HomeMy WebLinkAboutPermit File BLD-2020-003 2014 29th Place �T C? City of Anacortes Invoice/Permit#: BLD-2020-003
904 6th Street
Applied date: 01/07/2020
`"•" P.O.Box 547 Issue date: 01/07/2020
Anacortes, WA 98221-0547 Expire date: 07/05/2021
(360) 293-1901
Job Address: 2014 29TH PL Permit Type: Mechanical Permit
ANACORTES WA 98221-3870 Project:
APN: P122600
Remarks: Replace furace with air handler, install new heatpump.
Owner: SCHAEFFER ROBERT C Contractor: FOSS HEATING AND COOLING
Address: 3817 WHITMAN AVE N Address: 333 E BLACKBURN RD
SEATTLE WA 98103-8723 MOUNT VERNON WA 98273-9006
Phone: Phone: (360) 336-1517
License#: FOSSHCI983QA
General Information: Fees:
#of Air Handling Units>10000 1 Mechanical Permit Fees 52.25
#of Other Mechanical Units 1 Total Calculated: 52.25
Deposits/Receipts: 0.00
Total Due: 52.25
Permits and Inspe...- BLD-2020-003-2020
020006-0009 Keri Kna...01/07/2020 09:41AM
ggS6033r��3-nnFOSS HEATING
AND COOLING
TFII PERMJT B C I1 SP &L AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
emgrikf9 I6 OR WORK &•&JSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I
FORM 'eY'(E f+eftTHAT I HAVV.I3 AD AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRU. • 1-. ORRECT.ALL PROVISIONS
GT, THE
WTING OF AORINWICES GOVERNING THIS TYPE PERMIT DOES NOT PRESUME TO G VEOAUTHF OORIRKTYITO VIOLATELL BE PORDCANCELVTH.—O IIS10 ,S WITH WHET - SPEC IOF ANY OTHER STED HEREIN OR OATE OR
LOCAL LAW REGULATING CONST, CTION OR THE PERFORMANCE OF CONSTRUCTION.
7
SIGNATURRE,OF O €R HORIZED AGENT ISSU:D B
PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
PLUMBING & MECHANICAL PERMIT APPLICATION
Mailing Address: P.O. Box 547,Anacortes, WA 98221
\ row 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 SUBMIT ZAL REQUIREMENTS
PROJECT ADDRESS(Street,Suite#): Pareel(s)#:
Subdivision/Lot#:
L.or (2 Residential .G ". Commercial 0
APPLICANT: . Phone: Fax:
Address(Street,Ci ,State,.Zip): L E-M i Ads: , `
'?3'3 . ' c,,.4. .7 "mot (24 �T-`t --,-.0;.k,n t+-„•'{ eZ73 `r' e.%i 1 1 ersr GL.L4_J 4,. .0 ot�t
PROPERTYRWNER: Phone: Fax:
Address(Street,City,State,Zip): y E-Mail Addres j trtiJ
.3 4'- �1c 1 LIc,i,, �i�-1,,.r /'; tq,; e cyrti . 4C4:*
CONTACT PERSON: f Phone: Fax:'✓
........ 6.?4+4,1 -
Address(Street,Cify State,Zip): E-Mail Address:
CONTRACTOR:* 1 Phone: Fax:
(uc `t.
Address(Street,City,State,Zip): E-Mail Address
Contractor's License# Exp.Date:
*All Contractors&subcontractors must have a valid City of =05 a-`f' 4A' f t —I _-2'a
Anacortes business license prior to doing work in the City. Business License#: Exp.Date:
Contact the City's Finance Department at(360 299-1968. if7c-( T_,3f`Zi
Is this work,associated with another project? Yes 0 No p If yes,specify:
PROPOSED WORK:
IR j(-+:c-e- - r c C.__ aA, 4 .i 1r' Lt jL *
`(, -- 1 t r i-e,,,a., 4- to. „to
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: L qN...,.,.< tA Owner ❑ Agent C(specify): .tlC/e :feov
Signature: — Date: 1 6. 76 2-6
MECHANICAL:
Equipment Type: Appliance/Equipment Information(new and relocated): Total#:
Furnace: Gas#,_Elec#__Other: # BTUs:<1:.00k>100k_Location(s)
Wall Heater: Gas# Elec# Other: # BTUs:<100k>100k_Location(s)
Air Handler: Gas# Elec#!Other # BTUs:<100k>100k_Location(s)
Water Heater: Gas# Elec# Other: # BTUs:.<100k>100k. Location(s)
• :oiler/
eat Punte Roof Gas:#_Elec#`_Other: # BTUs: <100k, 100k-500k, 500k-
op Ilnit(Circle 1Mil HP: <3, 3-15. 15-30 Location(s).
selected):
Hydronic Heating: Gas# Elec# In-FloorWall.Radiant_Boiler BTUs: Location
Exhaust Fans Bath#Eitchen# Laundry# Other:
(single duct):
Fireplace/Insert: Gas#_Elec#__Other:. # Location(s)
Stove/Range/Oven: Gas# Elec#_other:_# Location(s)
Range Flood: # Location(s)
Refrigeration Unit: Gas#_Elec#_Other:_# Location(s)
Outdoor BBQ: Gas.# Elec#_Other: #_ Location(s)
Clothes Dryer Gas:#_Elec#Other:_# Locations)
Gas Piping: # Location(s)
Other: # Location(s)
Location(s)
TOTAL OUTLETS: 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, Water Service Line:
eye wash,etc.):
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: