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HomeMy WebLinkAboutPermit File BLD-2019-0814 4001 J Avenue © City of Anacortes Invoice/Permit#: BLD-2019-0814 G 904 6th Street Applied date: 12/12/2019 "."r P.O.Box 547 Issue date: 12/12/2019 0 Anacortes, WA 98221-0547 • (360) 293-1901 Expire date: 06/09/2021 Job Address: 4001 J AVE Permit Type: Mechanical Permit ANACORTES WA 98221-3539 Project: APN: P56949 Remarks: Install a gas stove to existing gas line. Owner: THOMAS SHARDLOW Contractor: CRAFT STOVE INSTL OF MV WA LLC Address: 4001 J AVE Address: 900 W DIVISION ST ANACORTES WA 98221-3539 MOUNT VERNON WA 98273-3226 Phone: Phone: (360) 336-2532 License#: General Information: Fees: #of Other Mechanical Units 1 Mechanical Permit Fees 34.15 Total Calculated: 34.15 Deposits/Receipts: 0.00 Total Due: 34.15 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 PRO ONS 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-2019-0814 - 2019 019504-0038 Carla Br... 12/12/2019 04:01 PM 12567 - CRAFT STOVE INSTL OF MV WA LLC BLD-2019-0814 Mechanical Permit Payment Amount: 34.15 Transaction Amount: 34.15 CHECK: 011633 4 '•( \ r... ,1 „.,i, .DEC 12�2ot9 rOE 19 a �fq ' . Cf T Y MMUNITY, • &ECONOMIC Ui ►r.•s " RTMENT ; PLUMBING & MECHANICAL P!-_RMIA ' , ION Mailing Address:P.O.Box 547,Anacortes, WA 98221 (Ii Office Location:904 eh 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: 9001 J -IN\Ic v \e P 5t0 9 N c-t q S©(l Subdivision/Lot#: RESIDENTIAL IA COMMERCIAL ❑ APPLIT: Phone: I Gra, -i- S+D\r -3c90-33C19-L S 2- Address(Street,City,State,Zip): Email Address: 1 1() W , 'bl.J S1b'n 1-4+. yernon wh 6 2zg Cra-c--i-sA--o.ies was kC� COMcas1-,met PROERTY OWNER: Phone: k\n,vrk.CkS 5tnc:JCa l uUJ 3 u b Zet 3--s3(oS Address(Street,City,State,Zip): Email Address: t-[bo l 'S Nie, Pc-naLoAts w N 61- 22-A CONTACT PERSON: Phone: n C_)u._ 3CP'b33C4)--2S32- Address(Street,City,State,Zip): Email Address: ci DD \NI ,b'v\Sion VW. V (nM W CkL13 Cra---1-s-1-ugeSvJ skOcoM_cs-1- net CONTRACTOR:* Phone: C,xcI.k - Si O\1e- I,n,S i a l Ict_-utnn 3(Q D-33(D—232 Address(Street,City,State,Zip): Email Address: qr)0 W,D\vksiors Mt-.Vexnur\ ki\{P (z-73 exa si-Dvswcd—ecui-.c s-f- ae± *All Contractors&subcontractors must have a valid City of Professional License#: Exp.Date: 7-6 Anacortes business license prior to doing work in the City. C � � 3 3 i ' Contact the City's Finance Department at(360)299-1968. Business License#: Exp.Date: Is this work,associated with another project? Yes ❑ No-V If yes,specify: PROPOSED WORK: I n s-E-zt, H as s i-n 4e -t-c intj 5 6tS, 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: 101A.A5 SOUS f 1 (Oh Owner ❑ Agent 4(specify): Ati fri a A Signature: Date: 1 I j 2/ 1 q 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#: \ 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): #: Location(s): Boiler: Gas#: Elec#: BTUs: Location(s): Other: #: Location(s): 1 I'f I-\ I lv, l !'( ' I -` I , v i 1 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 ❑ Dishwasher: Backflow Prevention Device: Urinal: Hose Bib: Floor Drain/Floor Sink: Drinking Fountain: Hydronic Heat in: Floor ❑ Wall ❑ Grease Interceptor: Other: Other: