HomeMy WebLinkAboutPermit File BLD-2021-0639 4606 San Juan Avenue Y
- ' Cv' y O nacorice llnvouce/P U° uBLD-2021-0639
904 6th Street
appllueol date: 07/27/2021
P.O.Box 547 Dssui date: 07/27/2021
Anacortes, WA 98221-0547
lQ� Expure date: 01i /23/2023
„44+(jam}/ (360) 293-1901
Job Address: 4606 SAN JUAN AVE Permit Type: Mechanical Permit
ANACORTES WA 98221-1122 Project:
APN: P81688
Remarks: REPLACE GAS WATER HEATER IN THE GARAGE FOR THE SAME. Owner: 360-391-4141
Owner: ERICKSON ERIC F Contractor: CPI PLUMBING & HEATING
Address: 4606 SAN JUAN AVE Address: 1900 RAILROAD AVE
ANACORTES WA 98221-1122 MOUNT VERNON WA 98273-4957
Phone: Phone: (360) 428-5636
License #:
General Information: Fees:
# of Gas Water Heaters <= 1001< 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 comme ed-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 n examine this application and know the same to
be true and correct.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY
Ndi�' PLANNING,COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
PLUMBING & MECHANICAL PERMIT APPLICATION
7 Mailing Address: P.O. Box 547,Anacortes, WA 98221
...lco% Once Location: 904 6th Street, Anacortes WA 98821
Phone: (360) 293-1901
PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PR JECT ADDRESS(Street,Suite#): PR�CEL(S)#: . PROJECT VALUATION:
Vit'11(24A Z i,,00
Subdivision/Lot#: RESIDENTIAL l COMMERCIAL 0
AP1PLIC T: Phone.
UAYe% \U'((1)i 11 l)\- a --IAt/5- �v
Address(Street,City,State ip): E nail Address:
-0
1010 cC AC & \ i`1►,I-Q., ESL irt] ,`C ci,Ci3 t.PkU;nb nd 0
PR QpERTY OWNER: Phone:,
c C 6 C:Y"Sb \ tam 3Ck -L\1 L.\\
Address(Street,City,State,Zip): Email Address:
CO ACT PERSON: Phone:
Address treet,City ate,Zip): Email Address:
CONTRACTOR:* Phone:
` ►YV.- CASKIP‘4CA rA
Address(Street,City,State,Zip): Email Address:
*All Contractors&subcontractors must have a valid City of Professional License#: Exp.Date:
Anacortes business license prior to doing work in the City. Business License#: Exp.Date:
Contact the City's Finance Department at(360)299-1968. RL vi•s n --i_15--(.3
Is this work,associated with another project? Yes 0 N7 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 toffy; y of Anacorte -
Print Name: '1,. ', i _ ' ,Al;_ ..Ii Owner 0 Agent specify):
Sigma ib . /F APPI Date:
/ ,
1
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): aebr- ` _
Heat Pump:
Elec#: Other#: Loc i n(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 A
t. flit M PIi'11BIN(; FIXTURES:
Fixture Type(new and relocated): Total#: Fixture Type(new and relocated): Total#:
Water Closet(Toilet): Refrigerator water supply(for water/ice dispenser): 1
Kitchen Sink: Pressure Reduction Valve/Pressure Regulator:
Utility Sink: Water Service Line:
Tub: Water Piping:
Hand Sink: Clothes Washer:
1
Shower: Electric Water Heater: Tank-less? Yes 0 No ❑
Dishwasher: I 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