HomeMy WebLinkAboutPermit File 4404 San Juan Avenue (v*L- Lttg of ( to
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BUILDING DEPARTMENT
CERTIFICATE OF OCCUPANCY #_ (57
This is to certify that the (Description/ of Building or Structure)-
Jilti6C6S ��mu 1 Xelcea7)Gc
Located At: 411.041 S JUAV A0bru0
STREET& NUMBER
F
Owner:
Constructed By:-Do a SIt v`42
OWNER OR CONTRACTOR, '
Bldg. Permit # 4✓J5t7 Date Of Issue:: �`1/�
Occ. Group: /2�3, 1,1 Use Zone: g'^
Has Been Inspected And Occupancy Is Hereby Authorized,
This `° N Day Of lir-=i!`� 9 SC
14
A HORIZING OFFICIAL
' SEE REVERSE SIDE FOR SPECIAL REQUIREMENTS.
Innain
. CITY OF ANACORTES
BLDG. 0 PLUMBING 0 MECHANICAL q
PERMIT :`41'.. O$#t
`'.ANACORTEES,$W173 ASH. DATE44WAIV 2 19 Z
h PERMISSION IS HEREBY GRANTED TO:
.OWNER J7f I ) 4alfi4 Mi.
ADDRESS 1'4o' SAil JUAu AdJe
LOCATION WHERE WORK IS TO BE DONE 2
I
CONTRACTOR LEMi Ise-`/ rdepL.als
TO ERECT 0 INSTALL i OR REPAIR 0
IN THE FOLLOWING MANNER: A races J &VVOIAfl c d lots
PERMIT EXPIRES ONE YEAR FROM DATE ISSUED
PLANS FOR CONSTRUCTION WERE NOT reSUBMITTED
WERE ❑
WORK TO BE DONE BY OWNER 0 CONTRACTOR X'
§ RECEIPT OF FEES IS ACKNOWLEDGED AS FOLLOWS:
TYPE APPROXIMATEORK VALUE PERMIT FEES
B OF W
ISSUING -I p QJ 4
BUILDING -I-- .
GAS PIPING In Ell
PLUMBING AND W.S. -I--
SEWER CONNECTION INSP. -� �1—
iiil
MECHANICAL rm
PLAN CHECK FEE -I--
I MISC. -_III
1
TOTAL ipm
ova a /j E
LEGAL DESCRIPTION - .t A 0 -000- - cxl
9
i
CITY INSPECTOR -
rf
CITY OF ANACORTES
BLDG. I, PLUMBING EE( MECHANICAL 171
b PERMIT N 4514
e Telephone293-5173 !`�[yf "
€ ANACORTES, WASH. DATE ' °7 /t, 19#S S j
hi PERMISSION}�IS HEREBY GRANTED TO: 1
B OWNER .. d2XX1 c;.+Jc utSu2)- 1
STREET
.. ADDRESS 4/tU L/ .--44/ ju4s rs —
LOCATION WHERE WORK IS TO BE DONE
CONTRACTOR L.,kb, J!c te .T
TO ERECT 13: INSTALL 0 OR REPAIR ❑�p
N/
IN yyTHE FOLLOWING MANNER: .?/4 Lei J. r ,Ye: Oka ;Y6A .S
�'q ,/ . it lir7 I : w ,t
i. G4 i. f /.4:iw
11Lvr j -..« - , ,5 i./= 7 Ltd. . . 9.
PERMIT EXPIRES ONE YEAR FROM DATE ISSUED .
c PLANS FOR CONSTRUCTION WERE
WERE NOT ❑❑ SUBMITTED
WORK TO BE DONE BY OWNER 0 CONTRACTOR ❑
I RECEIPT OF FEES IS ACKNOWLEDGED AS FOLLOWS:
4 APPROXIMATE VALUE
i TYPE OF WORK PERMIT FEES
r , it
F ISSUING /? o/
t BUILDING y.p 'A / ad lW J"
GAS PIPING . co
E PLUMBING AND W.S. d:,/ij O'7
f SEWER CONNECTION INSP. !— a 7
I MECHANICAL /6" U,)
PLAN CHECK FEED u 0
MISC.
rTOTAL `,. ? y`i 'a . $./ o u
LEGAL DESCRIPTION 414//O -- -°g%'604'
f'
Ci..-- 7".1--zr
t, ' z,
a ga'
CITY OF AN4CORTES
BLDG. Alt PLUMBINGD MECHANICAL ❑
- PERMIT r°N2 f 173
elephone
Ammonia,WA3,90, Date /8 AD r ,�'+Y
PERMISSION IS HEREBY GRANTED TO:
l OWNER ,r'tt{ 64I'/n•
STREET / '/
ADDRESS 3/40 Y 54r .?`~—
Location whete]work-is to be done
/
CONTRACTOR_7�e 1.at day. Op {
TO ERECT X INSTALL ❑ OR REPAIR ❑
IN THE FOLLOWING MANNER:
PERMIT EXPIRES ONE YEAR FROM DATE ISSUED
PLANS FOR CONSTRUCTION WERE NOT ❑ SUBMITTED
WERE fly,'
WORK TO BE DONE BY OWNER ❑ CONTRACTOR Jr
./
RECEIPT OF FEES IS ACKNOWLEDGED AS FOLLOWS: f
TYPE APIT K AwE PERMIT"St
State Building Code Surcharge r�
State Energy Study Surcharge
Building
Plumbing and W.S.
Mechanical
Plan Check Fee ' ' I
,i
is
faeS
w.l _ -P
TOTAL L . j,4ja
LEGAL DESCRIPTION 'Asti ,is
CITY It . ,
•
Nn�e.; MUST BE FILLED OUni' AND RETURNED TO BUILDING DEPARTMENT BEFORCOCCUPANCY>
—CAUTION —
This card must be posted in a conspicuous place on the premises.
INSULATION CERTIFICATION
THIS IS TO CERTIFY THAT, IN CONFORMANCE WITH THE CURRENT THERMAL PERFORMANCE STANDARDS (REVISED CODE
OF WASHINGTON, TITLE 19.27,_STATE OF WASHINGTON*) AND APPROVED PLANS, INSULATION HAS BEEN INSTALLED IN
THE BUILDING LOCATED AT: y. /
ADDRESS OF PROPERTY BLDG. P MIT NO. 5
I
Vapor barrier at 4 mil polyethylene or equivalent must be installed in crawl space.
Weatherstriping, caulking, gasketing and/or other treatment to prevent air leakage must be installed around all exterior openings.
i
ROOFS ll
Type of Material Manufacturer Thickness R Value"
(Or trade name)
EXTERIOR WALLS n / ���
Type of Material S<-< �/ Manufacturer /^lx<'-e"./ ` "5-I_ti.-_c-i- Thickness L- R Value*` �i
(Or trade name)" �l
CEILINGS '
BATTS: 7 �i .
Type of Material 'Li ( Manufacturer O'vr>, �i�-c,.-,--y Thickness /1 R Value*" / j_ ('
(Or trade name)
Sq. Ft. Covered
BLOWN:
Type of Material Manufacturer Thickness No. Bags I
(Or trade name)
Wt./Bag Sq. Ft. Covered R Value** ,
FLOORS 7 -7lj .7
Type of Material rrs�3-:-4'��( C�-:.r( Manufacturer r2=Le-P r`:;� -r-c-� Thickness ,J R Value" I ��
(Or trade name) 'r
SLAB ON GRADE
Type of Material Manufacturer Thickness R Value**
(Or trade name)
Width of Insulation Inches
FOUNDATION WALLS (if required)
Type of Material Manufacturer Thickness R Value"* ii
(Or trade name)
DUCT AND/OR PIPE INSULATION •
Type of Material Manufacturer Thickness R Value*" .
)
General Contractor (Builder) r /v-/ , / t `C.' ' S Contractor's Registration Number
/ X r--
By Title _ Date // - .S — c
//
Sub-contractor (Insulation Applicator)/r-:*-e-/"_-r "? t"-c' Contractor's Registration Number
(Insulation, Masonry, etc.) (State"SAME,/ if same General Contractor)
By Title ��"-(4 (I�_ `^_ ./� Date %�`_ � �7 `/
--
`Revised Code of Washington - Thermal Performance Standards, declares: Upon completion of the installation of insulation, a card certifying
that the insulation has been installed in conformance with the requirements of this 1977 amendatory act shall be completed and signed by the
builder or insulation applicator. For this purpose, any certification card which contains all the essential data may be used. The insulation l
compliance card shall indicate the "R" value of insulation (material only) installed in the ceilings, walls, floors, on the perimeter, and ducts. II
When loose fill insulation is used the card shall show the square footage and the number and weight of bags installed to obtain the"R"value
listed.The card must be posted at a conspicuous location within the building and will indicate the installation date.
"•R Value (thermal resistance) means the measure from the resistance of a material or building component to the passage of heat.The resistance
value (R) of mass type insulation shall be for the material only."R"values shall be as listed in the current ASHRAE Handbook of Fundamentals,
or as tested in accordance with current applicable standards.
No certification of occupancy or similar certification that a newly constructed apartment house three stories or less in height, home, or other
residential dwelling is habitable shall be issued by such a building department unless the structure at least satisfies the minimum energy insulation
standards established pursuant to this chapter.
BVB i
SANITRY SEWER H9K-UPS - •
DATE: ---3i=f3-a TIME: : _ ��
LOCATION: - - Ln rC,� �� ' �ir 'Zitrift�
RECEIPT NO. - .i-/-L -- -
OWNER: - -31U - - -
CONTRACTOR: Z7iSi� �""" . �5'
INSPECTED BY: rfl
COMMENTS -- - - * i ADil�`
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For Inspections Call CITY OF ANACORTES P. 0. Box 547
293-.19( 1 (fl BUILDING DEPARTMENT (-) 904-6th Street
24 Hrs. Notice Requested PERMIT APPLICATION Anacoxtes, WA 92221
Name (or Name of Business) APPLICANT artne1E THIS FORM WITHIN HEAVY LI E2 FUR'WORK
/721077� /�'_�ei WHICH THIS PERM FT WILL.BE APPLICARTR.
Mailing Address Cl.(
citycity4/kip Y
" l4 S T Telephone Number
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3PIIP92NG
No. water Type of Fixture or Item
3
$ FEE
��„! n S Bathtub
oset Clbilet)
Name .
Lavatory (Wash Basin)
Address
Shower
Kitchen Sink 6 D1sp.
•
City Telephone Niger Oistwasher
Laundry Tray
Name Clothes Washer
T l i �T7T7 7/Z�h r of 5 Water
/ �
Heater
Address
U c3 Z. 7 k S ' . Drinking FUmtain
/�/��� �/�, Floor - Sink or Drain
��/ " I01 C 0 i "'S Telephone— 3 .slop sink
State License Ember
1�,b /Z 0 r 1) Water Piping & Treating Equip.
tT/7��- < Waste Interoapbh
Residential Demlish Plaiting Vacuum Breakers
cUmercial Fearing Mechanical
Lawn Sprinkler Systea
Non-Comerctal Spa/Pool Add
A Alter Sign Repair .
PERM FT $
Legal Description of Property (Show Bela/ or Attach Four Copies) TOTAL FEE $
Lot Block of. Em7AEIICAL FAT. OAS on. LPG WE.
Type of Equipment FEE
Air Cold. Units - H.P. Ea. $
Refrigeration Units - H.E. ea.
Boilers - H.P. Ea.
Nature of W7or�k i /J Gas Flee A.C. Units - %image Ea.
' ) BUJ n �� Ti n�P `1 Forced Air Systems - B.T.O. HER.
7'T}`'[lt Silt' rpri . Uhl'Gravity ters - - B.T.U. M Pa.
Proposed F Wall Heaters - B.T.O. M
Use Unit Heaters - B.T.O. M
Evaporative Coolers
NCTICE Clothes Dryers .
This permit becomes null and void if uork or construction authorized is . Ventilation Fan
not ounennced within 180 days, or if construction or work is suspended
or abandoned for a period of 180 days at any time after work is con- Range Hood - Coml.
reamed. I hereby certify that I have read and e,eninned this applica-, Air Handling Unit • C.F.M.
tion and )mow the sane to be true and correct. All provisions of laws Incinerator
and ordinances governing this type of Mork will be emptied with
whether specified herein or not, the granting of a permit does not pre- Gas Piping
sure to give authority to violate or cancel the provisions of any other
state or local law regulating construction or the performance of con- Tanks
structim. z�tG/�/.! /T`///
Roan Heaters - Wood Stoves
Ciii ort1 /7' '_o"�_ Agent g
. NOTE: PER OT LIMI' CNE YEAR (Except DFDVLITIC16 AND MDVIKG PERMITS - I�
which shall be oanpleted in sixty days.) PELMET $
TOTAL FFE $
Side Yard Setback Street Set ark Rear Yard Setback APPROXIMATE
Lt. Rt. • woeVALUE PEIitAT FEES
Use Tone lot Area Vacant Site Issuing
Yes No Building 0
Type of Coast. Occupancy Group No. of Dwelling Units
Gas Piping
Size of Bldg. Sg.Ft. Carport • wax. Hoc. load Planting 8 W.S. •
D`
3rd Sewer Conn. Insp. CJJ
2nd Garage Fire Sprinklers Feq'd. Mechanical II
1st _Yes No
LI
Basement Fire Place/Insert mod Stove • Plan Check Fee
Deck �t,a c.f. 1 oz� �` , /8
State
8 Cbdel=arge gnu
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OFFICE COPY
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