbed Land/Soil SQ': Total Proposed: Cut: Fill:
New hard surfaces(pervious&impervious) ()
Land converted from native vegetation to lawn or landscaping SQ'
Land converted from native vegetation to pasture SQ'
MECHANICAL:
Equipment Type: Appliance/Equipment Information(new and relocated): Total#:
Furnace: Gas#: Elec#: BTU: Other#:
Wall Heater: Gas#: Elec#: Other:#: Location(s):
Gas Water Heater: #: Location(s):
Heat Primp: Elec#: Other#:
Air Conditioning: Elec#: Other#:
Radiant/Hydronic Heating: Gas#: Elec#: Other:#: Location(s):
Exhaust Fans: Bath#: Laundry#: Other: I
Range Hood: #: Location(s):
Fireplace: Gas#: Elec#: Other:#: Location(s):
Clothes Dryer&Duct: Gas#: Elec#: Other:#: Location(s): i
Stove/Range/Oven: Gas#: Elec#: Other:#: Location(s): i
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): I Refrigerator water supply(for water/ice dispenser):
Kitchen Sink: I Pressure Reduction Valve/Pressure Regulator:
Utility Sink: Water Service Line:
Tub: Water Piping:
Hand Sink: I Clothes Washer:
Shower: / Electric Water Heater: Tank-less? Yes d No AL
Dishwasher: Backflow Prevention Device:
Hose Bib: r' Other:
"- TOTAL PLUMBING IN IXTURES 7
Page 2 of 5
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