HomeMy WebLinkAboutPermit File BLD-2021-0823 3952 Rock Ridge Parkway 0 C Dt Sl� of Anacortes .r,.o
Invoice/Permit sre BL®-20211-0623
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� • ,� ��`_� 904 6th Street
- Applied date: 10/06/2021
P.O.Box 547 Issue date: 10/06/2021
_' 0,. Anacortes, WA 98221-0547
'�t " lB9t Expire date: 04/04./2023
Job Address: 3952 ROCK RIDGE PKWY Permit Type: Irrigation Permit
ANACORTES WA 98221 Project:
APNN:
Remarks: INSTALL AN IRRIGATION SYSTEM WITH BACKFLOW DEVICE.
Owner: BRIAN & HELEN WORTHINGTON Contractor: SALAZAR'S ALL SEASONS LDSN LLC
Address: 2520 BERENTSON CT Address: 1121 WEST DIVISION ST
ANACORTES WA 98221-4517 MOUNT VERNON WA 98273
Phone: (206) 612-8813 Phone: (360) 661-1471
License #:
General Information: Fees:
# of Backflow Devices 1 Plumbing Permit Fee 34.00
# of Water Piping 1 Total Calculated: 34.00
Deposits/Receipts: 0.00
Total Due: 34.00
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
V't Y 0 PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
` ,, PLUMBING & MECHANICAL PERMIT APPLICATION
,74 Mailing Address: P.O. Box 547,Anacortes, WA 98221
.?c0V 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:
Subdivision/Lot
RESIDENTIAL Ja' COMMERCIAL ❑
APPL CANT: Phone:// ,
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Address(Street,City,State,Zip): Email Addres :
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PROPERTY OWNER: Phone:
Address(Street,City,State,Zip): Email Address:
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CONTACT PERSON: Phone:
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Address(Street,City,State,Zip): Email Address:
CONTRACTOR:* `/ / Phone:
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Address(Street,City,State,Zip): j Email Address:
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*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. . Lll 2A S '7130,f a /20-1, s
Is this work,associated with another project? Yes 0 No,12( If yes, specify:
PROPOSED WORK:
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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/c/a 4 7ie// Owner e Agent ❑ (specify):
Signature: i.. Date: /1)7, 4,.1"._ /