HomeMy WebLinkAboutPermit File BLD-2019-0815 4905 Portalis Way X 6 r City of Anacortes
Invoice/Permit#: BLD-2019-0815
904 6th Street
Applied date: 12/12/2019
P.O.Box 547
Ups Anacortes, WA 98221-0547 Issue date: 12/12/2019
(360) 293-1901 Expire date: 06/09/2021
Job Address: 4905 PORTALIS WAY Permit Type: Mechanical Permit
ANACORTES WA 98221-4011 Project:
APN: P123903
Remarks:
Owner: JANICE L KHERIATY Contractor: WASHINGTON ENERGY SERVICES
Address: 4905 PORTALIS WAY Address: 3909 196TH ST SW
ANACORTES WA 98221-4011 LYNNWOOD WA 98036-5732
Phone: (425) 891-8567 Phone: (800)398-4663
License#:
General Information: Fees:
#of Gas Water Heaters<= 100k 1 Mechanical Permit Fees 38.20
Total Calculated: 38.20
Deposits/Receipts: 0.00
Total Due: 38.20
Permits and Insp.,.- BLD-2019-0815-2019
019526-0009 Keri Kna... 12/27/2019 12:03PM
11659-WASHINGTON ENERGY SERVICES
BLD-2019-0815 Mechanical Permit
THISMIT (BECOMES UWORK OR CONSTRUCTIONCaCTM101 ON OR WORK 8 i 0SP ND D IOR ABANDONED FOR A PERIOD OF 801 DAYS AT ANY TOME AFTER WORK IS 1COMMENC D. IF
I
HiE REt iGERIT4#01trtTHAT I HAVVF EAD AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS
@FI §0,01k 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 ' •NS)0F ANY OTHER STATE OR
LOCAL LAW REGULATING CONSTR CTION OR THE PERFORMANCE OF CONSTRUCTION.
C)Qs
S NATURE OF 0 R OR AUTHORIZED AGENT l ISS ED o
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PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
�e 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, Fax: (360) 293-1938
PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS(Street,Suite#): Parcel(s)#:
4905 Portalis Way P123903
Subdivision/Lot#:
Residential ® Commercial ❑
APPLICANT: Phone: Fax:
Nikki Hyett-Schnell/Washington Energy Services 206-378-6648
Address(Street,City,State,Zip): E-Mail Address:
3909 196th St SW Lynnwood WA 98036 NHyett-Schnell@washingtonenergy.com
PROPERTY OWNER: Phone: Fax:
Janice Kheriaty (425)891-8567
Address(Street City,State Zip_): E-Mail Address:
4905 Portalis Nay,ANAGORTES,WA,98221
CONTACT PERSON: Phone: Fax:
Nikki Hyett-Schnell 206-378-6648
Address(Street,City, State,Zip): E-Mail Address:
3909 196th St SW Lynnwood WA 98036 NHyett-Schnell@washingtonenergy.com
CONTRACTOR:* Phone: Fax:
Washington Energy Services 206-378-6648
Address(Street,City, State,Zip): E-Mail Address
3909 196th St SW Lynnwood WA 98036 NHyett-Schnell@washingtonenergy.com
*All License# Exp.Date:
All Contractors&subcontractors must have a valid City of WASHIES851 NS 09/07/19
Anacortes business license prior to doing work in the City. Business License#: Exp.Date:
Contact the City's Finance Department at(360)299-1968. 603522032 09/07/19
Is this work, associated with another project? Yes ❑ No IN If yes, specify:
PROPOSED WORK: REPLACING GAS WATER HEATER.
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:,�NIIKKI HYETT-SCHNELL Owner El Agent 0 (specify):
Signature:JV- ' Date: 12/12/2019
MECHANICAL:
Equipment Type: Appliance/Equipment Information(new and relocated): Total#:
Furnace: Gas#_Elec# Other: # BTUs:<100k >100k_Location(s)
Wall Heater: Gas#_Elec#_Other: # BTUs:<100k>100k_Location(s)
Air Handler: Gas ec#_Other: # BTUs:<100k>100k_Location(s)
Water Heater: as#X E c# Other: # BTUs:<100k>100k Location(s)
AC Unit/Boiler/
Heat Pump/ Roof Gas# Elec#_Other: # BTUs: <100k, 100k-500k, 500k-
Top Unit(Circle 1Mil HP: <3, 3-15,_15-30 Location(s)
selected):
Hydronic Heating: Gas#_Elec#_In-Floor_Wall Radiant Boiler BTUs: Location
Exhaust Fans Bath# Kitchen# Laundry# Other:
(single duct):
Fireplace/Insert: Gas#_Elec#_Other: # Location(s)
Stove/Range/Oven: Gas#_Elec#_Other:_# Location(s)
Range Hood: # Location(s)
Refrigeration Unit: Gas#_Elec# Other:_# Location(s)
Outdoor BBQ: Gas# Elec#_Other:_# Location(s)
Clothes Dryer&Duct: Gas#_Elec#Other:_# Location(s)
Gas Piping: # Location(s)
Other: # Location(s)
Location(s)
TOTAL OUTLET 1
PLUMBING FIXTURES:
Fixture Type(new and relocated): Total#: Fixture Type(new and relocated): Total#:
Water Closet(Toilet): Pressure Reduction Valve/Pressure Regulator:
Urinal: Backflow Prevention Device:
Sink(kitchen,laundry,lavatory,hand,bar,slop,
eye wash,etc.): Water Service Line:
Tub/Shower: Drinking Fountain:
Dishwasher: Clothes Washer:
Hose Bib: Hydronic Heat in: Floor 0 Wall 0
Water Heater Tankless? Yes 0 No ❑ Grease Interceptor:
Floor Drain/Floor Sink: Water Piping:
Refrigerator water supply(for water/ice
Other:
dispenser):
TOTAL OUTLETS: TOTAL OUTLETS: