HomeMy WebLinkAboutBLD-2009-0051 - RESIDENTIAL REMODEL ----` DOS a -_.'20/200? 001 1
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AZT Y Oj._ City of Anacortes Permit#: BLD-2009-0051
904 6th Street Issue date: 02/20/2009
P.O.Box 547
Anacortes, WA 98221-0547
Expire date: 02/20/2010 p
(360) 293-1901
Job Address: 5017 CHANNEL VIEW LN Permit Type: Single Family Alteration/Repair Permit
ANACORTES WA 98221-4090 Project:
APN: P31659
Remarks: Install new window in upper floor of residence.
Owner: PERRY KENNETH C Contractor:
Address: 5017 CHANNEL VIEW LN Address:
ANACORTES WA 98221-4090
Phone: Phone:
License#:
General Information: Fees:
Building Valuation 400 Plan Review Fee 6.50
State Building Code Fee 4.50
Building Permit Fee 10 00
Total Calculated: 21 00
Deposits/Receipts: 0.00
Total Due: 21.00
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 O. OCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
•
SIGVURE OF OWNER OR AUTHORI.4 GENT ISSU D BY
11Y 0 Residential Building Permit Application
` Building Department
'+ar�'tw" P.O. Box 547 Anacortes, WA 98221
y0013
Phone No.: 360-293-1901 FAX: 360.293.1938
SITE ADDRESS: 50/ 7 ejia nrtei V iy 3 Lanz
[-CONTRACTOR AOApplicant PROJECT DESCRIPTION
Name I n s&1/ I1t 5 / •X 5 r
Address � 6 j7 ,t rr
l� '�v� c�r2f� -�
City/State/Zip
Phone FAX `4( I I CO 60
State License# Exp �1
PARCEL NUMBER
City of Anacortes License
PROPERTY OWNER 'Applicant LEGAL DESCRIPTION
Name ken V--- JU Clh n /
Address 6 )) ( /J/l-/ L/
City/State/Zip tr/,(C/) its ((JA9 tLL j PIZ<OJE T VALUATION
22� �1 o o
Phone"rz fie FAX
Number of Dwelling Units
E-Mail Address Number of Stories
Building Area:
Architect O Designer 0 Engineer LApplicant 1s'Floor s.f 2nd Floor s.f.
Name ��'"` 3rd Floor s.f Basement s.f
Address Garage s.f Carport s.f.
City/State/Zip Deck s.f Lot Area s.f.
Phone FAX
,�! E-mail Address
CONTACT Applicant LENDER
LENDER INFORMATION MUST BE PROVIDED FOR PROJECTS OVER$5,000
Name IN VALUATION PER RCW.
Address Name
City/State/Zip Address
Phone FAX City/State/Zip
Ali E-mail Address Phone No.
CONTINUED ON THE BACK
Residential Mechanical Fixtures
Fuel Type
❑ Natural Gas ❑ Electric ❑ Wood ❑ Propane Gas ❑ Other
Type of Equipment Number of Type of Equipment Number of
Fixtures Fixtures
Furnace<=100K BTU Clothes Dryer
Boilers/AC/Heat Pump Gas Water Heater
Gas Outlets Gas Fireplace
Ventilation Fans Fireplace Insert
Stove,Appliance Other Units
Range Hood
Residential Plumbing Fixtures
Type of Fixture Number of Type of Fixture Number of
Fixtures Fixtures
Toilet Clothes Washer
Bathtub E►ectric Water Heater
Shower Utility Sink
Dishwasher Hose Bibb
Hand Sink Water Piping
Kitchen Sink w/Disposal Additional Fixtures
I HEREBY ACKNOWLEDGE IF HAVE READ THIS PERMIT APPLICANT AND STATE THE INFORMATION IS CORRECT,AND AGREE TO COMPLY
WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING ACITIVIES COVERED BY THIS PERMIT APPLICATION. WITH THIS PERMIT ALL
pNTRACTORS AND SUBCONTRACTORS SHALL IIAVE A CURRENT WASHINGTON STATE CONTRACTORS LICENSE AND A CITY BUSINESS
Li ENSE. STOP WORK ORDER ILL BE ISSUED ON JOB SITES WHERE CONTRACTORS/SUBCONTRACTORS ARE WORKING WITHOUT
PR ER,kICENSE.
PPLICANT'S SIGNATURE DATE
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