HomeMy WebLinkAboutPermit File BLD-2020-0069 2507 Fir Crest Boulevard S T C City of Anacortes
Invoice/Permit#: BLD-2020-0069
904 6th Street
-. Applied date: 02/10/2020
_ P.O.Box 547 Issue date: 02/10/2020
1 Anacortes, WA 98221-0547
r ' "3 Expire date: 08/08/2021
(360) 293-1901
Job Address: 2507 FIR CREST BLVD Permit Type: Mechanical Permit
ANACORTES WA 98221-8762 Project:
APN: P121956
Remarks: Replace gas water heater like for like.
Owner: ODOWD OLENE J Contractor: FOSS HEATING AND COOLING
Address: 2507 FIR CREST BLVD Address: 333 E BLACKBURN RD
ANACORTES WA 98221-8762 MOUNT VERNON WA 98273-9006
Phone: Phone: (360) 336-1517
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-2020-0069-2020
020053-0035 Erin Wil... 02/10/2020 01:33PM
6033-FOSS HEATING AND COOLING
AiS2099CiI • Lt AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
eON GTIID J OR WORK 0-SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I
IIi,E €tylipg,I I INtTHAT I HAVARAD AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS
AbiEIN OR NOT, THE
RA'N 1�JG OFDA�PERMIT DOES NOT PRESUME TO GIVEOICES GOVERNING THIS TYPE AUTHORITY UF `THOORIRKTYWITO VIOLATELL BE POR CANCEL THELIED WITH TPEOVPSONSR IOF ANED Y OTHER STATE OR
LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SIGNATURE OF;dy(/Ij1WOR AUTHORIZED AGENT ISSUED
PLANNING,COMMUNITY, &ECONOMIC DEVELOPM
ENT DEPARTMENT
L 4, PLUMBING 8, MECHANICAL PERMIT APPLICATION I
fi Mailing Address:P.a Bax 547,Anacortes, WA 98221
Office Location: 904 6`h Street,Anacortes WA 98821
'44" " Phone: (360)293-1901,Fax: (360)293-1938
PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS(Street,Suite#): Pareel(s).#: rm-5'07 "h C s L f kZk 9 5
Subdivision/Lot#:
3 Residential IKE Commercial E
APPLICANT Phone: Fax:
05s ( -4 . f- c.001,..4. 1,60 3, (5(7
Address(Street,City,State,Zip): E-Mail Address'
3`33 C t5E :;cove L' (Z ,V 44,u,4 L 4. 7 2 7 3 ,rcke-, Lv tass rrt .
f �
PROPERTY OWNER: Phone: Fax:
01ti�,�. �±atO.W ICI537 2l3
Address(Street,City,State,Zip): tt E-Mail Address:
('r'j.Cf."
CONTACT PERSON: Phone: Fax:
Address(Street,City,State,Zip): E-Mail Address:
CONTRACTOR:* Phone: Fax:
( Lc 4 Lt 7
Address(Street,City,State,Z : E-Mail Address
*All Contractors&subcontractors must have a validCity of Contractor's License# . Exp.Date:
Anacortes business license prior to doing work in the City. Business License#: Exp.Date:
Contact the City's Finance Department at(360)299-1968. ®mil T—I — z. ,
Is this work,associated with another project? Yes 0 No giib Tf yes,specify:
PROPOSED WORK:
( 'cct- 6cc .L.1o7c4r 7 6c t, /4 (tyke
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 Cr4�r wc_e___ Owner ❑ Agent R(specify): u.-
Signature: Date:
-Zak
i
MECHANICAL:
Equipment Type: Appliance/Equipment Information(new and relocated): Total#:'
Furnace: Gas#_Elec#_,Other # BTUs:<100k >I00k Location(s)
Wall Heater Gas#J Elec#_Other: #_BTUs:<100k>100k Location(s)
Air Handler Gas _Elec#_Other: # BTUs:<100k>100k_Location(s)
Water Heater: Gas# Elec# Other: # BTUs:<1 OOk>l 00k Location(s)
AC TJnit/Boiler./
Heat Pump/Roof Gas#_Elec##`Other: # `BTUs: <100k, 100k-500k, 500k-
Top Unit(Circle IMil HP: <3, 3=15,_15 30 Location(s)
selected):
Hydronic Heating: Gas#_Elec# In-FloorWall 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)
OutdoorBBQ: Gas#__Elec# Other:_# Location(s)
Clothes Dryer&Duct: Gas#_Elec#_Other:_# Location(s)
Gas Piping: # Location(s)
Other # Location(s)
# Location(s)
TOTAL OUTLETS:
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 ❑ Wall
Water Heater Tankless? Yes 0 No ❑ Grease Interceptor:
Floor Drain/Floor Sink: Water Piping:
Refrigerator water supply(for water/ice
dispenser): Other:
TOTAL OUTLETS: TOTAL OUTLETS: