HomeMy WebLinkAboutPermit File 1815 12th Street 0427904-1 0003 10/05,2004 002 4
X" Permit Fees 006058 $277.33
,bA1 0�:, City of Anacortes
Permit#: BLD-2004-0049
904 6th Street Issue date: 10/05/2004
P.O.Box 547
`+' Anacortes, WA 98221-0547 Expire date: 10/05/2005
' ,�O W,• (360) 293-1901
Job Address: 1815 12TH ST Permit Type: Single Family Alteration/Repair Permit
ANACORTES WA 98221 Project:
APN: P57125
Remarks: Remodel existing residence.
Owner: TOM ALLEN Contractor:
Address: PO BOX 817 Address:
ANACORTES WA 98221
Phone: Phone:
License#:
General Information: Fees:
Building Valuation 20000 Building Permit Fee 140.50
#of Bathtubs 1 Plan Review Fee 91.33
#of Lavatories 1 State Building Code Fee 4.50
#of Water Closets 1 Plumbing Permit Fee 41.00
Total Calculated: 277.33
Deposits/Receipts: 0.00
Total Due: 277.33
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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 HAV READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL
PROVISIONS OF7IAWS AND INANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR
NOT, THE pRANT N OF IT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER
STATE/OR LOQA ING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
, 141
SIGNATUI4E OF OWNER OR AUTHORIZED AGENT ISSUED BY
IC) .
, ! •
. • . ,
FOR INSPECTIONS CALL: CITY OF ANACORTES -. -,,TA
PERMIT d:f:4;;;d: 9031
293-1901 . ' BUILDING PERMIT
. .
24'Hrs. Notice Requested Sitehthiress, .
.. 18I5 12th Street
d ,
,d
'NAME (OR NAME OF BUSINESS) , .
PLUMBING Ted: E i pus : d , ,.
1SI, '
f: 2 MAILING ADDRESS ,.
,, TYPE,OF FIXTLIEKCIII-No.
ITEM FEE
4- -,t, 18)6 1 2th Street , .• ..,,
•, 1; CITY TELEPHONE NUMBER Water Closet . $
.r 1: Anacortes, WA 9922 1 • 1 Bathtub H •
; NAME LaVatory . ,
, .nnn '
' 1 , . , : Shower
ADDRESS :n
; Kitchen Sink,
-
I : : . . Dishwasher , •
,.
.< CITY TELEPHONE NUMBER Laundry Tray
-
Clothes Washer
...- ,
' II NAME . Water Heater "
.
Urinal
ADDRESS - : Drinking Fountain .
,' . Floor Sink cirDrain
.:.. .
CITY TELEPHONE NUMBER T Slop Sink . ,
Water Piping
_.
STATE LICENSE NUMBER CITY LICENSE NUMBER
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1E d i Dg4Sidentkat OMqn-Raidebtial " - , PERMIT $
0 iNbw ' gi Add' 'HIP 0.Alier 'i' 0 Repair , TOTAIJFEE ,: $
041ta1ding 11 0,Plurribing 0;Mechanical MECHANICAL
; 1
•;. ,1 0!Sign ! I 0 DeMolitiOn 0 Other ' D GAS 0 OIL 0 Ettor. , 0 OTHER
Legal DesCription of Property or Tax Account Number I'?
sr M :No. TYPE OF EQUIPMENT FEE! I Lot ' "'-ii Block 12 of
. ,
II 37 S5-002--008-0009 ,-,
. Air Cond. Unit ,
- 1 .
,. Refrigeration Unit— HP
' -Boiler— HP
• , Forced Air System— BTU/KW
: I Describe Work - Floor Furnace . .
' 1 Siding , : Wall.Heater ..
:
,
. ''. Unit Heater
. , Clothes Dryer .
,• :
.'Occupancy Use .n ,
Ventilation Fan ,
. .
U<Single Family Residence 0 Multi-Family Residence 7 Range HOod
0 Office 0 Retail 0 Storage 0 Church . Air Handling Unit—
. . CFM
0 Restaurant 0 Other . ; Pre-mantrfacuired Stove or Fireplace
- NOTICE ,
•- ,, ' GasPiping .
' -
.
This permit is issued by the Building Official and,wider tthe-provisions ,rovisions .
,
of the Uniform Building Code,shadeXpire.by limitiiioirand become null ,-r - ,. '
and void if the building orhvork anthofized by sucKISermit is riot Com- - , PERMIT $
j,. menced within 180 days froth the date of permit issuance,or if theibuilding TOTAL FEE - $ e•e
or work authorized by such'permit is suspended or abandoned at any time ,
Y.: after the work is commenced fora period Of 180 daye;
TOTAL,FEES ' VALUATION FEE
By affixing my signature, I hereby!certify that I:am the owner of the . Buildin ' ;340017.,.co. $ sa',Co
property for which this permit is issued Or aman authorized represen- ,
8 Check . Cr.CR;
._
n'. tative of the owner. : Plan .
,' 'Plumbing
All provisions of laws and ordinances governing this type of work will ."Mechanical ' ,,
..
be complied with whether specified herein or-not,Mehl-ding-routine calls
-.. for inspections. Sign
. Demolition
•. •
-. . ,,
''' 13 '''' t I Energy Surcharge
4.50
„_,• Signature of Owner oh'AuthOrized Agent (Date) State Surcharge
,Street Setback II !I SideNtard-Seibeck "' Rear Yani Setback ' Other .
TOTAL: $ 41/210 ei'at
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Use Zone Occupancy Group Type o : 'Conditions:f Const.
,
- Lot Area Vacant Site Dwelling Units ..
Ll Yes 0 No , .
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Fire Sprinklers Required No.of Stories Bedrooms Occupant Load
l: 0 Yes 0 No 2 2.
,2, Size of Bldg. Plans Checked By- , ,
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WHEN SIGNED AND DATED BELOW THIS IS PERMIT
ji Pervasion is hereby Ova to do the.ttboa deiailied work,acijOinitii.the conditions
't 1, hereon and ececihtg ik,th,approved Plans and^.speejpeatione attaining that°,subject to
i:' compliance'auk the ordinances ef,the CITY OF ANACORTES. . " "
:
0 8/1 5/9 1 '
Permit Issued By il"^t\ ,1( !x.1,, r,,, 1 I (I (tt'l'le I in.. C : ,
Building tifficial c(pate) , - : -
Edwin Frank :
, PERMIT N, ilrti
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Address /e/s /2 '"e-
Legal Description ��f r De_ 2 Y741/�
Assessors Account No. 37 tS'-OtZ-- 01)T—CoO7
Permit No. Date Description Date Finaled
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