HomeMy WebLinkAboutPermit File BLD-2022-0569 4701 Queen Ann Way City of Anacortes Invoice/Permit#: BLD-2022-0569
904 6th Street
Applied date: 07/19/2022
_ P.O.Box 547 Issue date: 07/19/2022
Anacortes, WA 98221-0547
Expire date: 01/15/2024
Job Address: 4701 QUEEN ANN WAY Permit Type: Reroof Single Family Residence
ANACORTES WA 98221-3213 Project:
APN: P59233
Remarks: Reroof,41 squares.
Owner: DARRELL&TERESA MCCARROLL Contractor: MOUNT BAKER ROOFING
Address: 4701 QUEEN ANN WAY Address: PO BOX 31100
ANACORTES WA 98221-3213 BELLINGHAM WA 98226
Phone: (360)840-4108 Phone: (360)733-0191
License#:
General Information: Fees:
Occupancy Group it-1 Building Permit Fee 279.25
Building Valuation 16615 State Building Code Fee Resi 6.50
Total Calculated: 285.75
Deposits/Receipts: 0.00
Total Due: 285.75
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 e e this application and know the same to
be true and correct.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISS
G� o PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
RE-ROOF PERMIT APPLICATION
�� r�. Mailing Address:P.O. Box 547, Anacortes, WA 98221
Office Location: 904 6h Street, Anacortes WA 98821
Phone: (360) 293-1901
PLEASE REFER TO THE RE ROOF PERMIT CHECKLIST FOR SUBMITTAL REQ UIREMENTS
RESIDENTIAL ❑ COMMERCIAL
PROJECT ADDRESS Street Suite#): PARCEL(s)#: P59233
4701 QUEEN ANN WAS(
Subdivision/Lot#: PROJECT VALUATION$
$16,615
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:
DARREL & TERESA MCCARROLL 360.840.4108
Address(Street, City, State,Zip): Email Address:
same as promect address tsmcarrollagmail.corn
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
*All Contractors& subcontractors must have a valid City of Contractor's License# Exp.Date: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 02/2023
PROPOSED WORK:
TYPE OF ROOFING: REROOF NUMBER OF LAYERS: 1
CLASS OF ROOFING: ❑ A ❑ B ❑ C NUMBER OF SQUARES: 41
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: Wendy Rodriguez Owner P Other P (specify): Employee MB
Signature: Wendy Rodriguez Date: 06/30/2022
Page 1 of 2
Gti o� PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
RE-ROOF PERMIT CHECKLIST
�� �w�. Mailing Address:P.O. Box 547, Anacortes, WA 98221
0W Office Location: 904 6th Street, Anacortes WA 98821
Phone: (360) 293-1901
= 9
OCCUPANCY GROUP: ❑ OFFICE ❑ CHURCH ❑ SCHOOL ❑ RETAIL ❑ RESTAURANT
INSTALLING OR REPLACING SHEATHING: 9 YES ❑ NO
WORK SCHEDULED TO BEGIN: J U LY 2022
WORK SCHEDULED TO END: AUGUST 2022
ROOF SQUARE FOOTAGE:
PERMIT TYPE:
SUBMITTAL REQUIREMENTS:
The number indicates the number of 9
04.
copies for submittal(if applicable).
...
°o -oti
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.
Page 2 of 2