HomeMy WebLinkAboutPermit File BLD-2021-0675 3902 Rock Ridge Parkway 1 ` 0 _ Cityof Anacortes
Invoice/Permit #: BLD-2021-0675
:_ 904 6th Street
Applied date: 08/10/2021
`"" P.O.Box 547
Issue date: 08/10/2021
,: Anacortes, WA 98221-0547
-';L 3 Expire date: 02/06/2023
:-.._et ± - (360) 293-1901
Job Address: 3902 ROCK RIDGE PKVVY Permit Type: Mechanical Permit
ANACORTES WA 98221-4515 Project:
APN: P125844
Remarks: INSTALL A DUCTLESS HEAT PUMP SYSTEM.
Owner: GARY & BONNIE DEWITT Contractor: FOSS HEATING AND COOLING
Address: 3902 ROCK RIDGE PKWY Address: 333 E BLACKBURN RD
ANACORTES WA 98221-4515 MOUNT VERNON WA 98273-9006
Phone: (360) 202-8709 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 e mined this application and know the same to
be true and correct.
,..........e.......a. i
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY
__Y 0 PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
PLUMBING & MECHANICAL PERMIT APPLICATION
7 Mailing Address:P.O. Box 547, Anacortes, WA 98221
COR. 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:
3 70:2 ROOD R496 f'Kwy r12,53yy $i9,778 ; 61
Subdivision/Lot#:
RESIDENTIAL COMMERCIAL ❑
APPLICANT: Phone:
6=055 1-fr'4 4,vp Gt)o-IVc.3 060).336 -15 7
Address(Street,City,State,Zip): Email Address:
,333 t„', 6tAc::.K6vf41 /O, ST-C, . Air, Vi5,1,4 / UM' `t'3.�73 Qrd CO 055 I)cal',i c.chvt
PROPERTY OWNER: Phone:
Cy•,2Y 6E wi r�r (360) 202.— s 7o�
Address(Street,City,State,Zip): Email Address:
�02 'oCks.RUUGE� fk"Y 11-N4co4)r .s W4 `'j'.21
CONTACT PERSON: Phone:
APP)' /N.3.5 c (36O) 3 36. 1 G/
Address(Street,City,State,Zip): Email Address:
333 C $L4C t;a,,v 40, S r7 A N vC44'ES/1- ia/4 w g;7} O',drl,_.0 -Pc: pa f',veg P c0.�a�►
CONTRACTOR:* Phone: c/
A PPS-,c,iv
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. si ss L ;Q p.i! �-
Contact the City's Finance Department at(360)299-1968. Business License#: Exp.Date:
Gay z 3G 0.41 `I/36/--'
Is this work,associated with another project? Yes ❑ No If yes,specify:
PROPOSED WORK: 1 v r. « 4 bverL-Cif ;'ir,41,
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: A i?-�Civ J, .' +/55.6-7 Owner ❑ Agent fC (specify): i'ss5 r7#r
/dY744r
Signature: Date: 8`'t 0r2
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: I
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 ❑
Dishwasher: Backflow Prevention Device:
Urinal: Hose Bib:
Floor Drain/Floor Sink: Drinking Fountain:
Hydronic Heat in: Floor 0 Wall ❑ Grease Interceptor:
Other: Other:
TOTAL PLUMBING FIXTURES: