HomeMy WebLinkAboutPermit File BLD-2020-0644 4406 San Juan Avenue Cityof Anacortes acortes Invoice/Permit #: BLD-2020-0644
.'�.. :...� ��`. 904 6th Street
\\ Applied date. 10/22/2020
"4"14111111t1111 , P.O.Box 547
Issue date: 10/22/2020
Anacortes, WA 98221-0547
µ,.. _, Expire date: 04/20/2022
(360) 293-1901
Job Address: 4406 SAN JUAN AVE Perm Vc Type: Mechanical Permit
ANACORTES WA 98221-1102 Project:
APN: P81731
Remarks: REPLACE GAS FURNACE FOR THE SAME.
Owner: DAVID ARNOLD Contractor: FOSS HEATING AND COOLING
Address: 4406 SAN JUAN AVE Address: 333 E BLACKBURN RD
ANACORTES WA 98221-1102 MOUNT VERNON WA 98273-9006
Phone: Phone: (360) 336-1517
L°ocense x : FOSSHCI983QA
General inf•rmation: 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. l have read and examihW this application and know the same to
be true and correct. /
SIGNATURE OF OVVNER OR AUTHORIZED AGENT ISSUED BY -`
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Finance Department
020380-•0140 Erin N. 10/28/2020 10:38AM
PERMITS AND INSPECTIONS
FOSS HEATING AND COOLING
BLD-2020-0644
Mechanical Permit
REPLACE GAS FURNACE FOR
THE SAME,
issued
2020 Item: BLD-2020-0644
Mechanical Permit Fees 38,30
Payment Id: 298070
38.30
Subtotal 38,30
Fee FEE 0,57
Total 30.87
03FINANCE CREDIT CARD 38,87
Visa ***p*******9774
Ref.,42316684762
Auth=07470G
9774
1
Change due 0.00
Paid by: FOSS HEATING AND COOLING
II I,V II 01111110111111 M1101111
Signature:
Thank you for your payment
COPY
DUPLICATE RECEIPT
, 1
1 1
I Y PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
1 PLUMBING & MECHANICAL PERMIT APPLICATION
1 ,,,,-.._
1411120t4" Mailing Address:P.O. Box 547, Anacortes, WA 98221
Office Location: 904 6"Street, Anacortes WA 98821
Phone: (360)293-1901
PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT'CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS(Street,Suite#): min/ , A PAACEL(S)#: PROJECT VALUATION:
t 0--`b >41 .A4241 I V% -''-'8 1 73 1 S-7g17, c 7
Subdivision/Lot#:
L of 7 ty RESIDENTIAL J1 COMMERCIAL 0
APPLICANT: A 1,, 17), ,i Phone: \ _.., .
ri her/ v.C.Ce.ft ( 60,/ 3?6"- I 51 7
Address(Street,City,State,Zip): Email Address:
$33 E 13/4.(.11- 17,,,,-,4 Rd, ,St-t, A fit f-,ifer.4,,,) t4f1 1827.3 ai-a1(?(.3 e c .y...d.t revi-iii 5 , cs 0 PA
, ...
PROPERTY OWNER: Phone
Pce iiT ;1/400 :(2S3)21g 7
Address(Street.City,State,Zip): Email Address:
q2-06 54h .11,-,; Avt, ilhacoritl, iv4 18;22/
CONTACT PERSON: Phone:
See A pp 1;cant
Address(Street,City, State,Zip): Email Address:
CONTRACTOR:*F.,0 S,5 H cri,-es 4_ c 01,„,,ii-Iv Phone:
60)336- i /7
Address(Street,City,State,Zip): Email Address:
$3;3 i: 8 I ackk,rn RA, c tt,i1 Int kffrni7 ,i+VII 7 P-7.1 t) r) 0 Fd.,.-.5
l
Professional License#: Exp.Date:
*All Contractors&subcontractors must have a valid City of F.-051.5N 0 ,g3 6zA 1 V if"22,
Anacortes business license prior to doing work in the City. Business License#: Exp.Date:
Contact the City's Finance Department at(360)299-1968. 60 J. .3‘ 631 L /30/2-i
Is this work,associated with another project? Yes 0 No/54 If yes,specify:
PROPOSED WORK: Rt r Ma c I,pnacy::, ,,,,,;H., i i-kr, ;, h-i„d,
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: A ncircy J I $,s'e II Owner 0 Agent '0 (specify): FOSS- 1-kot-;04.
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Signature: i.":7---.,,i, - Date: i CV—1/ —620