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HomeMy WebLinkAboutPermit File BLD-2021-0629 1916 Bay Place r Y Q Cityof A i cortttcs �s � 2 -::_ ilnvoice/E xmit : BLD-2021-0629 904 6th Street App6i"d date: 07/23/2021 P.O.Box 547 issue date: 07/23/2021 Anacortes, WA 98221 -0547 1891 Expire date: 01/19/2023 Job Address: 1916 BAY PL Permit Type: Reroof Single Family Residence ANACORTES WA 98221-2923 Project: APN: P59621 Remarks: INSTALLA CLASS AALUTAINUM METAL ROOF, 56 SQUARES. Owner: GERALD & JENNI NELSON Contractor: INTERLOCK INDUSTRIES INC Address: 1916 BAY PL Address: 26910 92ND AVE STE C5 NW ANACORTES WA 98221-2923 STANWOOD WA 98292 Phone: (360) 490-8822 Phone: (425) 422-0425 License #: General Information: Fees: Occupancy Group it-1 Building Permit Fee 1 ,077.75 Building Valuation 114773 State Building Code Fee Resi 6.50 Total Calculated: 1 ,084.25 Deposits/Receipts: 0.00 Total Due: 1 ,084.25 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 'thin 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 thl,s application and know the same to be true and correct. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY f.�t PLAG, COMMITY, & ECONOMIC DEVELOPMENT DEPARTM T jo rke RE-ROOF PERMIT APPLICATION .\\,........... Mailing Address: P.O. Box 547, Anacortes, WA 98221 4C0 ,..a~ Office Location: 904 6111 Street, Anacortes WA 98821 Phone: (360) 293-1901 PLEASE REFER TO THE RE-ROOF PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS ,f' RESIDENTIAL 0 COMMERCIAL PROJECT ADDRESS(Street,Suite# : PARCEL(s)#: JY/6 : ( P/acC Subdivision/Lot#: PROJECT VALUATION $ / APPLICANT: Phone: //y 7??, / 2 Address(Stree C}ty, State,Zip): ( . 5 ° ` dEmail Address: /659 U) ftlr t A. 0I �, . ice-14 7 Jd c,`Tor►t_ ,6) ;Attlefek re e t PROPERTY OWNER: Phone: Address(Street,City,State,Zip): Wei Email Address: f_ C��fz'( i q /'� Om/O.e .A-a r.�?S. l Address .c e ?' lc CONTACT PERSON: ! Phone: ‹..)i--,,c_ Aht.-/c,-Ke___ v2_5- _ q? __ , q?"---- Address(Street,City, State,Zip)? Email Address: l r3 it/ Fb� /We f1l�z� ,,- . 2 ‘ CONTRACTOR:* ��� �P Phone: i A ReW iF A j 'far `y 2 2. ©t(23— Address(Street,City, State,Zip): Email Address 1 ii 2S cT i o 92 A-t,� A/w/ S1 ide / ,e 29z.._ ,/Gv)'e X°iirAick l F , Contractor's License# Exp. Date: Ce *All Contractors&subcontractors must have a valid City of =)7T. Vet 44 Lc. Anacortes business license prior to doing work in the City. Business License#: Exp.Date: Contact the City's Finance Department at(360)299-1968. PROPOSED WORK: ?e.c* kCie): /7 )t) ' TYPE OF ROOFING: A/vm t.red c .flc* l NUMBER OF LAYERS: I CLASS OF ROOFING: W A 0 B ❑ C NUMBER OF SQUARES: J 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 / r application to the City- off Anacortes. J- 15 L (J Print Name: t/D eclat( . Owner >r Other 0 (specify): WLc<i?Liyeir Signature: � Date: 7 - 2 ^6 ( Page 1 of 2 • 43 . s „, ,,,,,z„,„.,0 STATE OF WASHINGTON BUSINESS LICENSING SERVICE Thank you for filing online Our processing time generally takes up to 10 business days. Some endorsements may take more time for state or city approval. You will receive your business license with approved endorsements in the mail. An updated business license will be mailed to you when additional endorsements are approved. Confirmation Number: 0-020-818-349 Filing Date and Time: 06/23/2021 11:50:56 AM Payment Method: Credit Card ending in 8915 There is a 2.5% credit card convenience fee charged by a third party vendor. Business Entity Information Entity Type: Corporation Name of Entity: INTERLOCK INDUSTRIES, INC. Account ID: 601828920-001-0001 Firm Name: INTERLOCK INDUSTRIES INC. Endorsement(s) Applied For Begin End Count Fee Anacortes General Business - 06/23/2021 06/30/2022 1 $40.00 Non-Resident $40.00 Fee Type Begin End Count Fee BLS Processing Fee 06/23/2021 1 $0.00 $0.00 Third Party Credit Card Fee $1.00 Grand Total: $41.00 • II 'I txL0004