HomeMy WebLinkAboutPermit File BLD-2020-0342 3008 W2nd Street 4S- ► f._ Cityof Anacortes
invoice/Permit #: BLD-2020-0342
904 6th Street
Applied date: 06/16/2020
P.O.BU 547
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Job Address: 3008 W 2ND ST Permit Type: Mechanical Permit
ANACORTES WA 98221-1350 Project:
APN: P58408
Remarks: REPLACE GAS FURNACE FOR THE SAME.
Owner: WAYNE D MACKEY Contractor: FOSS HEATING AND COOLING
Address: 3008 W 2ND ST Address: 333E BLACKBURN RD
ANACORTES WA 98221-1350 MOUNT VERNON WA 98273-9006
Phone: (406) 951-3930 Phone: (360) 336-1517
License #:
General Information: Fees:
# Forced Air Furnace <=100k 1 Mechanical Permit Fees 38.30
Total Calculated: 38.30
Deposits/Receipts: 0.00
Total Due: 38.30
The issuance or granting of this permit shall not be construed to be a permit for, or approval of, any violation of this Code or any other ordinance or order of
the City, of any state or federal law, or of any order, proclamation, guidance advice or decision of the Governor of this State. To the extent the issuance or
granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or
federal law, or order, proclamation, guidance advice or decision of the Governor of this State, this permit shall not authorize such work and shall not be
valid. The building official is authorized to prevent occupancy or use of a structure where in violation of this Code, any other City ordinances of this
jurisdiction or any other ordinance or executive order of the City, or of any state or federal law, or of any order, proclamation, guidance advice or decision of
the Governor. The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect,
inaccurate or incomplete information, or in violation of any City ordinance, regulation or order, state or federal law, or any order, proclamation, guidance or
decision of the Governor. This permit becomes null and void if work or construction authorized is not commenced within 180 days or if construction work is
suspended or abandoned for a period of 180 days at any time after work is commenced. I have read and examined this application and know the same to
be true and correct.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY
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Finance Department
020222-0033 Erin W. 06/16/2020 01:09PM
PERMITS AND INSPECTIONS
FOSS HEATING AND COOLING
BLD-2020-0342
Mechanical Permit
REPLACE GAS FURNACE FOR
THE SAME.
issued
2020 . Item: BLD-2020-0342
Mechanical Permit Fees 38.30
Payment Id: 284670
38.30
Subtotal 38.30
Fee FEE 0.57
Total 38.87
O3FINANCE CREDIT CARD 38.87
Visa ************3971
Ref=4206383726B
Auth=07636G
3971
1
Change due 0.00
Paid by: FOSS HEATING AND COOLING
1111111MINIIIIIINION1
Signature:
Thank you for your payment
COPY
DUPLICATE RECEIPT
L.D— 2 o2O—O
PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
L `' n � LUMBING & MECHANICAL PERMIT APPLICATION
Mailing Address:P.O. Box 547, Anacortes, WA 98221
Office Location: 904 6'h Street, Anacortes WA 98821
N 16 2020Phone: (360)293-1901, Fax: (360)293-1938
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PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS(Street Suite,#): Parcel(s)#: 7 -
Subdivision/Lot#: Residential At Commercial 0
APPLICAN Phone: Fax:
tit. *}. �..(20 �� y 3: - ( 0
Addressr(Streeet,City(,State,Zip): �.1 E-Mail ddress: (..�
2 17 c,c-kG�rs a. f r 4fi- !f C'�r"t�sC� t d' r� r to t !>rtt� t.v� %S r�9 c T {f� •�c9 �'�
PROPERTY OWNER: Phone: Fax:
Address(Street,City,State,Zip): E-Mail Address:
CONTACT PERSON: Phone: Fax:
1` c.-
Address(Street,City,State,Zip): E-Mail Address:
CONTRACTOR:* Phone: Fax:
A f; 4,el-F.
Address(Street,City,State,Zip): / t E-Mail Address
*All Contractors& subcontractors must have a valid City 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.
Is this work,associated with another project? Yes 0 No 0 If yes,specify:
PROPOSED WORK:
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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: (r.c (e-e Vs,L€,c Owner 0 Agent ir(specify):
Signature: Date: , (( "
MECHANICAL:
Equipment Type: Appliance/Equipment Information(new and relocated): Total#:
Furnace: Gas#,I Elec# Other: # BTUs:<100k_>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>1 OOk Location(s)
AC Unit/Boiler/
Heat Pump! Roof Gas 4___E1ec# Other: # BTUs: <100k, 100k-500k, 500k-
Top Unit(Circle 1Mil HP: <3, 3-15,_15-30 Location(s)
selected):
Hydronic Heating: Gas#_Elec#_In-Floor_Wall Radiant Boiler BTUs: Location
Exhaust Fans
Bath k 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)
Outdoor BBQ: Gas# Elec Other: #_ _ Location(s)
Clothes Dryer&Duct: Gas#_Elec#_Other_# Location(s)
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,
eye wash,etc.): Water Service Line:
Tub/Shower: Drinking Fountain:
Dishwasher: Clothes Washer:
Hose Bib: Hydronic Heat in: Floor 0 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: