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
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•-T 6', m I-.,, -.J ,m,.
nr iA• �41 CI I 't l
ri .-w '
q. :Y : PU
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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
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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
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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/
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