HomeMy WebLinkAboutPermit File BLD-2022-0021 4505 Blakely Drive G� ' o PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
A RE-ROOF PERMIT APPLICATION
k\tr47. Mailing Address:P.O. Box 547, Anacortes, WA 98221
cow Office Location: 904 6th Street, Anacortes WA 98821
Phone: (360) 293-1901
PLEASE REFER TO THE RE-ROOF PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
0 RESIDENTIAL ❑ COMMERCIAL
PROJECT ADDRESS(Street,Suite#): PARCEL(s)#:
4505 Blakely Dr, Anacortes, WA, 98221 P111887
Subdivision/Lot#: PROJECT VALUATION$
$9,621.00
APPLICANT: Phone:
Mt. Baker Roofing Inc 360.733.0191
Address(Street,City,State,Zip): Email Address:
PO Box 31100, Bellingham, WA, 98228 info@mtbakerroofing.com
PROPERTY OWNER: Phone:
James (Jim) Smith 360.770.3020
Address(Street,City,State,Zip): Email Address:
same as project address jimbarbs5@comcast.net
CONTACT PERSON: Phone:
Address(Street,City,State,Zip): Email Address:
CONTRACTOR:* Phone:
Mt. Baker Roofing Inc 360.733.0191
Address(Street,City, State,Zip): Email Address
PO Box 31100, Bellingham, WA, 98228 info@mtbakerroofing.com
Contractor's License# Exp.Date:
*All Contractors& subcontractors must have a valid City of MTBAKR1055ML 05/2022
Anacortes business license prior to doing work in the City. Business License#: Exp.Date:
Contact the City's Finance Department at(360)299-1968. 601526326 001 0001 02/2022
PROPOSED WORK: Remove current roofing and replace with 1 layer of new roofing
TYPE OF ROOFING:Composition NUMBER OF LAYERS: 1
CLASS OF ROOFING: ® A ❑ B ❑ C NUMBER OF SQUARES:30
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: Emily King Owner Other ❑ (specify): Employee MBRI
Signature: Emily King Date: 1.19.22
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,AS' O PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
�
I RE-ROOF PERMIT CHECKLIST
�� w7. Mailing Address:P.O. Box 547, Anacortes, WA 98221
7coR: Office Location: 904 6 Street, Anacortes WA 98821
Phone: (360) 293-1901
RE-ROOF:
OCCUPANCY GROUP: ❑ OFFICE ❑ CHURCH ❑ SCHOOL ❑ RETAIL ❑ RESTAURANT
INSTALLING OR REPLACING SHEATHING: ❑ YES 12f NO
WORK SCHEDULED TO BEGIN:January 2022
WORK SCHEDULED TO END:February 2022
ROOF SQUARE FOOTAGE:
PERMIT TYPE:
n 7: O
.0 SUBMITTAL REQUIREMENTS: E a z
n The number indicates the number of P
copies for submittal(if applicable).
—
o `c
. ...
... .,
___..____
Re-Roof Permit Application 1 1
Site Plan 1
Pedestrian Safety Plan 1
Installation Specifications and U.L. Listed Roof Assembly 1
Building Inspection Prior to Work-When Deemed Necessary
Final Inspection&Approval once Re-Roof is Complete-Performed
by City of Anacortes' Building Inspector'
NOTES:
1. The applicant is responsible for providing a method of safely accessing roof for inspection. Please call(360)
293-1901 to schedule an inspection.
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