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HomeMy WebLinkAboutPermit File BLD-2021-0964 1815 10th Street lnvoicce/"ermit : I L D-20021i =00964 904 6th Street A ppfie©9 date: lil30I2O21 %,:".11111111.1111 . P.O.Box 547 Dssuie date: 11/3©/2021i Anacortes, WA 98221-0547 ;t"`� �$9► 360 293-1901 �xpllr�e date: 5I2 I2r� ) 23 Cr Job Address: 1815 10TH ST Permit Type: Mechanical Permit ANACORTES WA 98221-1417 Project: APN: P56059 Remarks: REPLACE HEAT PUMP AND AIR HANDLER FOR THE SAME . Owner: ERIC & AMANDA BALTAZAR Contractor: FOSS HEATING AND COOLING Address: PO BOX 922 Address: 333 E BLACKBURN RD ANACORTES WA 98221-0922 MOUNT VERNON WA 98273-9006 Phone: (360) 293-5364 Phone: (360) 336-1517 License #: General Information: Fees: # of Heat Pumps <= 3 Hp 1 Mechanical Permit Fees 48.85 # OF AIR HANDLING UNITS <10000 1 Total Calculated: 48.85 Deposits/Receipts: 0.00 Total Due: ._- 48.85 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 comme Witjn 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 an xamined is application and know the same to be true and correct. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISS .,S1 Y 0 PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT Apie i PLUMBING & MECHANICAL PERMIT APPLICATION Mailing Address:P.O. Box 547, Anacortes, WA 98221 \7"kriPrs f';' 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: 1 ciV 5 /0 -117 sr-I., P 56059 1 ff, q 72 ig-7 Subdivision/Lot#: RESIDENTIAL ‘131 COMMERCIAL El APPLICANT: Phone: FOSS i-tEA 774/6 :Val Cd oi-i 416 (.366)3) --15/7 Address(Street,City,State,Zip): Email Address: :33? E. se iiit(eu,(4, (0, S're"A frir, V61,445.4/;1,1,74- y3;17) 0,-dep;c9fasi-fiecL:4,1.7. co„.2 PROPERTY OWNER: Phone: i , ,c 6/4 L TA Z 4 R ( 3 p D)2 7 3 - 5n it Address(Street,City,State,Zip): Email Address: po Gox 7 22- ,it A/44oz rt;--3- km 7322-1 — CONTACT PERSON: Phod: /VP/ (1')Viii:5-e.c (360).13‘— /5 i 7 Address(Street,City,State,Zip): Email Address: 33 3 lE.6i-414'80W RA Sre. A lilr,V.6g/vezpi. WA (4.2-7 3 otele;,5 0-1-85-c 6 cali--7, co;41 CONTRACTOR:* Phone: .. -.-E A l'PLI ci vr Address(Street,City, State,Zip): Email Address: Professional License#: Exp.Date: *All Contractors& subcontractors must have a valid City of F055' 1-1-c" II/V z2-- Anacortes business license prior to doing work in the City. Business License#: Exp.Date: Contact the City's Finance Department at(360)299-1968. °o 2-2 3t 0 3 i Is this work,associated with another project? Yes D No Z If yes,specify: PROPOSED WORK: A 01-46r: 11 rFiA r ev/d fl `i,I,iril 1-11;6--: 1A, k r j mp lot_v.i ,,,ii 41 (OWL Er?", 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: Att/P4-F147 ,j_ iltifia-24. Owner 0 Agent FC] (specify): 1-.2),$;f#4477/4/d. Signature: 4010 drair -- Date: IV 3 61-2( 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): l Air Conditioner/Handler: Elec#: / Other:#: Location(s): f 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: 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 ❑ Wall 0 Grease Interceptor: Other: Other: TOTAL PLUMBING FIXTURES: