HomeMy WebLinkAboutPermit File BLD-2021-0011 1319 6th Street -- - City of Anacortes Invoice/Permit #: BLD-2021-0011
904 6th Street
Applied date: 01/04/2021
P.O.Box 547
issue date: 01/04/2021
Anacortes, WA 98221-0547 Expire date: 07/03/2022
1$4' "s~ (360) 293-1901 p
Job Address: 1319 6TH ST Permit Type: Mechanical Permit
ANACORTES WA 98221-1723 Project:
APN: P55645
Remarks: REPLACE GAS FURNACE FOR THE SAME.
Owner: KATHLEEN DICKINSON LIVING TRUST Contractor: FOSS HEATING AND COOLING
Address: 1319 6TH ST Address: 333 E BLACKBURN RD
ANACORTES WA 98221-1723 MOUNT VERNON WA 98273-9006
Phone: (360) 755-6679 Phone: (360) 336-1517
License #:
General Information: 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. I have read and exa his application and know the same to
be true and correct.
SIGNATURE OF OWNER OR AUTHORIZED AGENT is.
z 'f V r} PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
PLUMBING & MECHANICAL PERMIT APPLICATION
74,41211,44 Mailing Address:P.O. Box 547, Anacortes, WA 98221
Office Location: 904.6`h Street, Anacortes WA 98821
Phone: (360) 293-1901
PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS(Street,Suite#): PARCELS #: PR .JECT VALUATION:
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.51i-v - .5z4 1 1.3 7<2
Subdivision/Lot#: RESIDENTIAL 1 COMMERCIAL,
APPLICANT: ,-- Phone:
(— 5 I/ed-I-1 a d cap iif ;' c3 4-69 3,io- 15t 7
Address(Street,City State,Zip): Email Address:
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PROPERTY OWNER: Phone:
Teti-b Ite,4 Die k",`rt, 6 Y 60,?7 5$ use 77
Address(Street,City,State,Zip): Email Address:
/311 6 t' .5; i4,,acv,c w,,, 1^2-1
CONTACT PERSON:. Phone:( v ' 151
Address(Street,City, State,Zip): Email Address: ,
3 3 F: B/iClf h 44-.4 Rd, 577,.4 is v'ct^ara? ivy 'e.�? r'� Y Ale.r <4- c'$$I)e •7`a , 6 0,7
CON TRACTOR:* / Phone:
Address(Street,City,State,Zip): Email Address:
*All Contractors&subcontractors must have a valid City ofpro Si iial License#: Exp.Date:
business licenseprior to doingwork in the City.
le")-2—
Anacortes Business License#: Exp.,Date:
Contact the City's Finance Department at(360)299-1968. 605 off,f30/ i
Is this work,associated with another project? Yes CI No If yes,specify:
PROPOSED WORK: a't lac, y f' fvr.4act 0,1f 4 I;ire ;n kiln,
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.
Td� f_ J 1I— .5'r 1y Owner 0 Agent [ (specify): t'O.9 /*el filly
Print Name: ,�'� t �`: � ;
Date: I-2/ /7'-0-
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Signature: . .r,_.