HomeMy WebLinkAboutBLD-2021-0715 - PLUMBING AND ELECTRIC WATER Invoice/Permit ;"1: BLD-2021-0715
904 61h Street appvDed date: 08/23/2021
P.O.Box 547 Issue date: 08/23/2021
Anacortes, WA 98221-0547
Y 1691
Expire date: 02/19/2023
t
(360) 293-1901
Job Address: 1102 12TH ST Permit Type: Plumbing Permit
ANACORTES WA 98221-2104 Project:
APN: P55259
Remarks: REPAIR 1" WATER MAIN AND THREE 3/4" BUILDING SUPPLIES.
Owner: THIRD STEVENSON PROP CORP Contractor: BARRON HEATING & A C
Address: PO BOX 711 Address: 5100 PACIFIC HVVY
DALLAS TX 75221-0711 FERNDALE WA 98248-9080
Phone: Phone: (360) 676-1131
License #:
General Information: Fees:
# of Water Piping 1 Plumbing Permit Fee 27.00
Total Calculated: 27.00
Deposits/Receipts: 0.00
Total Due: 27.00
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 ISSUED
CA-0 Y. 0 PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
i IMP, PLUMBING & MECHANICAL PERMIT APPLICATION
it 7' w� Mailing Address: P.O. Box 547, Anacortes, WA 9E221
`- CoS Office Location: 904 6`1 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:
11 Oa I a `' S.re,e_ A naccc4-e.S P S 5 259
Subdivision/Lot#: RESIDENTIAL ❑ COMMERCIAL D
APPLICANT: Phone:
BoXcon 1-lea-1;ng 3too -l07 lc- I 131
Address(Street,City,State,Zip): Email Address:
Slbo Pac:Ac 1-likg &v Fefrlaale (OA ggaug .SdcyF. eel:gran thaAinq.CcM
PROPERTY OWNER. Phone:
EMugfncy Ma.n atnonce Sclu�k;onS 570- -130 -7 7 to 0
Address(Street,City,State,Zip): Email Address:
(00 144„n Air l-lou k , P14 I ' S tJi.t)IL1& a wt secvicQS-a)cp•Cowl
CONTACT PERSON: Phone:
Bo cWn (-l034m 3b0 -(97 to• ( I 3
Address(Street,City,Sta't6,Zip): Email Address:
Try F®6occonlviAl•Covl
CONTRACTOR:* Phone:
Barron 1-k oii Act
Address(Street,City,Sta ,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. UMW HA 17 9 01 to/P31 90a 1
Is this work,associated with another project? Yes ❑ No MI If yes, specify:
PROPOSED WORK: Cu GonGre4C, exAcS repair it I/1140:tr ivieln cvna 'fee 3/1/1' bNi Will
s uccUes.
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: oc crewel" Owner 0 Agent . (specify): sa,Cofl
Signature: Date: $"I a3 i 9O19 I
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:WaU( M4v A #: , Location(s): 3
TOTAL MECHANICAL OUTLETS:
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 ❑ 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: