HomeMy WebLinkAboutPermit File bld-2021-0237 1922 23rd Street Y
►-' — 0 __ Cityof Anacortes
Invoice/Permit #: BLD-2021-0237
904 6th Street
‘`1:1"114111ItaliworApplied date: 03/29/2021
<_ P.O.Box 547 Issue date: 03/29/2021
1 ' Anacortes, WA 98221-0547
':t. _- Expire date: 09/25/2022
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Job Address: 1922 23RD ST Permit Type: Reroof Single Family Residence
ANACORTES WA 98221-2430 Project:
APN: P57570
Remarks: REMOVE OLD ROOFING AND REPLACE WITH 1 LAYER OF TIMBERLINE HDZ COMPOSITION SHINGLES, 27
SQUARES.
Owner: MARCEY DUNCAN Contractor: JOMAR RESIDENTIAL CONSTRUCTION INC
Address: 1922 23RD ST Address: 1922 23RD ST
ANACORTES WA 98221-2430 ANACORTES WA 98221-2430
Phone: (360) 588-1806 Phone: (360) 588-1806
License #:
General Information: Fees:
Occupancy Group it-1 Building Permit Fee 153.25
Building Valuation 8000 State Building Code Fee Resi 6.50
Total Calculated: 159.75
Deposits/Receipts: 0.00
Total Due: 159.75
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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 'h's application and know the same to
be true and correct.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY
'_Y PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
4
RE-ROOF PERMIT APPLICATION
:4. 47 Mailing Address: P.O. Box 547, Anacortes, WA 98221
` '-ico8x.' Office Location: 904 6`h Street, Anacortes WA 98821
Phone: (360) 293-1901
PLEASE REFER TO THE RE-ROOF PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
RESIDENTIAL ❑ COMMERCIAL ,
___ �PROJECT ADDRESS(Street,Suite#): P s #: ,
19g?--03 6t
, 7 Subdivision/Lot#: 9/ PROJECT LU JT\IQ $
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APPLICANT: one: '
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' Address(Street,City,State,Zip): ,,I Email Address:
PROPERTY OWNER: i 1COY b_um r-47I1 Phone: 18 l
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Address(Street,City,State Zi ) Yci Email Address:
CONTACT PERSON: f D h�h Phone: � ra I,�/�
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Address(Street,City,State,Zip): Email Address:
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CONTRACTOR:* Phone:J7 f0.2JCMb`
Address(Street,City,State,Zip): Email Address
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Contractor's License# Exp. Date:
*All Contractors& subcontractors must have a valid City off a.73 iq 1 03
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Anacortes business license prior to doing work in the City. Business License#: Exp.Date:
Contact the City's Finance Department at(360)299-1968. to 63,
.if 6 Liv 9-a )11.31 id I
PROPOSED WORK: 1 0 ►(�-t /6 N m..S e
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TYPE OF ROOFING: I etb€i-11ill 1 hi Z NUMBER OF LAYERS: r
CLASS OF ROOFING: ❑ A ❑ B ❑ C NUMBER OF SQUARES: Ti
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: It c\t‘ 17 ze II) r- Owner Other ❑ (specify):
Signature: /4/ Date: .3!45 43-i
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