HomeMy WebLinkAboutPermit File BLD-2021-0689 2016 10th Street ►- 0 _ Cityof Anacortes
_ Invoice/Permit #: BLD-2021-0689
904 6th Street
Applied date: 08/16/2021
P.O.Box 547 Issue date: 08/16/2021
0 Anacortes, WA 98221-0547
le 9E Expire date: 02/12/2023
.- (360) 293-1901
Job Address: 2016 10TH ST Permit Type: Mechanical Permit
ANACORTES WA 98221-1422 Project:
APN: P56122
Remarks: INSTALLATANKLESS GAS WATER HEATER.
Owner: ANDRICH BRET Contractor: BARRON HEATING & A C
Address: 2016 10TH ST Address: 5100 PACIFIC HVVY
ANACORTES WA 98221-1422 FERNDALE WA 98248-9080
Phone: Phone: (360) 676-1131
License #:
General Information: Fees:
# of Tankless Water Heaters 1 Mechanical Permit Fees 50.65
Total Calculated: 50.65
Deposits/Receipts: 0.00
Total Due: 50.65
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 examined this application and know the same to
be true and correct.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSU•
1. 1 5' o PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
i PLUMBING & MECHANICAL PERMIT APPLICATION
4 Mailing Address: P.O. Box 547, Anacortes, WA 98221
q ,,
,. 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:
(9OI6 /O s-i• Ay)o, c—ks P5-6(d,a
Subdivision/Lot#: RESIDENTIAL N COMMERCIAL ❑
AP ICANT: Phone:
a'aov) Heav4in 3po 67�' 1/3)
Address(Street,City,State,Zi ): Emai Address•
VA
PC .c f-Pi c o wry �S'��la� DISII U'A b04/0 1 G j Y O//W� NE�R/:, Phone: ,W)
1nC�►it C VJ _
Address(Street,City,State,Zip): Email Address:
o I o- 6-1-
CON CT PERSON: Phone:
" cf Iron 3 6o 6-76 )I3)
Address(Street,City,State,Zip): Email Address:
06 11 10.90(0AbOYIKDOVIArr4Thc3 CaW)
CONTRAC � ';* 'COO �� �1 Phone:
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. Bu iness License#: Exp.Date:
Contact the City's Finance Department at(360)299-1968. Kra t e 1-19 J-7 io/ 3/a
Is this work,associated with another project? Yes El No 0 If yes,specify: a
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 to the City off Anacortes.�
Print Name: 1��`-.."IC -.1 Owner ❑ Agent `1 (specify): ]OvirOY)
Signature: Date: ) ii 3/(&1 ; �1
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: #: 1 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):
w
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: