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Permit File BLD-2021-0618 2008 10th Street
�- Y 6-. Cityof Anacortes Invoice/Permit #: BLD-2021-0618 904 6th Street Applied date: 07/22/2021 P.O.Box 547 Issue date: 07/22/2021 t 1 • Anacortes, WA 98221-0547 ,, a� Expire date: 01/18/2023 (360) 293-1901 Job Address: 2008 10TH ST Permit Type: Mechanical Permit ANACORTES WA 98221-1422 Project: APN: P56124 Remarks: INSTALL A HEAT PUMP. Owner: VICKIE NEUPERT Contractor: FOSS HEATING AND COOLING Address: 2008 10TH ST Address: 333 E BLACKBURN RD ANACORTES WA 98221-1422 MOUNT VERNON WA 98273-9006 Phone: (360) 899-5251 Phone: (360) 336-1517 License #: General information: Fees: # of Heat Pumps <= 3 Hp 1 Mechanical Permit Fees 38.20 Total Calculated: 38.20 Deposits/Receipts: 0.00 Total Due: 38.20 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 exthis application and know the same to be true and correct. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUE Y F Y PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT 94, PLUMBING & MECHANICAL PERMIT APPLICATION ,. • Mailing Address:P.O. Box 547, Anacortes, WA 98221 Nic0 Office Location: 904 6th Street, Anacortes WA 98821 Phone: (360) 293-1901 PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS PROJECT ADDRESS(Street,Suite#): PARCEL(S)#: PROJECT VALUATION: 2 oa g 10 ri, sr P 56 iz y pi 578:y Subdivision/Lot#: RESIDENTIAL COMMERCIAL 0 APPLICANT: Phone: R 6S g Ar,VG AN) cCo o vC (3607 336--151 7 Address(Street,City,State,Zip): Email Address: 331r BL4cKRc'k/" RQ STr: A /'I T v(,fN4 t wA 41$z73 CrderstDoss' eu4,:71, c on PROPERTY OWNER: Phone: ViOW: AIR/PEW r f360)5/j 5251 Address(Street,City,State,Zip): Email Address: 2cog 1674 St-, AN4co.ra tV4' 9g22/ vneuper+ Icrear , COP) CONTACT PERSON: Phone: I AND/ 4 ySSEt (366)3 ,-l 517 Address(Street,City,State,Zip): Email Address: 333 F PLACif Buie'if RD, ST E .4 .MT. V EifroAl ►✓A Y 79 orders' ®'f0SSf t V/ r C6" CONTRACTOR:* Phone: sa--C ,1PPLw24'r Address(Street,City,State,Zip): Email Address: *All Contractors&subcontractors must have a valid City of Professional License#: Exp.Date: r©ssyCT Anacortes business license prior to doing work in the City. g3 61 rate Business License#:: Exp.Date: Contact the City's Finance Department at(360)299-1968. 022.3e 43i 5/30/z4 Is this work,associated with another project? Yes 0 No/Da If yes,specify: PROPOSED WORK: I N5TALaf'v' H ,Ar- fc)t 14 P, I declare under penalty of perjury that the information I have provided on this form/application is true,correct,and complete,and that I am the property owner or duly authorized agent of the property owner to submit a permit application to the City of Anacortes. Print Name: ,4 it/DR FL✓ J v5$j L,L Owner 0 Agent (specify): TOSS Signature: Date: 7/22/2 t MECHANICAL: Equipment Type: Appliance/Equipment Information(new and relocated): Total#: Furnace: Gas#: Elec#: Other#: Location(s): 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: PLUMBING FIXTURES: 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 0 Wall 0 Grease Interceptor: Other: Other: TOTAL PLUMBING FIXTURES: