HomeMy WebLinkAboutPermit File BLD-2022-0504 520 4th Street Q ' City of Anacortes Invoice/Permit#: BLD-2022-0504
904 6th Street
Applied date: 06/28/2022
P.O.Box 547
,4 Issue date: 06/28/2022
< ! 1 Anacortes, WA 98221-0547 Expire date: 12/25/2023
00 (360) 293-1901
Job Address: 520 4TH ST Permit Type: Mechanical Permit
ANACORTES WA98221-1612 Project:
APN: P56504
Remarks: Install a 30K btu heat pump with 3 heads. Owner: 360-941-7148.
Owner: PAUL AND LAURASPEHAR Contractor: ISLAND DUCTLESS HEAT PUMPS
Address: 520 4TH ST Address: PO BOX 88
ANACORTES WA 98221-1612 FREELAND WA 98249-0088
Phone: Phone: (360)321-4252
License#:
General Information: Fees:
#of Heat Pumps—3 Hp 1 Mechanical Permit Fees 38.20
Total Calculated: 38.20
Deposits/Receipts: 0.00
Total Due: 38.20
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 ex i ed thi application and know the same to
be true and correct.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUE
y O PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
Mailing Address: P.O. Box 547, Anacortes, WA 98221
Office Location: 904 61h Street, Anacortes WA 98821
� �, Phone: 360 293-1901
t )
PLUMBING & MECHANICAL PERMIT APPLICATION
Please complete all applicable information and submit to buildingpermit@cityofanacortes.org
PROPERTY`INFORMATION
PROJECT ADDRESS ASSESSORS PARCEL NUMBER
PROJECT VALUATION
RESIDENTIAL COMMERCIAL
PROPERTY OWNER OWNER PHONE
OWNER ADDRESS OWNER EMAIL
APPLICANT INFORMATION
PROPERTY OWNER CONTRACTOR F—IOTHER:
NAME PHONE
ADDRESS EMAIL
CONTRACTOR INFORMATION
NAME PHONE
CONTRACTOR'S BUSINESS LICENSES* STATE LICENSE# EXPIRATION
*All Contractors & Subcontractors must have a valid
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:
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? YES NO
If YES, provide the permit/application number:
Plumbing/Mechanical Permit Application
Updated December 2021 Page 1 of 3
APPLIANCE/EQUIPMENT INFORMATION(NEW AND RELOCATED)
EQUIPMENT TYPE Indicate the number of fixtures for each equipment type TOTAL
ELECTRIC OTHER-Please specify COMMENT
Furnace
Wall Heater
Water Heater
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
PLUMBING:FIXTURES _.
Mitt It
TYPE(NEIW AND REC ED) 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:QFloor 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
r f
rbMMERCIAL RESIDENTIAL
..
m M Q
MI r gUtREMENTS _ c z cIn
Plumbing&Mechanical Permit Application ✓ ✓ . ✓
Mechanical Plans ✓
Structural Calculations ✓
State Non-Residential Energy Code Compliance Form ✓
Manufacturer's Specifications/Cut Sheets ✓ ✓ ✓
Plumbing Plans ve
Listed&Tested Fire Stopping Assemblies ✓
Elevation View for Roof Mounted Equipment ✓ ✓
Existing Floor Plan t� ✓ ✓>
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.
A I I1t 1 FlEt fEMENTS$i;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 hest of m M
nowledge and abilities.
4a.k,L 4�420_� I
SIGNATUR DATE
Plumbing/Mechanical Permit Application
Updated December 2021 Page 3 of 3