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HomeMy WebLinkAboutPermit File BLD-2020-0038 4016 Peters Lane 1T - © v City of Anacortes Invoice/Permit#: BLD-2020-0038 904 6th StreetApplied date: 01/27/2020 P.O.Box 547 Anacortes, WA 98221-0547 Issue date: 01/27/2020 (360) 293-1901 Expire date: 07/25/2021 Job Address: 4016 PETERS LN Permit Type: Mechanical Permit ANACORTES WA 98221-3948 Project: APN: P100315 Remarks: Replace gas water heater like for like. Owner: BERG EDWARD G Contractor: CPI PLUMBING & HEATING Address: 4016 PETERS LN Address: 1900 RAILROAD AVE ANACORTES WA 98221-3948 MOUNT VERNON WA 98273-4957 Phone: Phone: (360)428-5636 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-2020-0038-2020 020039-0083 Erin WI... 01/30/2020 04:22PM 11731 -CPI IIPLRUppMBIII}NaaG&HEATING 11g- iIVII)T�ECDIVIEINPETitAND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF CsONS tlftlEI N:OR WORK I BS 'SPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I Fg ytig�Frj��r .Flyn HAT I HAVf3, FAD AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS 4 gr 1 G QF A ORDINANCES GOVERNING THIS TYPE OF WORK DOES NOT PRESUME TO GIVE AUTHORITY ITO VIOLATEPOR CANCEL THETPRO SPECIFIEDNS OF ANY OTHOER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED B L PLANNING„ COMMUNITi% & ECONOMIC DEVELOPMENT DEPARTMENT ;.: ,.t: ,:, ! 4P.4' PLUMBING & MECHANICAL PERMIT APR./CATON . Mailing Address: P,O. Box 547, Anacories, WA 9822.1 (Vice Location: 904 0 Stivet, Anocortes Wil 98.821 Phone: (.360) 2934901 -PLEASE REFER TO TPIE PLUMBING & MECHANICALPERMITCHECKLIS T FOR'SUBMITTAL REQUIREMENTS PROJECT ADDRESStreet, Suite ;9: PAREL(S) #; I PROIECT VAL1.7ATON:- -2to\t.Q ex.5: LekrIP . P‘.0b. Vr:,.) '1, k NIDD OD • 4 - - stitglivisionfLot #: RESIDENTIAL ; COMMERCIAL 0 APPLICANT:, , Phone: S -CtD - • : - ', n 3Cp0- 4-7--;(8-54 :5 , . ' Address (Street, City,Atate, PP): Email Address: , PROPERTY OWN:ER_ ,e„ Phone: oN V304 - 5ctiko Address (Street, City, State., Zip) Email Address 4D\AP C)Q-- ek,>,,.TY\P.,,__ 4J--\ft- %ilk exNMYc;*feS\C'cz):Corrf:CD-SSt-, r'' CONTACT PERSON: Phone: , Addmss (Street, Cit) 'take, Zip): . Email Address: , 401: t) A-' tikri C.._- '-)',NCL .C11%241 eNNI-sk\ne.S.V70:C- • ._. --c_g.,th_- - - ‘i: ::_._ ..S CONTRACTOR:* I Phone: 9NNA \60vir)r) k \-\ect-V,r% 1 at5D- 8-Mi .- 5(&•;5(4, Address (Street. City. State. ' -ip): - -_ ' Email Address: • 9t71 ' Cx\1)Z cp,g‘upor\Vt(lei\iC-Olty-.) - ProlesSional noebSe*1: 1 ExpiDate: *An Contractors ii sobrontracton must have avalid City of : \X L-Xj:NA trID 40.44A1A . 2-,C)23 1 AnairorieS husinaslicense prior to doing work in the:City. Be" Licence #: 1 Exp. Date: Contact the Cit.Cs Finance:Department at 06()299-1968, is this work, associated with another project? Yes -0 NoXe, if yes, vecify: • PROPOSED WORK: . . ..._ „. . _ ! I declare under penalty of ped urS.'-that the infortntiiion'l have provided on this form/application is true, comet, and complete, and that-I a ill the iprpperty owner or duly authorized-auent of the!property owner to submit a permit application to the City of Anacortes. • Print Name: -t• R. ..0.-X\ - V-A,r--., Owner 0 Agnt„*:(speci-M: 1Z> • - ' Signature: - _________ Date: ‘\ 14\;3-0 -- :I 1 Equipment Type; Appliance/Equipment information (new and.relocated): Total#: Furnace: Gas#: Elec..#: Other It: Location(s): Wall Heater Gas#: Elec #:: Other: #: -Location(s-); Gas Water Heater: #: :Location(s): C=. .. :a.. : .., Bice#: Other#: Location.(s): Heat Pump: � Air Conditionerdlandler.: 1 'Eke#: Other:#: Location(s): 3 Radiant/Hydronic.Heating: Gas#: •Elec#: Other.:.#:. Location(s): ' Exhaust Fans: I Bath#: Laundry 4: Kitchen#: Others : Range;Hood: #: Type 9 or 2 (Circle which one) Location(s): I Fireplace: Gas#: Elec#: Other: 4: :Location( ): Clothes Dryer &-Duct: ] Gas#: Elec #: Other:-#: Location(s): - Stove/Range/Oven: I 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): TOTAL MECHANICAL OUTLETS:- 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: PPressure:Reduction Valve/PressureRegirlator: Utility Sink: Water Service Line: Tub: Water Piping: Hand Sink: Clothes Washer: Shower: Electric Water Heater: Tank-less? Yes No 0 Dishwasher: Back-flow Prevention Device: Urinal: Hose Bib: Floor Drain I Floor Sink: Drinking Fountain: Hydronic Heat in: Floor © Wall 0 t'Grease Interceptor: Other: Other: I I E TOTAL PLUMBING FLXTU