HomeMy WebLinkAboutPermit File BLD-2021-0146 2515 Creekside Lane Y City of Anacortes Invoice/Permit#: BLD-2021-0146
904 6th Street
Applied date: 02/19/2021
P.O.Box 547
Anacortes, WA 98221-0547 Issue date: 02/19/2021
`- Expire date: 08/18/2022
'' (360) 293-1901
Job Address: 2515 CREEKSIDE LN Permit Type: Mechanical Permit
ANACORTES WA 98221-2459 Project:
APN: P83996
Remarks: REPLACE GAS FURNACE IN THE GARAGE.
Owner: HENEKS HELEN I Contractor: CPI PLUMBING&HEATING
Address: 2515 CREEKSIDE LN Address: 1900 RAILROAD AVE
ANACORTES WA 98221-2459 MOUNT VERNON WA 98273-4957
Phone: Phone: (360)428-5636
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
examined this application and know the same to be true and correct.
g
SIGNATURE OF OWNER OR AUTHORIZED AGENT
ISSUED :Y 'C
0Y (a PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
r % . PLUMBING & MECHANICAL PERMIT APPLICATION
�, ! Mailing Address: P.O. Box 547, Anacortes, WA 98221
i CD9 Once Location: 904 61h Street, Anacortes WA 98821
Phone: (360) 293-1901
PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT A(DRESS Street,Suite#): PARCEL(S)#: PR JECT VALUATION:
Subdivision/Lot#: RESIDENTIAL COMMERCIAL 0
PLICANT: \ Phone:--,
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Address(Street,city,State,Zip): }mailrAddress:
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PROPERTY OWNER: Phone:,
Address(Street,City,State,Zip): Email Address:
CVS[TACT PERSON: Phone:
PL X . 49,0 -s61 _ S9c/
Addresg(-Street,City,State,Zip): Email Address:
CONTRACTOR:* Phone:
., OS ONC-a'\-
Address(Street,City,State,Zip): Email Address:
*All Contractors&subcontractors must have a valid Cite of Professional License#: Ex .Dated'
Anacortes business license prior to doing work in the City. sill ess License#: Exp.Date:
e'�� ns'# x p�at ! EA
Contact the City's Finance Department at(360)299-1968.
Is this work,associated with another project? Yes ❑ No\FA., If yes, specify:
PROPOSED WORK —
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 th-City of Anacortes
Print Name: T X\oiM L \.\\-\i C Owner 0 Agent (specify): L2,1
Signature: Date: Vi 'Z I
Equipment Type: Appliance/Equipment Information(new and relocated): Total#:
r Furnace: Gas#: \ Elec#: Other#: Location(s)60(Q 1
Wall Heater: Gas#: Elec#: Other:#: Location(s):
Gas Water Heater: #: Location(s):
Heat Pump: Elec#: Other#: Location(s):
Air Conditioner/Handler: Elec#: Other:#: Location(s):
Radiant/Hydronic Heating: Gas#: Elec#: Other:#: Location(s):
Exhaust Fans: Bath#: Laundry#: Kitchen#: Other#:
Range Hood: #: Type 1 or 2(Circle which one) Location(s):
Fireplace: Gas#: Elec#: Other:#: Location(s):
Clothes Dryer&Duct: Gas#: Elec#: Other:#: Location(s):
Stove/Range/Oven: Gas#: Elec#: Other:#: Location(s):
Refrigeration Unit: Elec#: Other:#: Location(s):
Gas Piping/Outlet(s): #: Location(s):
Boiler: Gas#: Elec#: BTUs: Location(s):
Other: #: Location(s):
TOTAL MECHANICAL OUTLETS.
Fixture Type(new and relocated): Total#: Fixture Type(new and relocated): Total#:
Water Closet(Toilet): Refrigerator water supply(for water/ice dispenser):
Kitchen Sink: Pressure Reduction Valve/Pressure Regulator:
Utility Sink: Water Service Line:
Tub: Water Piping:
Hand Sink: Clothes Washer:
Shower: Electric Water Heater: Tank-less? Yes 0 No 0
Dishwasher: Backflow Prevention Device:
Urinal: Hose Bib:
Floor Drain/Floor Sink: Drinking Fountain:
Hydronic Heat in: Floor ❑ Wall 0 Grease Interceptor:
Other: Other:
TOTAL PLUMBING FIXTURES: