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HomeMy WebLinkAboutPermit File 4518 Anaco Beach Road SG% . 0-', City of Anacortes Invoice/Permit#: BLD-2015-0164 904 6th Street Applied date: 04/15/2015 P.O.Box 547 Issue date: 04/15/2015 01 Anacortes, WA 98221-0547 Expire date: 10/1112016 ' �V (360) 293-1901 V Job Address: 4518 ANACO BEACH RD Permit Type: Grading Permit ANACORTES WA 98221-8707 Project: • APN: P61875 Remarks: Excavate for road and sidewalk construction as well as utlities Owner: LANDED GENTRY Contractor: Address: 504 E FAIRHAVEN AVE Address: BURLINGTON WA 98233-1846 Phone: (360) 755-9021 Phone: License#: General Information: Fees: CUBIC_YARDS 916 Engineering Services 3,356.20 Grading Plan Review Fee 37.00 Grade and Fill 194.50 Total Calculated: 3,587.70 Deposits/Receipts: 0.00 Total Due: 3,587.70 gym, --i .n m _..5 c: CI t. r" .4e. 1. ,b ,n 'Li: I '_:, '-�- .� ,. , •-T 6', m I-.,, -.J ,m,. nr iA• �41 CI I 't l ri .-w ' q. :Y : PU r. '0 I kin Cil THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 D 'S, RF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMr\ ENCEJ.; l HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL FROVISA OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR�NOTI,:SI�- GRANTING 0 PERMIT DOES NOT PRESUM TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STAYE.'C7h�, -....,.. LOCH G LATI G CONSTRUCTION THE PERFORMANCE OF CONSTRUCTION. r ''' M' .., . . co 40 co 1 [___Q SIG ATU - 0 OR AUTHORIZED AGENT ISSUED BY . L. 1 cif)) Cpc)D1 rririiir MAR 1 7 2015 Uk '=•0 4 CITY OF ANACORTES GRADE AND FILL PERMIT APPLICATION Owner Information Site Address: 4518 Anaco Beach Road Date: March 17,2014 Landed Gentry 504 E Fairhaven Ave. Applicant/Owners Name: Mailing Address: City: Burlington State: WA Zip: 98233 Phone: 3 6 0-9 41-4 9 0 0 Legal Description of Proposed Site: Lot: 73&74 Block: Addition:Plat of Anaco Beach Parcel No.: P61875 Contractor Information Contractor's Name: To be determined Mailing Address: City: State: Zip: Phone: Contractors License No.: Expiration Date: Describe work to be performed: Excavate for road and sidewalk construction as well as utilities. Quantities of export&import material(cubic yards) 550 cy export,366 cy gravel import Check List: Yes No Not Applicable Approved Land Use Permit X SEPA(over 500 cubic yards) X Other Agency Permits (if required) X Fees I,hereby certify that I have read and examined this application and the City of Anacortes Grading Standards. Performance of the proposed work shall follow ail applicable laws and regulations.The owner/applicant shall assume full and complete responsibility for said work and shall be responsible for the acquisition and compliance of all applicable permits and/or authorizations,which may include,but are not limited to,WSDW Hydraulic Project Approval(HPA),WSDOE Notice of Intent(NOI),any Corp of Engineers Fill Permits,the requirements of the Endangered Species Act,and the Forest Practices Application (FPA). — 1 .� -1 � 1 , . Signed: Date: Applicant Approved: Date: Building Department 7 C:1Documents and Settingslcervantesj\Local Settings\Temporary Internet Files 1OLK3FIAPPENDFX J GRADING 06TBC(3).doc ANACORTES PUBLIC WORKS DEPARTMENT - t nv_ ENGINEERING PLAN REVIEW FEE AND CONSTRUCTION FEES • SITE INFORMATION AND PROJECT VALUE OWNER: Landed Gentry Inc . 4518 Anaco Beach Road SITE ADDRESS: Construct 9 Lot SP with associate PROJECT DESCRIPTION: Boar1 and Ut-i 1 it i' s PROJECT VALUE [PV]: $ 142, 810 (Page 3 of 3 Total Cost) ENGINEERING PLAN REVIEW FEE ENGINEERING PLAN REVIEW FEE (.005 of Project Value) $ 11.4.05-- TOTAL ENGINEERING REVIEW FEE $ DUE AT TIME OF SUBMITTAL OF PLANS FOR REVIEW CONSTRUCTION INSPECTION FEE CONSTRUCTION INSPECTION FEE BASE FEE $ 500.00 CONSTRUCTION INSPECTION FEE (.015 of Project Value) $ 21 t47...iS CONSTRUCTION INSPECTION FEE SUBTOTAL $ Z 'c4142.-•I5 REDUCTION * TOTAL CONSTRUCTION INSPECTION FEE $ 7-lo4Z DUE UPON CONSTRUCTION PLAN APPROVAL * SUBJECT TO THE DIRECTOR OF ENGINEERING & DEVELOPMENT SERVICES APPROVAL,A 50% REDUCTION TO THE CONSTRUCTION INSPECTION FEE MAY BE ASSESSED IF THE DEVELOPER PROVIDES ON-SITE CONSTRUCTION INSPECTION AND CONSTRUCTION ENGINEERING THROUGH PRIVATE CONSULTANTS TO THE SAME STANDARD AS THAT OF THE CITY. Plan Review Fee: $ 114•OS +Construction Inspection Fee: $ ZCo41•IC = $_ ; '0' 2-9 Page 1 of 3 Engineering Plan Review Fee and Construction Inspection Fee Project Number A-041- APPENDIX D: INSP-05 (January 2009) • • ANACORTES PUBLIC WORKS DEPARTMENT ENGINEERING PLAN REVIEW FEE AND CONSTRUCTION FEES ENGINEERING AND INSPECTION FEE WORKSHEET (DEVELOPER DEDICATED ASSETS) Engineering Project No. Project Location p 411A- 1 lf 4518 Anaco Beach Road Project Name Project Engineer Developer Beachwood Short Plat Dale Herrigstad PE Landed Gentry The Developer shall enter the quantities shown on the construction drawings to be submitted to the City for review. This document is used to maintain the City's inventory of Public Works infrastructure and determine the amount of Engineering &Inspection Fees due to the City. • --I .UESCRIPT7QN • U:\ITS DtMt4I II Y Un.t Cri5I lo'al CcsL PEE-AMOUNT 6" L.F. 465 $25.00 $11 , 625 8" L.F. 330 $30.00 $9 , 900 10" L.F. $37.00 12" L.F. 12 2 $45.00 $5, 4 9 0 15" L.F. cc 18" L.F. u 24" L.F. N Other * Other cc Catch Basin,Type 1 EA 1 $740.00 $7 4 0 Catch Basin,Type II EA $3500.00 Storm Manholes EA $5000.00 Ponds EA Bioswales EA Vaults or other water EA quality measures 6' L.F. 164 $35.00 $5 , 740 8" L.F. 3 2 4 $45.00 $14 , 580 10" L.F. 12" L.F. 15" L.F.m 18" L.F. >- 24" L.F. cc Other I- z Other w Sanitary Manholes 48" EA 1 $5000.00 $5, 0 0 0 Sanitary Manholes EA Other Lift Station EA `A Page 2 of 3 Engineering Plan Review Fee and Construction Inspection Fee Protect Number �`11� 020-pt4 APPENDIX D: INSP-05 (January 2009) ANACORTES PUBLIC WORKS DEPARTMENT s ENGINEERING PLAN REVIEW FEE AND CONSTRUCTION FEES DE`;uijyi1ION UNIT:; ' 'JUAN'ITV ' :tin].200 Irctal C.p.st . ' EE AMOUNT i 4" L.F. 9 2 $45/$55 $4 4 0 6" L.F. $55/$75 8" L.F. 2 2 5 $55/$75 $12 , 375 w 12" L.F. $65/$80 i-- a 16" L.F. $75/$90 Other L.F. Water Meter EA 9 $200.00 $1, 800 Fire Hydrant EA 1 $5000.00 $5, 0 0 0 ($4)2'x length Street Construction S.F. F 11, 700 ($3) 24'x $3 2, 760 Length_Width_ length ($2.80)20'x length w Street Lights EA $3000.00 r Street& Stop Signs EA $200.00 Curb&Gutter L.F. 907 $14.00 $1 2 , 698 Overlay,Asphalt TON $100.00 Overlay,Concrete 'S.Y: Sidewalk S.Y. 3 4 2 $28.80 $9, 8 5 2 Wheelchair Ramps S.Y. 10 $36.00 $3 6 0 Landscaping S.Y. $27.00_ Trails S.F. Stream Enhancement S.F. Other Other Temporary w Erosion/Sediment Sum 1 $2000.00 $2, 000 = Control+' 0 Earthwork C-Y. 5 5 0 $15.00 $8, 2 5 0 _ Traffic Control $2000.00 Erosion Control 1 $500.00 $5 0 0 Utility EA $275.00 Relocation/Adjustment TOTAL COSTS $ 142 , 810 't Temporary Erosion/Sediment Control includes: Clear and Grade, Fill and Grade, ESC Supervisor, and Silt Fencing. Page 3 of 3 Engineering Plan Review Fee and Construction Inspection Fee Project Number 1�"d�r� APPENDIX D: INSP-05 (January 2009) Y ., % -— O City of Anacortes. Invoice/Permit#: BLD-2015-0164 G � ".- 904 6th Street Applied date: 04/15/2015 1`�-✓l��1' P.O.Box 547 Issue date: 04/15/2015 0 Anacortes, WA 98221-0547 ; Expire date: 10/11/2016 ,4 C (360) 293-1901 Job Address: 4518 ANACO BEACH RD Permit Type: Grading Permit ANACORTES WA 98221-8707 Project: APN: P61875 Remarks: Excavate for road and sidewalk construction as well as utlities Owner: LANDED GENTRY Contractor: Address: 504 E FAIRHAVEN AVE Address: BURLINGTON WA 98233-1846 Phone: (360) 755-9021 Phone: License#: General Information: Fees: CUBIC_YARDS 916 Engineering Services 3,356.20 Grading Plan Review Fee 37.00 Grade and Fill 194.50 Total Calculated. 3,587,70 Deposits/Receipts: 0.00 Total Due: 3,587.70 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 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY G1 Y Off._ City of Anacortes Invoice/Permit#: BLD-2015-0164 904 6th Street Applied date: 04/15/2015 P.O.Box 547 Issue date: 04/15/2015 to- Anacortes, WA 98221-0547 , kit Expire date: 10/11/2016 (360) 293-1901 Job Address: 4518 ANACO BEACH RD Permit Type: Grading Permit ANACORTES WA 98221-8707 Project: APN: P61875 Remarks: Excavate for road and sidewalk construction as well as utlities Owner: LANDED GENTRY Contractor: Address: 504 E FAIRHAVEN AVE Address: BURLINGTON WA 98233-1846 Phone: (360) 755-9021 Phone: License#: General Information: Fees: CUBIC_YARDS 916 Engineering Services 3,356 20 Grading Plan Review Fee 37 00 Grade and Fill 194 50 Total Calculated: 3,587.70 Deposits/Receipts: 0.00 • Total Due: 3,587.70 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 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY 1T Off._ City ofAnacortes Invoice/Permit#: BLD-2015-0253 904 6th Street Applied date: 06/01/2015 P.O.Box 547 Issue date: 06/01/2015 r;;2 1, 0 Anacortes, WA 98221-0547 Expire date: 05126/2016 '`-,4'qC 'w> (360) 293-1901 Job Address: 4518 ANACO BEACH RD Permit Type: Demolition Permit ANACORTES WA 98221-8707 Project: APN: P61875 Remarks: Removal of house, cabin and shed for new subdivision. Owner: ELLIN WILLIAM L Contractor: Address: 4518 ANACO BEACH RD Address: ANACORTES WA 98221-8707 Phone: Phone: License#: General Information: Fees: Total Calculated: Adjustments' Deposits/Receipts: Total Due: 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 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CO E PERFORMANCE OF CONSTRUCTION. SIGNATURE OF OM I OR AUTH ED AGENT ISSUED B�_'�_3 SG% . 0-', City of Anacortes Invoice/Permit#: BLD-2015-0164 904 6th Street Applied date: 04/15/2015 P.O.Box 547 Issue date: 04/15/2015 01 Anacortes, WA 98221-0547 Expire date: 10/1112016 ' �V (360) 293-1901 V Job Address: 4518 ANACO BEACH RD Permit Type: Grading Permit ANACORTES WA 98221-8707 Project: • APN: P61875 Remarks: Excavate for road and sidewalk construction as well as utlities Owner: LANDED GENTRY Contractor: Address: 504 E FAIRHAVEN AVE Address: BURLINGTON WA 98233-1846 Phone: (360) 755-9021 Phone: License#: General Information: Fees: CUBIC_YARDS 916 Engineering Services 3,356.20 Grading Plan Review Fee 37.00 Grade and Fill 194.50 Total Calculated: 3,587.70 Deposits/Receipts: 0.00 Total Due: 3,587.70 gym, --i .n m _..5 c: CI t. r" .4e. 1. ,b ,n 'Li: I '_:, '-�- .� ,. , •-T 6', m I-.,, -.J ,m,. nr iA• �41 CI I 't l ri .-w ' q. :Y : PU r. '0 I kin Cil THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 D 'S, RF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMr\ ENCEJ.; l HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL FROVISA OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR�NOTI,:SI�- GRANTING 0 PERMIT DOES NOT PRESUM TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STAYE.'C7h�, -....,.. LOCH G LATI G CONSTRUCTION THE PERFORMANCE OF CONSTRUCTION. r ''' M' .., . . co 40 co 1 [___Q SIG ATU - 0 OR AUTHORIZED AGENT ISSUED BY . L. 1 cif)) Cpc)D1 rririiir MAR 1 7 2015 Uk '=•0 4 CITY OF ANACORTES GRADE AND FILL PERMIT APPLICATION Owner Information Site Address: 4518 Anaco Beach Road Date: March 17,2014 Landed Gentry 504 E Fairhaven Ave. Applicant/Owners Name: Mailing Address: City: Burlington State: WA Zip: 98233 Phone: 3 6 0-9 41-4 9 0 0 Legal Description of Proposed Site: Lot: 73&74 Block: Addition:Plat of Anaco Beach Parcel No.: P61875 Contractor Information Contractor's Name: To be determined Mailing Address: City: State: Zip: Phone: Contractors License No.: Expiration Date: Describe work to be performed: Excavate for road and sidewalk construction as well as utilities. Quantities of export&import material(cubic yards) 550 cy export,366 cy gravel import Check List: Yes No Not Applicable Approved Land Use Permit X SEPA(over 500 cubic yards) X Other Agency Permits (if required) X Fees I,hereby certify that I have read and examined this application and the City of Anacortes Grading Standards. Performance of the proposed work shall follow ail applicable laws and regulations.The owner/applicant shall assume full and complete responsibility for said work and shall be responsible for the acquisition and compliance of all applicable permits and/or authorizations,which may include,but are not limited to,WSDW Hydraulic Project Approval(HPA),WSDOE Notice of Intent(NOI),any Corp of Engineers Fill Permits,the requirements of the Endangered Species Act,and the Forest Practices Application (FPA). — 1 .� -1 � 1 , . Signed: Date: Applicant Approved: Date: Building Department 7 C:1Documents and Settingslcervantesj\Local Settings\Temporary Internet Files 1OLK3FIAPPENDFX J GRADING 06TBC(3).doc ANACORTES PUBLIC WORKS DEPARTMENT - t nv_ ENGINEERING PLAN REVIEW FEE AND CONSTRUCTION FEES • SITE INFORMATION AND PROJECT VALUE OWNER: Landed Gentry Inc . 4518 Anaco Beach Road SITE ADDRESS: Construct 9 Lot SP with associate PROJECT DESCRIPTION: Boar1 and Ut-i 1 it i' s PROJECT VALUE [PV]: $ 142, 810 (Page 3 of 3 Total Cost) ENGINEERING PLAN REVIEW FEE ENGINEERING PLAN REVIEW FEE (.005 of Project Value) $ 11.4.05-- TOTAL ENGINEERING REVIEW FEE $ DUE AT TIME OF SUBMITTAL OF PLANS FOR REVIEW CONSTRUCTION INSPECTION FEE CONSTRUCTION INSPECTION FEE BASE FEE $ 500.00 CONSTRUCTION INSPECTION FEE (.015 of Project Value) $ 21 t47...iS CONSTRUCTION INSPECTION FEE SUBTOTAL $ Z 'c4142.-•I5 REDUCTION * TOTAL CONSTRUCTION INSPECTION FEE $ 7-lo4Z DUE UPON CONSTRUCTION PLAN APPROVAL * SUBJECT TO THE DIRECTOR OF ENGINEERING & DEVELOPMENT SERVICES APPROVAL,A 50% REDUCTION TO THE CONSTRUCTION INSPECTION FEE MAY BE ASSESSED IF THE DEVELOPER PROVIDES ON-SITE CONSTRUCTION INSPECTION AND CONSTRUCTION ENGINEERING THROUGH PRIVATE CONSULTANTS TO THE SAME STANDARD AS THAT OF THE CITY. Plan Review Fee: $ 114•OS +Construction Inspection Fee: $ ZCo41•IC = $_ ; '0' 2-9 Page 1 of 3 Engineering Plan Review Fee and Construction Inspection Fee Project Number A-041- APPENDIX D: INSP-05 (January 2009) • • ANACORTES PUBLIC WORKS DEPARTMENT ENGINEERING PLAN REVIEW FEE AND CONSTRUCTION FEES ENGINEERING AND INSPECTION FEE WORKSHEET (DEVELOPER DEDICATED ASSETS) Engineering Project No. Project Location p 411A- 1 lf 4518 Anaco Beach Road Project Name Project Engineer Developer Beachwood Short Plat Dale Herrigstad PE Landed Gentry The Developer shall enter the quantities shown on the construction drawings to be submitted to the City for review. This document is used to maintain the City's inventory of Public Works infrastructure and determine the amount of Engineering &Inspection Fees due to the City. • --I .UESCRIPT7QN • U:\ITS DtMt4I II Y Un.t Cri5I lo'al CcsL PEE-AMOUNT 6" L.F. 465 $25.00 $11 , 625 8" L.F. 330 $30.00 $9 , 900 10" L.F. $37.00 12" L.F. 12 2 $45.00 $5, 4 9 0 15" L.F. cc 18" L.F. u 24" L.F. N Other * Other cc Catch Basin,Type 1 EA 1 $740.00 $7 4 0 Catch Basin,Type II EA $3500.00 Storm Manholes EA $5000.00 Ponds EA Bioswales EA Vaults or other water EA quality measures 6' L.F. 164 $35.00 $5 , 740 8" L.F. 3 2 4 $45.00 $14 , 580 10" L.F. 12" L.F. 15" L.F.m 18" L.F. >- 24" L.F. cc Other I- z Other w Sanitary Manholes 48" EA 1 $5000.00 $5, 0 0 0 Sanitary Manholes EA Other Lift Station EA `A Page 2 of 3 Engineering Plan Review Fee and Construction Inspection Fee Protect Number �`11� 020-pt4 APPENDIX D: INSP-05 (January 2009) ANACORTES PUBLIC WORKS DEPARTMENT s ENGINEERING PLAN REVIEW FEE AND CONSTRUCTION FEES DE`;uijyi1ION UNIT:; ' 'JUAN'ITV ' :tin].200 Irctal C.p.st . ' EE AMOUNT i 4" L.F. 9 2 $45/$55 $4 4 0 6" L.F. $55/$75 8" L.F. 2 2 5 $55/$75 $12 , 375 w 12" L.F. $65/$80 i-- a 16" L.F. $75/$90 Other L.F. Water Meter EA 9 $200.00 $1, 800 Fire Hydrant EA 1 $5000.00 $5, 0 0 0 ($4)2'x length Street Construction S.F. F 11, 700 ($3) 24'x $3 2, 760 Length_Width_ length ($2.80)20'x length w Street Lights EA $3000.00 r Street& Stop Signs EA $200.00 Curb&Gutter L.F. 907 $14.00 $1 2 , 698 Overlay,Asphalt TON $100.00 Overlay,Concrete 'S.Y: Sidewalk S.Y. 3 4 2 $28.80 $9, 8 5 2 Wheelchair Ramps S.Y. 10 $36.00 $3 6 0 Landscaping S.Y. $27.00_ Trails S.F. Stream Enhancement S.F. Other Other Temporary w Erosion/Sediment Sum 1 $2000.00 $2, 000 = Control+' 0 Earthwork C-Y. 5 5 0 $15.00 $8, 2 5 0 _ Traffic Control $2000.00 Erosion Control 1 $500.00 $5 0 0 Utility EA $275.00 Relocation/Adjustment TOTAL COSTS $ 142 , 810 't Temporary Erosion/Sediment Control includes: Clear and Grade, Fill and Grade, ESC Supervisor, and Silt Fencing. Page 3 of 3 Engineering Plan Review Fee and Construction Inspection Fee Project Number 1�"d�r� APPENDIX D: INSP-05 (January 2009) Y ., % -— O City of Anacortes. Invoice/Permit#: BLD-2015-0164 G � ".- 904 6th Street Applied date: 04/15/2015 1`�-✓l��1' P.O.Box 547 Issue date: 04/15/2015 0 Anacortes, WA 98221-0547 ; Expire date: 10/11/2016 ,4 C (360) 293-1901 Job Address: 4518 ANACO BEACH RD Permit Type: Grading Permit ANACORTES WA 98221-8707 Project: APN: P61875 Remarks: Excavate for road and sidewalk construction as well as utlities Owner: LANDED GENTRY Contractor: Address: 504 E FAIRHAVEN AVE Address: BURLINGTON WA 98233-1846 Phone: (360) 755-9021 Phone: License#: General Information: Fees: CUBIC_YARDS 916 Engineering Services 3,356.20 Grading Plan Review Fee 37.00 Grade and Fill 194.50 Total Calculated. 3,587,70 Deposits/Receipts: 0.00 Total Due: 3,587.70 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 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY G1 Y Off._ City of Anacortes Invoice/Permit#: BLD-2015-0164 904 6th Street Applied date: 04/15/2015 P.O.Box 547 Issue date: 04/15/2015 to- Anacortes, WA 98221-0547 , kit Expire date: 10/11/2016 (360) 293-1901 Job Address: 4518 ANACO BEACH RD Permit Type: Grading Permit ANACORTES WA 98221-8707 Project: APN: P61875 Remarks: Excavate for road and sidewalk construction as well as utlities Owner: LANDED GENTRY Contractor: Address: 504 E FAIRHAVEN AVE Address: BURLINGTON WA 98233-1846 Phone: (360) 755-9021 Phone: License#: General Information: Fees: CUBIC_YARDS 916 Engineering Services 3,356 20 Grading Plan Review Fee 37 00 Grade and Fill 194 50 Total Calculated: 3,587.70 Deposits/Receipts: 0.00 • Total Due: 3,587.70 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 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY 1T Off._ City ofAnacortes Invoice/Permit#: BLD-2015-0253 904 6th Street Applied date: 06/01/2015 P.O.Box 547 Issue date: 06/01/2015 r;;2 1, 0 Anacortes, WA 98221-0547 Expire date: 05126/2016 '`-,4'qC 'w> (360) 293-1901 Job Address: 4518 ANACO BEACH RD Permit Type: Demolition Permit ANACORTES WA 98221-8707 Project: APN: P61875 Remarks: Removal of house, cabin and shed for new subdivision. Owner: ELLIN WILLIAM L Contractor: Address: 4518 ANACO BEACH RD Address: ANACORTES WA 98221-8707 Phone: Phone: License#: General Information: Fees: Total Calculated: Adjustments' Deposits/Receipts: Total Due: 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 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CO E PERFORMANCE OF CONSTRUCTION. SIGNATURE OF OM I OR AUTH ED AGENT ISSUED B�_'�_3 C) City of Anacortes Invoice/Permit#: BLD-2015-0253 .� � � 904 6th Street ,,,� Applied date: 06/01/2015 } 11111 P.O.Box 547 Issue date: 06/01/2015 <. ' ' G . Anacortes, WA 98221-0547 Expire date: 05/26/2016 ;..� �„v, `~ (360)293-1901 Job Address: 4518 ANACO BEACH RD Permit Type: Demolition Permit ANACORTES WA 98221-8707 Project: APN: P61875 Remarks: Removal of house,cabin and shed for new subdivision. Owner: ELLIN WILLIAM L Contractor: Address: 4518 ANACO BEACH RD Address: ANACORTES WA 98221-8707 Phone: Phone: License#: General Information: Fees: Total Calculated: Adjustments: Deposits/Receipts: Total Due: 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 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY ti 11$ llWiff1 `► s CITY OF ANACORTES 015 R , DEMOLITION PERMIT APPLICATlit727-ranzreb AEI Site Address: Ari4Cd> Assessors Account No.: 32.7ill 3®Z 74 ? Date: / ' S Lot(s): Block: Addition: Owners Name:, A.4)0a1.itnerLL L Contractors Name:14 4iai'j Address: 9)Y 0 g1-A4✓tae- 44•3an Address: soy, „cr �¢✓,,`y l3v•1�,� State: L I* Zip: q$02.2.3 State: G-��i�- Zip: �?Y02--.3,3 Phone: 34.e- 7 SIS-- 2( x /3 Contractors License: L A`4Q4'4Do Pot? Phone: 3&0 - 6'7- 5'o Have Utilities Been Disconnected? Description of proposed demolition. Water Dept.: Yes No 44141D' je7 ,kt/ Electric: Yes No (� /� Cable: Yes No Yttti1 5t7a03°•b'L- Gas: Yes No How Will Materials be disposed? ZuccA. BARRICADES TO BE PROV ' F BL PROTECTION,AREA MUST BE ROPED OFF! Ap cant's or Ag is Signature ASBESTOS WARNING Breathing asbestos is hazardous to your health. Before starting a renovation or demolition project, survey for friable asbestos materials. Notify Northwest Air Pollution Authority prior to asbestos removal or containment 1600 S. 2'Street,Mt. Vernon,WA 98273 (360) 428-1617. Fire Department Approval:a '"-Q- Date: - (—I S Police Dept. Approval: / 6:: (D/L Date: 7 5 �j�� w► 111 �Public Works Department Approval: , V� ' t� '� PP C} p tByM..-• Date: Museum: Date: Comments: y , - Environmental Abatement Services Inc 6/1/2015 Brian Gentry Landed Gentry Asbestos Abatement Project Completed at: 4518 Anaco Beach Road, Anacortes, WA Per the. Asbestos Survey conducted by Dave Phillips, .(certification #149322), EAS (contractor #ENVIRAS014RA, asbestos certification #01279) removed asbestos containing material from the above address specifically, 168 SF of sheet vinyl and 880 SF of popcorn ceiling, texture. • According to local state and federal regulations, materials containing more than one percent,(1%) asbestos must be removed prior to any remodel, renovation or demolition activity. The material was removed by Certified Asbestos Workers under the direct supervision of a Certified Asbestos Supervisor in accordance with all applicable local, state and federal regulations"on' 5/28/2015. The materials collected were packaged for final disposal in compliance with.all.applicable federal, state and local laws. If materials are identified less than 1% asbestos on the survey work practices and worker protection must be in compliance with WAG 2962-62-077. Additional information is available with directive WRD 23.30 available on. the Washington State Department'of Labor and Industries website. The building surveyed, the materials found to contain more than 1% asbestos removed and properly . . disposed of in accordance with all applicable regulations. A copy of the survey with laboratory report, and this letter, may be used as documentation of the completion of asbestos identification and removal. Any planned remodeling, renovation, or demolition activities should be approved to proceed. Sincerely, CATHERINE D'MARQUEZ OWNER PO Box 2503/18365 W Lincoln St. Phone(360)755-1085 Mount Vernon,WA 98273 Fax(360)588-4180 .. - h CJ N_ O r _ L. I N T X 4y isiSpawn aPLL " zoottas :Panessul a1Ra 4 " N. / n/Jibed/ e1PenvIn dq 44123 Y.ft_ 03YNY H3 8 0J BI Sf- ;sSaspPV - ". f r ( �.c.i— ry -� *4%6 8£ 2pgtaa aSsss j it ,c,6 0£J - eaoON antee g - if s-g iT fignaa k SE Sfullln-?PL I :ags t» ayjti; a11"1pua PoSinsu111564 seq aauapisal Z141E01101 Ml nicion3 aM C991, 9£t (69E) Xtl EGZ88'VIAIFICINt13AlNItOW Inns-in(cog) V 3�tldS"1^s ONil ti�t - Xi_ 6£9E-9E&.(os)33440 '3 Nil ‘t44101,INtlilSisit 1 NfllVd 5UV3 iri LLVcns e anivista 0 r. I r�, `l MECHANICAL PERMIT CITY OF ANACORTES PERMIT NO. : MEC97-0079 P.O. BOX 547 APPLIED: 07/10/97 ANACORTES, WA 98221 ISSUED: 07/10/97 (206) 293-1901 EXPIRES: 07/10/98 SITE ADDRESS: 4518 ANACO BEACH RD ASSESSOR'S PARCEL NO. : 3858-000-074-0008 PROJECT DESCRIPTION: Relining Flue — OWNER — CONTRACTOR WM ELLIN SOOTBUSTERS 4518 ANACO BEACH ROAD P.O. BOX 2148 ANACORTES WA 98221 OAK HARBOR WA 98277 293-6465 293-4699 SOOTB**056JM TYPE OF WORK. . . :REP BOILERS/COMPRESSORS- DOMES. INCIN •0 TYPE OF USE •RES 0-3 HP • 0 COMML. INCIN •0 3-15 HP • 0 RELOC/REPAIR. . . : 0 FUEL TYPES 15-30 HP • 0 CLOTHES DRYERS. : 0 :? • 30-50 HP • 0 GAS WTR HEATERS: 0 FURN < 100K BTU: 0 50+ HP • 0 STOVE, APPLI. . . : 0 FURN >=100K BTU: 0 AIR HANDLING UNITS-- FIRE LOG/LITE. . : 0 FURN - FLOOR. . . : 0 <= 10000 cfm. : 0 WOODSTOVES • 0 UNIT HEATERS. . . : 0 > 10000 cfm. : 0 OTHER UNITS • 1 VENT FANS • 0 EVAP COOLERS. . . : 0 GAS OUTLETS • 0 VENT SYSTEMS. . . : 0 HOODS • 0 VENT W/O APPLI. : 0 — FEES — NOTES Code Amount---- By- Date---- Receipt PRMT $ 28.50 MD 07/10/97 7171 TOTAL $ 28.50 I hereby acknowledge that I have read this permit and state that the above information is correct, and agree to comply with all ordinances and Laws regulating activities covered by this permit. f ite-A- e— U Ak cal aJA c Q_ L6A SOo?Qu-c7zus Issued by leant or Owner' s Signature 24 Hour Notice Re uired For All Inspections mec_prmt, Rev: 06/11/92 • -. FOR INSPECTIONS CALL: CITY OP ANACORTES PERMIT i4! 9822 293.1901 BUILDING PERMIT 24 Hrs. Notice Requested Site Address 4518 Anaco Beach Rd . NAME (OR NAME OF BUSINESS) PLUMBING W.L. Ellin MAILING ADDRESS Na TYPE OF FIXTURE OR ITEM FEE 4518 Anaco Beach Rd CITY TELEPHONE NUMBER Water Closet $ _ Anacortes, WA 98221 293-6489 Bathtub NAME _Lavatory Shower ADDRESS Kitchen Sink Dishwasher CITY TELEPHONE NUMBER Laundry Tray _ _Clothes Washer NAME Water Heater Owner Urinal IL ADDRESS Drinking Fountain Floor Sink or Drain CITY TELEPHONE NUMBER Slop Sink 8 ,Water Piping STATE LICENSE NUMBER CITY LICENSE NUMBER lResidential ❑ Non-Residential PERMIT $ aNew ❑Add ❑ Alter ❑ Repair TOTAL FEE $ ' ilBuilding 0 Plumbing 0 Mechanical MECHANICAL ❑ Sign 0 Demolition 0 Other ❑ GAS ❑ OIL 0 EfECT. 0 OTHER Legal Description of Propq . ;ThSr:Accoum_hfuirtber. No. ' ``H'FFF' k tWEQ; FEE Lot Block of Air Cond. Unit $ Refrigeration Unit— HP Boiler— 1, HP Forced Air System— BTU/KW Describe Rbrk Floor Furnace Reroof of shop Wall Heater Unit Heater Clothes Dryer Occupancy Use Ventilation Fan Mingle Family Residence 0 Multi-Family Residence Range Hood ❑Office 0 Retail 0 Storage 0 Church Air Handling Unit— CFM ❑ Restaurant 0 Other Pre-manufactured Stove or Fireplace NOTICE Gas Piping This permit is issued by the Building Official and,under the provisions of the Uniform Building Code,shall expire by limitation and become null and void if the building or work authorized by such permit is not corn- PERMIT $ meng d within 180 days from the date of permit issuance,or if the building TOTAL FEE $ or,work authorized by such permit is suspended or abandoned at any time - after the work is commenced for a period of 180 days. TOTAL FEES VALt1ATION FEE By affixing my signature, I hereby certify that I am the owner of the Buildin 700.00'; $ 13 00 property for which this permit is issued or am an authorized represen- g U UU tative of the owner. Plan Check All provisions of laws and ordinances governing this type of work will Plumbing ' be complied with whether specified herein or not,including routine calls Mechanical for'inspections. Sign Demolition i(/eeh - f" l�Z Energy Surcharge Sinners d owner or authorized Agent (Date) State Surcharge 4 tot) Other Seer Setback Side Yard Setick Rear'Ord Se*ackTO fAL $ 1 7 .50 use Tare Occupancy Group 'type d Coos. Conditions: Lot Area Vora She Dwelling Uniu ❑Yes ❑No Fire Sprinklers Required No.of Stories Bedrooms Occupant Load ❑Yee ❑No She of Bldg. Plans Checked By: WHEN BONED AND DAM BELOW,TUR IS YOUR PERIM' Pendia it kewbl Ives to We the abovesdaabed wale ace ding to the easdidos haste aid sadrtSto to the eppoved piste sad petlBatlaes prWeig thaw subject to eohpW—with the ordinances of the CITY OF ANACORTES. �^y f / 06/09/92 Permit Issued By1 r / i ij? .4 .f41. t +'iO . Building Official (Date) Edwin Frank PERMIT N.9 9822 .5 'Jfi w1'.�N.`{ -1' :.+ -,.,`S,, ,�y}•..Hti+.+.{T`W.a}yNA�T . . _..e,.. N • - FOR INSPECTIONS CALL: CITY OF ANACORTES PERMIT icfl 7092 293-1901 BUILDING PERMIT 4518 Anaco Beach Road 24 Hrs. Notice Requested Site Address WNAME (OB f N®�n OF BUSINESS) PLUMBING gnAll a O each Road Na TYPE OF FIXTURE OR ITEM FEE Anacortes, WA 98221 3 R --VtE_NUMBER Water Closet $ f�ff44 Bathtub NAME Lavatory Shower .5 ADDRESS Kitchen Sink ' ` Dishwasher CITY TELEPHONE NUMBER Laundry Tray , Clothes Washer NAME Water Heater Owner Urinal m Q ADDRESS . Drinking Fountain CPS3 Floor Sink or Drain z CITY TELEPHONE NUMBER Slop Sink u Water Piping STATE LICENSE NUMBER CITY LICENSE NUMBER C Residential 0 Non-Residential • PERMIT $ ❑ New 41.D Add ❑Alter ❑ Repair TOTAL FEE $ • 11 Building ❑ Plumbing 0 Mechanical MECHANICAL, ❑ Sign ❑ Demolition D Other ❑ GAS ❑ OIL ❑ ELECT. ❑ OTHER • Legal Description of Property o��3 4 Block or lhx Account Number Na TYPE OF EQUIPMENT FEE of LANACO BEACH ADDITION Air Cond. Unit $ 3858-000-074-0008 • Refrigeration Unit— HP Boiler— HP Forced Air System— BTU/KW Describe Work . Floor Furnace BUILD 12° X 24' PATIO COVER PER Wall Heater • SKETCH APPROVED. Unit Heater Clothes Dryer ' Occupancy Use Ventilation Fan DI Single Family Residence ❑Multi-Family Residence Range Hood 0 Office , ❑ Retail ❑Storage 0 Church Air Handling Unit— CFM ❑ Restaurant ❑ Other Pre-manufactured Stove or Fireplace NOTICE Gas Piping This permit is issued by the Building Official,and,under the provisions of the Uniform Building Code,shall expire by limitation and-become null and void if the building or work authorized by such permit is'not coon- PERMIT $ . menced within 180 days from the date of permit issuance,or if the building or work authorized by such permit is suspended or abandoned at any lime TOTAL FEE $ after the work is commenced for a period of 180 days. TOTAL FEES VALUATION FEE By affixing my signature, I hereby certify that I am the owner of the Building property for which this permit is issued or am an authorized represen- i ,000.00 $ 1 E .00 i tative of the owner. Plan Check C .00 Allprovisions of laws and ordinances Plumbing governing this type of work will Mechanical be complied with whether specified herein or not,including routine calls for inspections. Sign C � t ��y/� /� Demolition /l�,lX_ /'®fi "� �$.. fro Energy Surcharge Signature of Owner or Agent Mate) State Surcharge 4 .50 street Setback side Yard Setback Rearffi &d d ick Other /j TOTAL $ 22.50 Use Zone Occupancy Group Type of cmn. Conditions:' Lot Area Vacant site Dwelling Units • ❑yes ❑No . Fire Sprinklers Required Na of Stories Bedrooms Occupant Load ❑Yes -O No . Size of Bldg. Plans Checked By: EF WHEN SIGNED AND DATED BELOW,791E IB YOUR PERMIT Pembina Is hereby given to do the above desalbed work wording to the conditions hereon and wording to the approved,plane and apedBetloae pertaining thertw subject to - compliance with the adlnnn to of the ANACORTES. Permit Issued By !' ..r4ertak 03/15/90 Bmld tg Official (Date) • Edwin Frank PERMIT f9QT92 1� ^ CITY OF ANACORTES BLDG. sgr, PLUMBING ❑ MECHANICAL ❑ PERMIT it' 735$ Telephone 293-1901 Anecortee.WA Date JG is at. / Z. 19 r3 PERMISSION IS HEREBY GRANTED TO: I OWNER OP' G- ,1Gte-A✓ STREET ff � A { �� ADDRESS %(1r') Amin- c Kc ft Location where work is to be done CONTRACTOR OCgiA) -ea' - TO ERECT I? INSTALL ❑ J/OR REPAIR ❑ IN THE FOLLOWING MANNER: 15 'Yb r -Pe gslC rJ ec` 'de cIL. PERMIT EXPIRES ONE YEAR FROM DATE ISSUED PLANS FOR CONSTRUCTION WERE NOT ❑WERE 49UBMITTED WORK TO BE DONE BY OWNER CONTRACTOR 0 RECEIPT OF FEES IS ACKNOWLEDGED AS FOLLOWS: TYPE APPROXIMATE VALUE PERMIT FEES OF WORK State Building Code Surcharge si j U State Energy Study Surcharge • Building 6700 Qc // 9 U ' Plumbing and W.S. Mechanical Plan Check Fee TOTAL / &co Oa' /G CA"// LEGAL DESCRIPTION 7-7) 73 de7V 4xixsfv 4f 6.I Ar�td/ C P Lion wow; .-tikiteta AJ OS*/5'SO NE /24.32' /20.35' ,k. G o A \I t `qA' LOT LOT 71L 73 p ft b ty � \ J t ` 2 0 OP / . 6o / `'a, o0 / CPC,' / t tr / s>O. SCaL& to = 4o' s4.F to 4% T�//S l�LAT /ND/C4TE,S ACTUAL FIELD 4 SZJ2VEY OF LOTS .73 S 74 O,' A,VACC ''�y� .SEACR SI�BD/V/SION seAair CQU.t/j'Y A6 6URVEYE0 A-012 W. G, EGG/A./ IA/ . MAY, /97/ s'N.N.....%, VIKPAT =.lc'. G. icTRAIRAjk'ICK ' , of i4A.;.,, p/`S., r i9 vk gFGisr€ck- x.i - -