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Permit File BLD-2020-0591 2805 Grady Lane
- 0 : _ Cityof Anacortes Invoice/Permit #: BLD-2020-0591 904 6th Street Applied date: 09/29/2020 _ `11.01,00114elowe'r .:1,'_ P.O.Box 547 Issue date: 10/28/2020 _ ; S Anacortes, WA 98221-0547 Expire date: 04/26/2022 ,:LL' fit,?;. " (360) 293-1901 p Job Address: 2805 GRADY LN Permit Type: Single Family Residence Permit ANACORTES WA 98221 Project: APN: P126317 Remarks: NEW SFR Owner: JOHN & SARAH LOUDERMILK Contractor: STRANDBERG CONSTRUCTION Address: 1233 1A/ PIERCE ST Address: PO BOX 319 HOUS T ON TX 77019 ANACORTES WA 98221-0319 Phone: Phone: (360) 293-7431 License #: General Information: Fees: Basement Square Footage 1279 Water GFC 8,169.00 New or Replaced Hard Surface 3870 Plan Application Fee 200.00 1st Floor Square Footage 1889 Building Permit Fee 3,946.25 Garage Square Footage 559 Plan Review Fee 2,565.06 Deck Square Footage 243 Mechanical Permit Fees 121 .80 Porch Square Footage 70 Plumbing Permit Fee 139.00 # of Radiant Hydronic Piping 1 State Building Code Fee Resi 6.50 Stove, Appliance 1 Sewer Inspection Fee 51 .08 Building Valuation 650000 Storm Drain GFC-Residential 1 ,696.09 of Clothes Dryers 1 Sewer GFC-Residential 9,140.86 # of Clothes Washers 1 Park Impact Fee 615.00 • of Gas Fireplace 1 Traffic Impact Fee 2,765.69 Non Sprinklered SFR Fire Fee 100.48 # of Gas Piping 1 EMS Impact Fee 356.26 # of Gas Water Heaters <= 100k 1 SFR/duplex: site plan/design 60.00 # of Water Piping 1 Stormwater Review 309.60 # of Hose Bibs 4 # of Kitchen Sinks 1 Total Calculated: 30,242.67 # of Hand Sinks 4 Deposits/Receipts: 0.00 # of Range Hoods 1 • of Showers 2 Total Due: 30,242.67 # of utility Sinks 1 # of Ventilation Fans 5 # of Water Closets (Toilets) 3 Permits and insp... - i1LD-2020-0591 - 2020 020395-0009 Keri Kna... 11/12/2020 10:59AM 12277 - JIM SYKORA BLD-2020-0591 Single Family Residence Permit Payment Amount: 30,242.67 Transaction Amount: 30,242.67 CHECK: 040355 Finance Department ; 020395-0009 Ker i K . 11/12/2020 10 :59AM _...,,,..j.6%,'„,-- -,. i '�_ City of Anacc BLD-2020-0591 904 6th Street PERMITS ANO INSF'ECTI015 00 09/29/2020 P.O.Box 547 JIM SYKORA P 1 o/2s12o2o "` � Anacortes, WA BLD-2020-0591 g: 04/26/2022 _.' ..0,4 �� (360) 293-1901 Single Family Residence � '0. ' ` Permit NEW SFR issued 2020 item: DLD-2020-0591 Plan Application Fee 200 .00 Building Permit Fee 3,946.25 Plan Review Fee 2,565 .06 Mechanical Permit Fees 121 .80 Plumbing Permit Fee 139.00 State Building Code Fee Resi 6.50 Sewer Inspection Fee 51 .08 Storm Drain GFC-Residential 11696 .09 Sewer GFC-Residential 9, 140 .86 Park Impact Fee 615 .00 Traffic Impact Fee 2,765 .69 Non Sprinklered SFR Fire Fee 100 .4O EMS Impact Fee 356 .26 SFR/duplex : site plan/design 60.00 Stormwater Review 309 ,60 Water GFC O, 169.00 Payment Id: 299029 30,242.61 Subtotal 30,242.67 Total 30,242.61 CHECK 30,242 ,67 Check Number040355 _________ Change due 0.00 Paid by : JIM SYKORA The issuance or granting of this permit shall not bf Dili 11111111111111 1$111111111111110111111111111lis Code or any other ordinance or order of the City, of any state or federal law, or of any ordf of this State. To the extent the issuance or granting of this permit is interpreted to allow const , ___.- _- _. . ,n is prohibited or restricted by any state or federal law, or order, proclamation, guidance adv ( ---� -�� ;� -..��, - _ -- not authorize such work and shall not be valid. The building official is authorized to preve °':' 46* " "4" ; Code, any other City ordinances of this jurisdiction or any other ordinance or executive or( ••,, _,,,.,"""`".`"'° •oclamation, guidance advice or decision of the Governor. The building official is authorized k u ,Ja r^- - °-4-41 Q 4-4 j --3 >ued in error or on the basis of incorrect, inaccurate or incomplete information, or in violatic "°°vul iw, or any order, proclamation, guidance or decision of the Governor. This permit becomes ni i .o; 4,A ......A ; )d within 180 days or if construction work is suspended or abandoned for a period of 180 day: fined this application and know the same to be true and correct. d � c,-„ Thank you for your payment SIGNATURE OF OWNER OR AUTHORIZED AGI COPY DUPLICATE RECEIPT 2015 Washington State Energy Code: UA Alternative Worksheet,Type R-3 Occupancies Loudermilk Residence 2805 Grady Lane,Anacortes WA 98221 Missing Vertical Glazing Information 3,168 V Codel or Similar Door V 2 3 ° 8 ° • Copyright 2013,WSUEEP10-009(Version 11)Copied by permission from Washington State University Extension Energy Program. (see copyright restrictions) 9/28/2020 1 of 4 2015 Washington State Energy Code: UA Alternative Worksheet,Type R-3 Occupancies W 01 Milgard or Similar Vinyl Windows 1 6 EIMIE W02 Milgard or Similar Vinyl Windows13 1 ©EM o W03 Milgard or Similar Vinyl Windows 12. 1 ©©MIE W 04 Milgard or Similar Vinyl WindowsCI 1 4 ME o W 05 Milgard or Similar Vinyl Windows V 1 4 0__ W 06 Milgard or Similar Vinyl Windows V 1 4 0_ o W 07 Milgard or Similar Vinyl Windows V 1 4 0__ W 08 Milgard or Similar Vinyl Windows12 1 4 0 EM o W 09 Milgard or Similar Vinyl Windows CI 1 4 0__ W 10 Milgard or Similar Vinyl Windows 12 1 4 0 M o ®Milgard or Similar Vinyl Windows CI 1 4 0__ min Milgard or Similar Vinyl Windows CI 1 4 0 EM o Ism Milgard or Similar Vinyl Windows CI 1 4 0__ W 14 Milgard or Similar Vinyl Windows CI 1 4 0 M o ®Milgard or Similar Vinyl Windows CI 1 4 ° 4 0 W 16 Milgard or Similar Vinyl Windows 12 1 4 0 EM o ®Milgard or Similar Vinyl Windows CI 1 4 ° 4 0 W 18 Milgard or Similar Vinyl Windows CI 1 4 0 M o W 19 Milgard or Similar Vinyl Windows CI 1 4 ° 4 0 W20 Milgard or Similar Vinyl Windows 12 1 _ .11 0 ®Milgard or Similar Vinyl Windows CI 1 .11 0 mg Milgard or Similar Vinyl Windows V 1 © o= o ®Milgard or Similar Vinyl Windows V 1 © 0 4_ W24 Milgard or Similar Vinyl Windows V 1 © ° 4_ ®Milgard or Similar Vinyl Windows V 1 © ° 6 0 W26 Milgard or Similar Vinyl Windows V 1 © ° 6 0 ®Milgard or Similar Vinyl Windows V 1 _ ° 6 0 W28 Milgard or Similar Vinyl Windows V 1 © ° 6 0 W29 Milgard or Similar Vinyl Windows V 1 4 0© 0 W30 Milgard or Similar Vinyl Windows V 1 4 0© 0 ®Milgard or Similar Vinyl Windows V 1 4 0_ o ®Milgard or Similar Vinyl Windows12 1 4 0 NM o ®Milgard or Similar Vinyl Windows 1:1. 1 4 °NM o W36 Milgard or Similar Vinyl Windows V 1 © ° 4_ ®Milgard or Similar Vinyl Windows V 1 © o© o W38 Milgard or Similar Vinyl Windows V 1 © o© o W 39 Milgard or Similar Vinyl Windows CI 1 _ o© 0 W40 Milgard or Similar Vinyl Windows 12 1 _ .111 o W41 Milgard or Similar Vinyl Windows CI 1 _ o_ o W42 Milgard or Similar Vinyl Windows CI 1 _ o_ o W43 Milgard or Similar Vinyl Windows 1 _ Mil o W44 Milgard or Similar Vinyl Windows CI 1 _ MI o W45 Milgard or Similar Vinyl Windows CI 1 _ o_ o W46 Milgard or Similar Vinyl Windows 12 1 _ Mil o Patio Milgard or Similar Vinyl Windows CI 1 6 ° 8 0 W49 0 MEM. W50 0 _MEM. MEI GIMEME ® 0 _-.-. W56 0 MEM. Mg CI MEM. El 0 _____ W59 0 _MEM. W60 - MEM. Copyright 2013, 9/28/2020 2 of 4 2015 Washington State Energy Code: UA Alternative Worksheet,Type R-3 Occupancies -R49 blown Attic STD baffled12 1,889 - V 0 MIM -2 x 6 Exterior wall with R-21 Batt insulation CI 2,051 - 1 - 1 - C - 1 - C - 1 -R20 Fully insulated Slab 64 - 1 - C - 1 -R21 Batt 3.5'depth w/TB El 882 98 M CI M CI Copyright 2013,WSUEEP10-009(Version 11)Copied by permission from Washington State University Extension Energy Program. (see copyright restrictions) 9/28/2020 3 of 4 2015 Washington State Energy Code: UA Alternative Worksheet,Type R-3 Occupancies • • • m • • • • • • • • • • Copyright 2013,WSUEEP10-009(Version 11)Copied by permission from Washington State University Extension Energy Program. (see copyright restrictions) 9/28/2020 4 of 4 G11Y0 i101e ii.7 c, gCOR't Planning, Community, & Economic Development Department 904 6th St. / P.O. Box 947, Anacortes, WA 98221 360-293-1984 AGENT AUTHORIZATION FORM Use this form to authorize someone other than the property owner to apply for permits for the subject property.Project Name: LOUckrVhi k y cd e c Property Address: 2 $OS C raa,1 L e_ City, State, Zip: AvAAC.or IZ-S W A- l ? ZZ1 AUTHORIZATION STATEMENT I / we, as the owners of the property identified above, authorize the below listed individual to act as our agent to submit applications, receive correspondence regarding the above-listed application, and sign and to receive notices on my/our behalf. DESIGNATED AGENT Agent Name: J i 41" Si ko ra. Agent Address: 0 L1 3 Your y V J, Agent City, State, Zip: (kit o Ul+ V tr icon, vJ IA °I, g2�3 PROPERTY OWNER SIGNATURE(S)** Signature: __ Signature: Printed Name: S'aro-L t LDtkt r I k` Printed Name: John L L-OU Qrw‘;(k--1 r- Title: 0 W Yvt.r- Title: 0 ' "-°r— Company: Company: q Date: 1 1(C (Zv Date: q J 42-0 **Each property owner listed must have their signature notarized. STATE OF ) aRiar,S ) ss. COUNTY OF S<IC TT' have satisfactory � li�i/ I certify that I know or evidence th the person who appeared before me, and said person acknowledged that he/she signed this instrument, and acknowledged it as a free and voluntary act for the uses and purposes mentioned in this instrument. �P Given under my hand and official seal this ��S day of , 2Q,2J 0„""� JORGE R. CANTU ;1'PY•PU©��i i::�1 Notary Public,State of Texas ry Public :YV Comm. Expires 04-11-2021 Notary ID 6629366 Residing at GA el" My appointment expireti4L//'���/ STATE ss. CO U NTY-efir / /� ��l� !� L ' 71-- is I certify that I know or have satisfactory evidence that�0 .� U ��'f�� the person who appeared before me, and said person acknowledged that he/she signed this instrument, and acknowledged it as a free and voluntary act for the uses and purposes mentioned in this instrument. Given under my hand and official seal this / day of � , 2Q 111111 1 Ota 'u• IC JORGE R. CANTU Notary Public,State of Texas s� Comm.Expires 04-11-2021 Residing at .�'( ''/%/2;1 ;� Notary ID 6629366 Rt /'I HN`` �T //�®�/My appointment expires FOUNDFOUND REBAR & CAP REBAR & CAP q�o FLAGGED WHITE STA7 SET WHITE STAKE NEAR, 125 N �� 00 00 E___ 12p EAR, 'SD SD SD 10' PRIVATE STORM DRAIN EASEMENT �ti / 13p� zc / RICKS 2 / / V_ fit, // LOT 5 ol ,. LOT 6 785n SQ_ FT. EXIST, o copi r-- HOUSE z 2805 GRADY LANE l-7-ROCKS \ DID NOT FIND LANDSCAPING (ID REBAR. SET 0 RIMITER WHITE STAKE ATE s 135 �� \ CORNER. ,) so W \ (� q DRY UTILITIES ' "' WATER METER 1 \ �—v FOUND PK NAIL IN \N LOT 8 SIDEWALK SET WHITE STAKE G 4 .\ \13 NEAR R=50' - L=30' 0 /- FOUND REBAR & \CAP SET WHITE '.- \ \ STAKE NEAR \ \ \ ! GRAPHIC SCALE 10 0 10 20 40 ( IN FEET ) 1 inch = 20 ft. Loudermilk Topography and Boundary HERRIGSTAD ENGINEERING & SURVEYING Survey 4320 WHISTLE LAKE ROAD 2805 Grady Lane, Anacortes ANACORTES, WA 98221 299-8804 Completed September 20, 2016 • l ,� PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT ` '' Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location:904 6th Street, Anacortes WA 98821 ,tl+i ,;,, ` ! Phone: (360)293-1901 Residential Building Permit Application Submittal Packet New Single Family Residences (SFR) Duplexes Additions and Remodels(SFR & Duplex) Accessory Dwelling Units Manufactured Homes Residential decks and retaining walls SUBMITTAL CHECKLIST x _� 04 � s n O Residential Building Permit 0 ., " _ ,+,, L 6 C O P. i m O U N Submittal Requirement Checklist c RI ' 3 ° °' C On N (J LL 2) ` 0 C Z. O fa U C - (I O to . CS rp 4— N • a See pages 2-3 of this handout for information about each 3 C w Q v submittal item listed below. Z ,c , Q 0 cc . g =o N i O Residential Building Permit Application Form (FORM BP-1-attached) X X X X X Structure&Site Information Form X (FORM BP-2-attached) X X X X X Mechanical& Plumbing Fixtures Form X X X X (FORM BP-3-attached) Architectural Plans (requirements listed on FORM BP-4-attached) X X X X X Stormwater Management Minimum Requirements Determination X X X X (FORM BP-5,attached) X Stormwater Site Plan X X X X Site Plan & Landscape Plans X (requirements listed on Form BP-6) X X X X X )[ Structural Plans&Calculations X X X X X f, Energy Code Plans& Forms X X --- Manufacturer's Specifications/Cut Sheets X - Copy of recorded survey X X X X Technical Reports X X X X — Other Required Permits X X X X X X ADU Affidavit of Owner Occupancy(signed) X Required Number of Copies and Plan Size Fees 2 paper copies of each item above • Plan review deposit is taken at time of Plans must be minimum 11" x 17", to scale, and legible application submittal. 1 reduced size copy(maximum size 11"X 17")of the Site • Permit fees are paid prior to building Plan, Floor Plan and complete Building Plans permit issuance. J Page 1 of 18 Res.Building Permit Application Submittal Checklist Updated October 10,2019 NT PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT AN Mailing Address: P.O. Box 547, Anacortes, WA 98221 y. Office Location: 904 6th Street, Anacortes WA 98821 , >,�q �. Phone: (360)293-1901 REQUIRED SUBMITTAL INFORMATION Additional details on certain submittal items is provided below to ensure Applicants are fully aware what City staff will be looking for when an application is submitted to the City. FORMS AND PLANS • FORM BP-1: RESIDENTIAL BUILDING PERMIT APPLICATION FORM. Provides key information about your project, including type of permit you are applying for, and property owner, contractor, and contact information. • FORM BP-2: STRUCTURE AND SITE INFORMATION FORM. Provides key information about the proposed structure, including height, floor areas, fire protection proposed, and asks questions about site characteristics that are used to determine whether your project requires any other information or additional permit applications to be submitted. • FORM BP-3: PLUMBING AND MECHANICAL INFORMATION. Form BP-3 provides space for you to fill in fixture information for plumbing and mechanical appliances and equipment that are included as part of your project. • FORM BP-4: ARCHITECTURAL PLAN REQUIREMENTS. Form BP-4 contains a list of all the items required to be shown on Architectural Plans. • FORM BP-5: STORMWATER MANAGEMENT DETERMINATION FORM. Most development within the City of Anacortes that involves disruption of soils,or construction of buildings, streets, parking lots, etc. requires a Stormwater review. Stormwater review requirements are based on either the amount of soil to be disturbed (grading,vegetation removal), or the amount of hard surface that is created or replaced on a site (building footprint, concrete, asphalt or gravel parking, sidewalk, etc.). Form BP-5 assists you in determining the level of stormwater review (applicable Minimum Requirements) required for your project. • STORMWATER SITE PLAN. The Stormwater Site Plan is the comprehensive report containing all of the technical information and analysis necessary for regulatory agencies to evaluate your project for compliance with stormwater requirements. The level of stormwater review and contents of the Stormwater Site Plan will vary with the type and size of the project, and individual site characteristics. Use Form BP-5 to determine the level of stormwater review and then complete the applicable Stormwater Minimum Requirements Form on the Public Works- Engineering Department Forms website and provide required submittal items/plans. • FORM BP-6: SITE PLANS& LANDSCAPE PLANS. Form BP-6 contains a list of all the items required to be shown on Site and Landscape Plans. • STRUCTURAL PLANS: Plans prepared and stamped by a State of Washington licensed professional structural engineer drawn at a scale approved by the Building Official clearly indicating the information required by the "Permits" section of the currently adopted International Building Code and Chapter 19.27 RCW(State Building Code Act, Statewide amendments), and City submittal forms including: structural members labeled as to size and spacing as well as bracing, blocking, bridging, special connectors, and anchor bolts; cross-section details, as needed,to show typical foundation, floor, wall, ceiling and roof construction; insulation of walls, floors and roof/ceiling; and details of stairs, fireplaces and special construction, if any. Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 2 of 18 G‘'t Y U� PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 . _ Office Location: 904 6th Street, Anacortes WA 98821 .qw Phone: (360)293-1901 • STRUCTURAL CALCULATIONS: An analysis of loads, materials, etc., prepared and stamped by a State of Washington licensed professional structural engineer. • ENERGY CODE FORMS: The standard Washington State Energy Office form requesting the information required under Chapter 51-11 WAC detailing building components used to comply with the State Residential or Nonresidential Energy Code, as applicable. • MANUFACTURER'S SPECIFICATIONS/CUT SHEETS: A document that summarized the performance and other technical characteristics of a product, machine, component, material, or subsystem (e.g., a power supply) in sufficient detail that allows the City to determine the product will be incompliance with applicable codes. • COPY OF RECORDED SURVEY. A survey of your property is needed so that conformance with minimum setback requirements and other development standards can been confirmed and verified on site by the inspectors. Property markers must be visible on your property. If they are not at the time an inspection is requested, you may need to have a new survey completed. OTHER SUBMITTALS DETERMINED ON A CASE-BY-CASE BASIS TECHNICAL REPORTS Following is a list of technical reports that will be required to be submitted to the City when certain circumstances exist on or near a site an Applicant is planning on making improvements to. The general triggers for each of the listed technical reports I provided below: A. CRITICAL AREAS REPORTS: In general, Critical Area reports are required when wetlands and/or streams are located on or near a site. Critical area mitigation plans may also be required, depending on the project proposal. See Anacortes Municipal Code Ch. 17.70 for additional information. B. GEOTECHNICAL REPORT: In general, Geotechnical Reports are required when work is proposed on or near slopes in excess of 15%and/or known landslide hazard areas. See Anacortes Municipal Code Ch. 17.70 for additional information. OTHER PERMITS DETERMINED ON A CASE-BY-CASE BASIS OTHER FORMS Following is a list of other permits that could be required in certain circumstances. The general triggers for each of the listed permits is provided below. A. FILL AND GRADE PERMIT: Grading (importing, exporting, and/or moving material on a site) of more than 50 cubic yards and/or if grading modifies the existing flow of stormwater or groundwater. B. RIGHT-OF-WAY PERMIT: A right-of-way permit is required anytime the public right-of-way is disturbed or obstructed in any way by private development or the general public. Res. Building Permit Application Submittal Checklist Updated October 10,2019 Page 3 of 18 PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location: 904 6th Street, Anacortes WA 98821 jqf `� Phone: (360)293-1901 Page left blank intentionally. Res. Building Permit Application Submittal Checklist Updated October 10,2019 Page 4 of 18 �1�Y PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 y Office Location: 904 6th Street, Anacortes WA 98821 VP:,COIF Phone: (360)293-1901 FORM BP-1: RESIDENTIAL BUILDING PERMIT APPLICATION 1. PROPERTY INFORMATION Project Address(Street,Suite U): Assessor Parcel Number: 2-SO i G F2r�+�y tr's N.4E- P 12-103 i`T Subdivision/Lot#: Zoning Designation: Lot area (size): L.GT (e R2. 785r, sq.ft. 2. TYPE OF PROJECT 14 New SFR ❑ New Accessory Dwelling Unit: ❑ Deck/porch (new/repair) ❑ New Duplex ❑ Attached to Primary Unit 0 Detached from Primary Unit ❑ Interior remodel ❑ New Addition to SFR ❑ Garage, carport or accessory building ❑ Fence or retaining wall or duplex (new/repair) ❑ Other: Project Summary: /'Eta! 5 IA 1 \ Z, C P rZ (v-13‘►�P+ Project Valuation: $ 4 O K 3. PROPERTY OWNER INFORMATION Name: Phone: -I 01Ati St)►Zrart Out) W1 tLtiG Address(Stet,City,State,Zip): Email Address: J 2333 lry PIER-Gr.-ST, HV V5Tv►.I 1 4. CONTRACTOR INFORMATION Name:* Phone: r 2-0,14 u5&t,.l c n o PN4 - 10 e - 2 6(3 -1131 Contractor's Business Licenses State License#: City License#: *All Contractors&Subcontractors must have a valid City 51-YZA N C l O 20 C.C- of Anacortes business license prior to doing work in the Expiration Date: Expiration Date: City. 0 z 21 Address(Street,City,State,Zip): Email Address: 5. CONTACT PERSON Select one person the city will contact for anything related to this project: ❑ Applicant ❑ Property Owner ❑ Contractor ® Other(list below) Oel5 t(a Name: J t v\A )YKoas.A Phone: 31vV- 929 41,039 Address(Street,City,State,Zip): Email Address: 14043 YvuL4 12-0. ev, kov-e-howAeats .c) YYt o r\i o►'J in" 115113 Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 5 of 18 ` � PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT 4 Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location: 904 6th Street, Anacortes WA 98821 .,NYAI(IIII1c ,4. Phone: (360)293-1901 kt 6. LENDER INFORMATION RCW 19.27.095 requires the City to obtain information with regard to lenders. If there are no lenders involved with your project, write"no lenders"on the Name Line below. Name: Phone: Address(Street,City,State,Zip): Email Address: 7. ACKNOWLEDGEMENTS & SIGNATURE Read and initial each of the following statements prior to signing this application: J�5I understand that when a building permit application is taken in over the counter it does not mean the application has been deemed technically complete and sufficient for staff review. )c* I understand that if I submit incomplete, inaccurate, and/or erroneous information it will take the City longer to process my permits. ��y I understand and acknowledge that I could be responsible for providing as-built drawings (on paper or electronically) as part of the project's certificate of occupancy process. I understand and acknowledge that Special Inspections could be required as part of my project, and 91 if needed I will be required to pay for the cost of these inspections. I understand and acknowledge that financial securities could be required as part of the work I am �1 S completing and I agree to provide the items needed for the City to calculate these securities and to provide the securities themselves. I understand that if permits are reviewed concurrently such as design review,site plan,traffic concurrency, etc., any required revisions to one permit may affect the entire plan set and could g; add costs and time to the project. I hereby declare that I am either the owner of the property listed on this application or the owner of this property has authorized me to be their representative to act for them. I also declare under penalty of perjury under the laws of the State of Washington that all of the statements and answers contained herein, and the information submitted with this application form is in all respects, true, correct, and complete to the best of knowledge and belief. t Nyvti-4-- ALI[1-1.0--- Sig, ature Date tZ t\ Printed Name Res. Building Permit Application Submittal Checklist Updated October 10,2019 Page 6 of 18 0� PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location: 904 6th Street, Anacortes WA 98821 '',4' F Phone: (360)293-1901 FORM BP-2: STRUCTURE AND SITE INFORMATION 1. PROPERTY WHERE WORK IS OCCURRING ADDRESS: 7- 0 5 &RA 'fLANt � PARCEL l�rrv�GU a2 SCS w.f.; q E Z'Z. NUMBER(S) 1 31 7 2. DETAILED PROPOSED STRUCTURE INFORMATION Complete the following information as it relates to your project. Mark items that are not applicable with "N/A". Structure height: AREA SQUARE FOOTAGE OCCUPANCY GROUP CONSTRUCTION TYPE OCCUPANT LOAD is`Floor: 1,6 Eci I'z[S. 2"d Floor: 3rd Floor: Basement: ( 21 Garage: 5 5 c� Total deck: Total porch: 7 Cj 570N+AC�E Other: u 509 Other: Other: 3. QUESTIONS ABOUT THE PROPOSED STRUCTURE Is a fire sprinkler system being installed? ❑ YES © NO Is a monitored fire alarm being installed? ❑ YES © NO Are retaining wall(s) being built? ❑ YES ® NO Are structural plans required? 0 YES ❑ NO 4. PROJECT SITE INFORMATION A. Is work within the City's right-of-way proposed? If yes, you will be required ❑ YES ® NO to submit a right-of-way permit application. If you have already submitted a ROW permit, list the permit number here: B. Is the property located in a flood zone? ❑ YES ® NO If yes, list the flood zone designation: C. Are there slopes in excess of 15%on or abutting the site? If yes, a ❑ YES EJ NO geotechnical report will likely need to be submitted. Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 7 of 18 y �. PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT `, ," Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location: 904 6th Street, Anacortes WA 98821 14,4 z'` Phone: (360)293-1901 #a„ C 01 D. Are there critical areas or buffers on or abutting(within 300-feet of)the ❑ YES 0 NO project site? If yes, a critical areas report will likely need to be submitted. E. is the lot less than 5,000 sq.ft. in area? ❑ YES 0 NO If yes,your site and building will need to comply with the standards in AMC 19.43.010.C. F. Is your project involving an accessory dwelling unit? ❑ YES ❑ NO if yes,your site and building will need to comply with the standards in AMC 19.47. G. Will more than 2-acres be cleared and/or more than 5,000 board feet ❑ YES Q NO (about 1 log truck load) of timber be harvested? If so you may need to obtain a forest practices permit from DNR. H. Is this project subject to the SEPA process? If yes,you will be required to ❑ YES Q NO submit a SEPA checklist. If you have already completed the SEPA process, list the permit number here: 5. REQUIRED SIGNATURE I hereby declare that I am either the owner of the property listed on this application or the owner of this property has authorized me to be their representative to act for them. I also declare under penalty of perjury under the laws of the State of Washington that all of the statements and answers contained herein, and the information submitted with this application form is in all respects, true, correct, and complete to the best of knowledge and belief. WOM4 - q - zs Signature Date Prvv1�5 `7`l' D V-4 Printed Name Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 8 of 18 t Y ,� PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT •L . "` Mailing Address: P.O. Box 547, Anacortes, WA 98221 .� Office Location: 904 6th Street, Anacortes WA 98821 1 '`' Phone: (360)293-1901 4cctt; FORM BP-3: PLUMBING AND MECHANICAL FIXTURES MECHANICAL Equipment Type: Appliance/Equipment Information(new and relocated): Total#: Furnace: Gas#: Elec#: BTU: Other#: • Wail Heater: Gas#: Elec#: Other:#: Location(s): Gas Water Ikcp. xz- #: 1 Location(s): ) Heat Pump: Elec#: Other#: Capacity: Air Conditioning: Elec#: Other#: Capacity: Radiant/Hydronic Gas#: 1 Elec#: Other:#: Location(s): 4illr ( Exhaust Fans: Bath#: i' Laundry#: ( Other: 5 Range Hood: #: 1 Location(s): K,-rc - --► I Fireplace: Gas#: ( Elec#: Other:#: Location(s): ( Clothes Dryer& Duct: Gas#: I Elec#: Other:#: Location(s): ( Stove/Range/Oven: Gas#: I Elec#: Other:#: Location(s): i Gas Piping/Outlet(s): #: Location(s): Boiler Gas#: Elec#: BTUs: Location(s): Other: #: Location(s): TOTAL MECHANICAL OUTLETS:I f I ,,, PLUMBING Fixture Type (new and relocated): Total#: Fixture Type (new and relocated): Total#: Water Closet(Toilet): 3 Refrigerator water supply(for water/ice I Kitchen Sink: ( Pressure Reduction Valve/Pressure Regulator: Utility Sink: l Water Service Line: Tub: I Water Piping: Hand Sink: _ 4 Clothes Washer: I Shower: Z. Electric Water Heater: Tank-less? Yes CI Dishwasher: ( Backflow Prevention Assembly: Hose Bib: it Other: TOTAL PLUMBING FIXTURES: ( q Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 9 of 18 Nt � PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT „ ' Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location: 904 6th Street, Anacortes WA 98821 4 � Phone: (360)293-1901 0cz FORM BP-4: ARCHITECTURAL PLAN REQUIREMENTS 1. PROPERTY WHERE WORK IS OCCURRING ADDRESS: Z805 LR \ D`l L.M'tt—i E , lSt o R1 S VAN ci g2-21 PARCEL NUMBER(S) 12(0 3 1 1 2. GENERAL INFORMATION This form is intended to assist applicants in creating complete, code compliant architectural plans. Please check the plans you wish to submit to make sure they contain each of the listed items. To the right of the Requirements column is space for you to list the sheet number of the plan set where the listed information is shown. • Minimum Plan Size: 11"x 17"and drawn in an architectural scale. • Architectural plans for structures 4,000 square feet or larger are required to be prepared and stamped by an architect licensed in the State of Washington. • Structural plans must be stamped by a structural engineer licensed in the state of Washington. 3. REQUIREMENTS FOR ALL ARCHITECTURAL PLANS COMPLETE REQUIREMENTS PAGE#ON ? YOUR PLANS Cover(or 1'` page) must include: • Site address • Parcel number • Lot number(if applicable) Al. • Lot size • Lot coverage • % impervious surface coverage Floor plans with existing(if applicable) and proposed building layout with square A5 1 A8 footages and with the use of each room/area labeled. Window and door sizes labeled and window ventilation area. Commercial, Multi-Family, and Mixed-Use Structures must also include door and window A5. a 8 schedules. Plumbing, duct, and electrical layout. Penetration protection must be shown. A.5 , AS Opening headers, size, and material. Pr , Ag Cross section details, showing typical foundation, floor, wall, ceiling and roof A 13-gllb construction and insulation. Structural members labeled as to size and spacing as well as bracing, blocking, A0, A 10 bridging, special connectors, and anchor bolts. Details documenting energy code compliance. RS , F18 Exterior building elevations demonstrating compliance with applicable structure All type design standards (small lot, duplex, or ADU) and maximum building height A1� Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 10 of 18 `‘� PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location:904 6th Street, Anacortes WA 98821 4? Phone: (360)293-1901 Building height(see AMC 19.42.120 for measurement methods,exceptions and modifications). • Label the building height at the highest point of the structure from the average A 1 T of the natural topography at the foundation at the front of the building. • Label the average elevation of the natural topography at the front of the + building. r�1e • Label the elevation at the center of all exterior walls of the proposed building. • For ADUs only,include elevations demonstrating compliance with the height/setback plane(see AMC 19.47.030(C)(6)). Special details as needed (i.e., stairs,fireplaces, special construction). Insulation and insulation values of walls,slab, floors, and roof/ceiling. Ara - Alto Existing and proposed grades with slope of lot shown. A n- p1tg Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 11 of 18 `` rJ� PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.D. Box 547, Anacortes, WA 98221 Office Location: 904 6th Street, Anacortes WA 98821 . Ir . Phone: (360)293-1901 FORM BP-5: STORMWATER MANAGEMENT MINIMUM REQUIREMENTS DETERMINATION 1. PROPERTY WHERE WORK IS OCCURRING ADDRESS: Z Qj(J S (ire-AiD Y , I ips co rz 5 1MN g Z"Z4 PARCEL NUMBER(S) I '2-La 3 1 2. GENERAL INFORMATION Most development within the City of Anacortes that involves disruption of soils,or construction of buildings, streets,parking lots,etc. requires a Stormwater review. Stormwater review requirements are based on either the amount of soil to be disturbed (grading,vegetation removal), or the amount of hard surface that is created or replaced on a site(building footprint,concrete,asphalt or gravel parking,sidewalk,etc.) This form is largely targeted for small projects and single family residences. For larger projects and more information please refer to the Anacortes Municipal Code(Chapter 19.76 Stormwater Management)and the latest Washington State Department of Ecology Stormwater Management Manual for Western Washington (Ecology Manual). 3. HARD SURFACE AREA CALCULATION Please calculate your project's hard surface amount;guidance is provided on the next page of this document. Use your project's total hard surface calculation to follow the flow chart(s)in this packet and determine the level of stormwater management required for you project. When determining your permit level or if stormwater thresholds are met or exceeded the entire project must be considered. A project is that portion of a property,properties,or right of way subject to land disturbing activities, new hard surfaces and replaced hard surfaces. The hard surface on your property will determine the storm water utility fees and the stormwater general facility charge. All new or replaced hard surfaces should be accounted for. Below are excerpts from the Anacortes Municipal Code and Ecology Manual that may assist you in preparing this information. "Hard surface area"means an impervious surface,a permeable pavement,or a vegetated roof. "Impervious surface"means a non-vegetated surface area which either prevents or retards the entry of water into the soil mantle as under natural conditions prior to development. A non-vegetated surface area which causes water to run off the surface in greater quantities or at an increased rate of flow from the flow present under natural conditions prior to development. "Replaced impervious surface"means,for structures, the removal and replacement of impervious surfaces down to the foundation. For other impervious surfaces, the removal down to bare sail or base course and replacement. K Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 12 of 18 Y 0,4 PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 y Office Location:904 6th Street, Anacortes WA 98821 q1� Phone: (360)293-1901 Land disturbance Description Total (SF) Total Area of Land disturbing activity Total area converted from vegetation to lawn or landscaped areas Hard surface area calculation Existing Removed Proposed Proposed Description (SF) (SF) Replaced New (SF) (SF) Non Pollution Generating Hard Surface Area (Sidewalks, paths,patios,etc.) Pollution Generating Hard Surface Area (Driveways, parking areas,etc.) Total Hard Surface Site Size Existing impervious surface coverage% (sq.ft. hard surface/site size) Use the information in the above table to navigate the flow chart(s) on the next page and determine the applicable stormwater management minimum requirements for your project. Then complete the applicable Stormwater Minimum Requirements Form on the Public Works - Engineering Department Forms website and provide required submittal items/plans. Check applicable box Minimum Requirements Determination Minimum Requirements #1-9. Minimum Requirements #1-5. R .Building PerrilApplication Submittal Checklist Updated October TO,2019 Minimum Requirement#2. Page 13 of 18 • PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location:904 6th Street, Anacortes WA 98821 �y11010 �' Phone: (360)293-1901 s, COVFLOW CHART FOR DETERMINING REQUIREMENTS FOR NEW DEVELOPMENT Start Here Does the site have 35% Yes See Redevelopment Minimum or more of existing ► Requirements and Flow Chart impervious coverage? (Figure I-2.4.2). No Does the project convert 3/4 y acres or more of vegetation to Does the project result in lawn or landscaped areas,or 5,000 square feet,or No convert 2.5 acres or more of greater,of new plus ► native vegetation to pasture? replaced hard surface —-------- area? \No Y Yes Yes Does the project result in 2,000 square feet,or greater,of new plus All Minimum Requirements replaced hard surface area? apply to the new and replaced hard surfaces and converted vegetation areas. Yes No Does the project have land Minimum Requirements#1 disturbing activities of 7,000 44 through#5 apply to the new square feet or greater'? and replaced hard surfaces Yes �........-- and the land disturbed. NO Minimum Requirement#2 applies. rACM Figure 1-2.4.1 Flow Chart for Determining Requirements for New Development DEPARTMENT CF Revised June 2015 ECOLOGY Please see httplAvvvvvecy.vva.gov/oopyright html for copyright notice including g permissions, State of Washington limitation of liability,and disclaimer. Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 14 of 18 •"' PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location:904 6th Street, Anacortes WA 98821 •�2q /y Phone: (360)293-1901 ,, c,°Et FLOW CHART FOR DETERMINING REQUIREMENTS FOR REDEVELOPMENT Does the project result in 2,000 square feet,or more,of new plus replaced hard surface area? OR Does the land disturbing activity total 7,000 square feet or greater? JYes No Minimum Requirements#1 through#5 apply to the new and replaced hard Minimum Requirement#2 applies. surfaces and the land disturbed. Next Question i Does the project add 5,000 square feet or more of new hard surfaces? OR Convert 3/4 acres or more of vegetation to lawn or landscaped areas? OR Convert 2.5 acres or more of native vegetation to pasture? Yes No All Minimum Requirements apply Next Question to the new hard surfaces and the ► Is this a road related project? No converted vegetation areas. Yes Does the project add 5,000 square feet or more of new hard surfaces? vi Yes No Is the total of new plus replaced hard surfaces Do the new hard r 5,000 square feet or more, surfaces add 50%or No No additional No AND more to the existing ► 41 does the value of the proposed improvements hard surfaces within requirements. P P P including interior improvements-exceed the project limits? 50%of the assessed value(or replacement value)of the existing site improvements? Yes All Minimum Requirements apply to the new and replaced J hard surfaces and converted vegetation areas. , Yes rain. Figure 1-2.4.2 — Flow Chart for Determining Requirements for Redevelopment DEPARTMENT OF Revised June2015 ECOLOGY Please see hltplAvww.ecywa.gov/copyright.htmi for copyright notice including permissions, State of Washington limitation of liability,and disclaimer. Res. Building Permit Application Submittal Checklist Updated October 10,2019 Page 15 of 18 •♦I PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT t `'' `'' Mailing Address: P.O. Box 547, Anacortes, WA 98221 17 Office Location: 904 6th Street, Anacortes WA 98821 f •'` Phone: (360)293-1901 FORM BP-6: SITE PLAN REQUIREMENTS 1. PROPERTY WHERE WORK IS OCCURRING ADDRESS: 2.SOS.' v.•t 1.--)eNt-4 A-r/A TE-S (tip a 8 Z PARCEL NUMBER(S) l 2-61, 3 I 7 2. GENERAL INFORMATION This form is intended to assist applicants in creating complete, code compliant site plans. Please check the plans you wish to submit to make sure they contain each of the listed items. To the right of the Requirements column is space for you to list the sheet number of the plan set where the listed information is shown. • Minimum Plan Size: 11" x 17" and drawn in an engineering or architectural scale. 3. INFORMATION REQUIRED ON ALL SITE PLANS COMPLETE? REQUIREMENTS PAGE#YOUR PLANS Cover sheet must contain all of the following: • Vicinity Map • Name of the project • Name, address, and telephone number of owner and agent(s) • Name, address, and telephone number of Applicant(if different from the owner) • Zoning designation of the site A z • Area, in square feet and acreage, of the project site • Reference to the Building Code used • Proposed use • Occupancy group • Construction type • Square footage and height of each individual building • Percent lot coverage • Percent impervious surfaces Scale and North Arrow Property features: Location, identification, and dimensions of all property lines and easements. All easements shown on the title report,Record of f c 2- Survey, or plat must be dimensioned and shown. Location and dimensions of existing critical areas (wetlands, streams, I steep slopes) and their associated buffers. N Location of Ordinary High Water Mark and shoreline jurisdiction limits N �I� (if adjacent to a shoreline). Existing and proposed contours and site elevations (i.e. finished grades) at 5-foot minimum increments. The horizontal and vertical PCL control datum must be clearly shown. Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 16 of 18 .G1 � PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 14 Office Location: 904 6th Street, Anacortes WA 98821 O ' Phone: (360)293-1901 Structures: Location, identification, dimensions and size of all existing and proposed buildings and other structures. O 2- Location of existing and proposed retaining walls, rockeries, and N101% Location, identification, and dimensions of all setbacks. A 2 Show proposed projections into required setbacks, including dimensions (see AMC 19.44.140) AZ Utilities & Easements: Location and dimensions of existing and proposed stormwater, sanitary sewer, potable water, and fiber lines/facilities. All wells and A, 2- septic systems located on or near the project site must also be identified. Location of all existing and proposed fire hydrants within 300 feet of the boundary of the project site. Pc 2- Location and dimensions of existing and proposed freestanding lighting fixtures, utility junction boxes, public utility transformers. Ik 2 Stormwater Proposed Temporary Erosion and Sediment Control Measures, if not 0Ti2. located on other plans. �,�NS Proposed permanent stormwater management BMPs. Zo wt "`� Access, Circulation & Parking Location, identification, and dimensions of all existing and proposed on-site and adjacent streets and alleys, including the location and dimensions of all existing and proposed curbs,gutters, sidewalks, 1k`2, median islands, and street trees. Show existing and proposed vehicular access to the site, including the IN 2- size and location of driveways and curb cuts. Show existing and proposed parking spaces, including surface material and dimensions of spaces. N 16 Open Space (ADUs, Small Lots, and Duplexes) Show calculations, location, dimensions and provided square footage of required open space area per AMC 19.43.010.C, E, or AMC 19.47, N )11 as applicable. Landscaping Show the location and design of landscape areas to be preserved and planted, and a plant list to include the location, number, size and type A Z of plant material by botanical and common name. Location of irrigation system if a permanent or temporary system is proposed. to)►'k Show the location of existing trees to be retained in conformance with AMC 16.50, and tree protection measures to be implemented, A,.z- when applicable. Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 17 of 18 GVV Y PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location: 904 6th Street, Anacortes WA 98821 \94'qky Phone: (360)293-1901 cC►R Provide a maintenance plan for any infiltration-based stormwater best management practices (BMPs) built as part of the landscaping design, including the specifications and maintenance procedures of any soil amendments. Show new trees to be planted and tree unit credit calculations, in conformance with AMC 16.50 Tree preservation, when applicable k2 The following table,with project specific information filled in, must be placed on the site plan: Required Landscaping For Example Calculations Site Area 7,500 sq.ft. of site area to be landscaped(per 20%-R2A zone q AMC Tables 19.42.020-.030) 1,500 sq.ft. required 1,850 sq.ft. provided Compliance with AMC Ch. 16.50 Tree unit credits required: Tree Preservation. • 8 tree units required Tree unit credits retained: • 2 trees 6"dbh =4 tree unit credits retained Tree unit credits provided: • 2 new deciduous trees(min. 2" caliper @ 6"above ground) • 2 new evergreen trees(8'in height) Number of required street trees 1 per 30'of frontage 60 lineal feet of frontage=3 street trees Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 18 of 18