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HomeMy WebLinkAboutPermit File BLD-2020-0110 4122 Clyde Way (2) LDoo -6 ( IC ,�vc y o� PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT RESIDENTIAL BUILDING PERMIT APPL,C i Iptit 15 f �7 re Mailing Address: P.O. Box 547, Anacortes, WA 981 I 15 1�1 Office Location: 904 661 Street, Anacortes WA 988i1 MAR 1 5019 Phone: (360) 293-1901 ITY OF AN+CORTES PLEASE REFER TO THE RESIDENTIAL BUILDING PERMIT CHECKLIST BELOW FOR SUBMITTAL REQUIREMENTS 1 PROJECT ADDRESS(Stree Suit #):- PARCEL(S)#: y 1 'a_- C'l a e 'ct Subdivision/Lot#: l y PROJECT VALUATION: $ 30oy APPLICANT: Phone: IJO'O t Ii1atiA-0/V C 3 60 5C/9— S O 3 4 Address Street,City State Z. ) Ema A dress: PROPERTY OWNER:( y Phone: 6 Address(Street,City, State,Zip): Email Address: CONTACT PERSON: Phone: I -,j'cc.AA_-Q— Address(Street,City, State,Zip): Email Address: LENDING AGENCY: Phone: Address(Street,City, State,Zip): Email Address: CONTRACTOR:* f Phone: Address(Street,City, State,Zip)`:! Email Address: Professional License#: EXp.Date: *All Contractors&Subcontractors must have a valid City of Anacortes business license prior to doing work in the City. Contact Business License#: Exp.Date: the City's Finance Department at(360)299-1968. __/. PROPOSED WORK: .7,v 5-'1-0-t/ Li`$ 6 rV3I' t o- r' i N v ,_2„,-i uy:p 4:It'IQ ett©j d ��, - PROPOSED NEW SQUARE FOOTAGE: Basement SQ': El Finished Basement: ❑ Unfinished Basement Pt Floor SQ': Garage/Carport SQ': 2nd Floor SQ': Deck/Covered Porch/Patio SQ': Fire Sprinkler: ❑ Yes 4 No Lot Area SQ': /0 LUE,0 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 City of . a rtes. Print Name: i'/1 i a, L, Owner itl Agent ❑ (specify): Signature: b Date: V/5 , / tJ Page 1of5