HomeMy WebLinkAboutPermit File BLD-2022-0347 4910 Macbeth Drive (2) Gl � PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
Mailing Address: P.O. Box 547, Anacortes, WA 98221
Office Location: 904 6th Street, Anacortes WA 98821
M $' Phone: (360) 293-1901
PLUMBING & MECHANICAL PERMIT APPLICATION
Please complete all applicable information and submit to buildingpermit@cityofanacortes.org
PROPERTY INFORMATION
PROJECT ADDRESS ASSESSORS PARCEL NUMBER
4910 Macbeth Drive P59782
PROJECT VALUATION
n RESIDENTIAL n COMMERCIAL
PROPERTY OWNER OWNER PHONE
Dennis Shay 360-588-9840
OWNER ADDRESS OWNER EMAIL
4910 Macbeth Drive djxshay@gmail.com
APPLICANT INFORMATION
(PROPERTY OWNER pi CONTRACTOR pi OTHER:
NAME PHONE
Sarah Eckenrode _ 360-428-5636
ADDRESS EMAIL
1900 Railroad Avenue Mount Vernon WA office@cpiplumbing.com
CONTRACTOR INFORMATION
NAME PHONE
CPI Plumbing & Heating _ 360-428-5636
CONTRACTOR'S BUSINESS LICENSES* STATE LICENSE# EXPIRATION
*AII Contractors & Subcontractors must have a valid CPIPLPH791 NB 7/20/23
City of Anacortes business license prior to doing work UBI LICENSE# EXPIRATION
in the City.
ADDRESS(STREET,CITY,STATE,ZIP) EMAIL
PROJECT INFORMATION
DESCRIPTION OF PROPOSED WORK:
Replacement of electric water heater
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? YES X NO
If YES,provide the permit/application number:
Plumbing/Mechanical Permit Application
Updated December 2021 Page 1 of 3
MECHANICAL
APPLIANCE/EQUIPMENT INFORMATION (NEW AND RELOCATED)
EQUIPMENT TYPE Indicate the number of fixtures for each equipment type TOTAL
GAS ELECTRIC OTHER-Please specify COMMENT
Furnace
Wall Heater
Water Heater 1 1
Heat Pump
Air Conditioner/Handler
Radiant/Hydronic Heating
Exhaust Fans
Range Hood
Fireplace
Clothes Dryer& Duct
Stove/Range/Oven
Refrigeration Unit
Gas Piping/Outlet(s)
Boiler BTUs:
Other
TOTAL MECHANICAL OUTLETS 1
PLUMBING FIXTURES
FIXTURE TYPE(NEW AND RELOCATED) TOTAL FIXTURE TYPE(NEW AND RELOCATED) TOTAL
Toilets Refrigerator water supply
Kitchen Sink Pressure Reduction Valve/Regulator
Utility Sink Water Service Line
Tub Water Piping
Hand Sink Washing Machine
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 Grease Interceptor
Other-please specify:
TOTAL PLUMBING FIXTURES
Plumbing/Mechanical Permit Application
Updated December 2021 Page 2 of 3
PLUMBING & MECHANICAL PERMIT APPLICATION CHECKLIST
COMMERCIAL RESIDENTIAL
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0 SUBMITTAL REQUIREMENTS D C D C
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Plumbing& Mechanical Permit Application ✓ ✓ ✓ ✓
Mechanical Plans ✓
Structural Calculations ✓
State Non-Residential Energy Code Compliance Form ✓
Manufacturer's Specifications/Cut Sheets ✓ ✓ ✓
Plumbing Plans ✓
Listed &Tested Fire Stopping Assemblies ✓
Elevation View for Roof Mounted Equipment ✓ ✓
Existing Floor Plan ✓ ✓ ✓ ✓
New Floor Plan ✓ ✓ ✓ ✓
NOTE:
1. Handouts and standard details may be found on the City's Planning, Community, & Economic
Development website or can be obtained at city hall during normal business hours.
2. Plans, calculation, & reports prepared by state licensed architects or professional engineers must
be stamped and signed by the design professional.
3. If installing a backflow prevention device, it will need to pass test results of which will need to be
submitted to the city for review.
ACKNOWLEDGEMENTS & SIGNATURE
By affixing my signature hereto, I certify that I am the owner,or am acting as the Owner's authorized
agent, and that the application and documents contained with this submittal are complete and
accurate to the best of my knowledge and abilities.
Digitally signed by Sarah Eckenrode
Sarah Eckenrode D ou,N:ecnmai=Sl Sarahrah@ Eckenrodecpi ,oplumbi=nCg PIco Plumbingm,cUS1&Heating, 5/11/1^^
Date:2022.05.11 09:26:39-07'00'
SIGNATURE DATE
Plumbing/Mechanical Permit Application
Updated December 2021 Page 3 of 3