HomeMy WebLinkAboutPermit File BLD-2022-0687 1419 10th Street 4 City of Anacortes Invoice/Permit#: BLD-2022-0687
G 904 6th Street
Applied date: 08/29/2022
P.O.Box 547
KAA
Anacortes, WA 98221-0547 Issue date: 08/29/2022
Expire date: 02/25/2024
(360) 293-1901
Job Address: 1419 10TH ST Permit Type: Single Family Interior Only Alteration Permit
ANACORTES WA 98221-1923 Project:
APN: P55732
Remarks: Replace 1 window and 1 entry door. No change to size or structure.
Owner: JUDITH KAROLICK Contractor: THE HOME DEPOT
Address: 1419 10TH ST Address: PO BOX 105451
ANACORTES WA 98221-1923 ATLANTA GA 30348
Phone: (505)470-1115 Phone: (360) 945-2787
License#:
General Information: Fees:
Building Valuation 10985 Building Permit Fee 195.25
Plan Review Fee 126.91
State Building Code Fee Resi 6.50
Total Calculated: 328.66
Deposits/Receipts: 0.00
Total Due: 328.66
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 a his application and know the same to
be true and correct.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY
PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
Mailing Address: P.O. Box 547, Anacortes, WA 98221
c�oR Office Location: 904 61h Street, Anacortes WA 98821
Phone: (360) 293-1901
RESIDENTIAL BUILDING PERMIT APPLICATION
THIS APPLICATION PACKET IS USED FOR THE FOLLOWING PROJECT TYPES:
Single-Family Residences (SFR), Duplexes, Additions & Remodels, Accessory Structures (i.e. garages,
carports), Accessory Dwelling Units, Manufactured Homes, Residential Decks & Retaining Walls, and
Docks& Pilings.
FORM BP-1: RESIDENTIAL BUILDING PERMIT APPLICATION
PROPERTY INFORMATION
PROJECT ADDRESS(STREET,SUITE#) ASSESSOR PARCEL NUMBER
1419 10TH ST P55732
SUBDIVISION/LOT# ZONING LOT AREA(SIZE)
SQ. FT.
TYPE OF PROJECT
NEW ADDITION X REPAIR REMODEL CHANGE OF USE
IX4SFR Duplex ❑Deck/Porch
Accessory Dwelling Unit: ❑Detached ❑Attached ❑Retaining Wall
❑ Manufactured Home ❑Accessory Structure
❑ Shoreline Structure(dock, pilings,floats etc.) * ❑Other:
*If application is for a shoreline structure, please complete the Shoreline Structure Checklist.
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? I YES ✓ NO
f YES, provide the permit/application number:
PROJECT SUMMARY: PROJECT VALUATION
Remove and replace 1 window and 1 entry door. No (Cost of Materials & Labor)
size/structural changes. $ 10985.09
PROPERTY OWNER INFORMATION
NAME PHONE
JUDITH KAROLICK 505-470-1115
ADDRESS(STREET,CITY,STATE,ZIP) EMAILADDRESS
1419 10TH ST, Anacortes WA 98221
CONTRACTOR INFORMATION
NAME* PHONE
Home Depot The 360-945-2787
CONTRACTOR'S BUSINESS LICENSES STATE LICENSE# EXPIRATION
*All Contractors&Subcontractors must have a valid City HOMED**088RH 7/17/22
of Anacortes business license prior to doing work in the UBI# EXPIRATION
City.
601262719
ADDRESS(STREET,CITY,STATE,ZIP) EMAILADDRESS
PO Box 105451, Atlanta GA 30348 naida@nwpermit.com
Page 1 of 17
Res.Building Permit Application Submittal Checklist
Updated April 20,2021
CONTACT PERSON -Select one person the city will contact for anything related to this project:
EC APPLICANT []PROPERTY OWNER []CONTRACTOR ❑OTHER(LIST BELOW)
NAME PHONE
Northwest Permit Inc. 360-945-2787
ADDRESS(STREET,CITY,STATE,ZIP) EMAILADDRESS
1026 SW 151st St, Burien WA 98166 naida@nwpermit.com
LENDER INFORMATION
RCW 19.27.095 requires the City to obtain information with regard to lenders. If there are no lender
involved with your project, write "no lenders"on the Name Line below.
NAME PHONE
ADDRESS(STREET,CITY,STATE,ZIP) EMAILADDRESS
ACKNOWLEDGEMENTS & SIGNATURE
Read and initial each of the following statements prior to signing this application:
NK I understand that when a building permit application is taken in over the counter it does not mean
the application has been deemed technically complete and sufficient for staff review.
NK I understand that if 1 submit incomplete, inaccurate, and/or erroneous information it will take the
City longer to process my permits.
NK I understand and acknowledge that I could be responsible for providing as-built drawings(on paper
or electronically)as part of the project's certificate of occupancy process.
NK I understand and acknowledge that Special Inspections could be required as part of my project, and
if needed 1 will be required to pay for the cost of these inspections.
NK I understand and acknowledge that financial securities could be required as part of the work I am
completing and I agree to provide the items needed for the City to calculate these securities and to
provide the securities themselves.
N K I understand that if permits are reviewed concurrently such as design review, site plan, traffic
concurrency, etc., any required revisions to one permit may affect the entire plan set and could add
costs and time to the project.
I hereby declare that 1 am either the owner of the property listed on this application or the owner of
this property has authorized me to be their representative to act for them. I also declare under penalty
of perjury under the laws of the State of Washington that all of the statements and answers contained
herein, and the information submitted with this application form is in all respects, true, correct, and
complete to the best of knowledge and belief.
ltl)ae 0& Alm 8/29/2022
SIGNATURE DATE
Naida Khan/Northwest Permit Inc.
PRINTED NAME
Res.Building Permit Application Submittal Checklist
Updated December 2021
Page 2 of 17
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CTB HDE-Lynnwood
2902A Lincoln Way
Lynnwood,WA 98087
Quote Name: 11169416 KAROLICK Quote Number: SQPEV1041022_1
Customer: HDE Created Date: 7/29/2022
Payment Terms: Modified Date: 7/29/2022
Sales Representative: Warren Steiner Mobile: PO Number:
warren_c_steiner@homedepot.com Total Windows: 1
Weighted Average: U-Factor: .29,SHGC: .28,VT: .53 Total Doors:
Total Sq Ft: 48.00
Comments: Total Perim Ft: 30
Est. Delivery:
For warranty information please visit www.milgard.com/warranty/
Billing Information Shipping Information
Name: HDE Name: HDE
Address: 2455 Paces Ferry Road Address: 2455 Paces Ferry Road
Atlanta,GA 30348-5581 Atlanta,GA 30348-5581
Phone: Phone:
Fax: Fax:
Email: Email:
Line: 1 Location: Living
Quantity: 1 Tuscany V400,8120T, DV, No Fin (Block Frame), Ext White/Int White, U-Factor: .29,SHGC: .28,VT: .53
Argon Gas Filled
Model=Double Vent
Size=Net Frame: 104 7/8"x 65 1/2"
Dimensions=Sash Width:One Quarter
Handing=XOX
Energy Package=Energy Star North-Central
Glass=DV 1.1 Left Vent, DV 1.1 Right Vent:3/32"SunCoat(Low-E)over 3/32"Clear with Gray
♦ ♦ Foam Spacer, DV 1.1 Center Fixed: 1/8"SunCoat(Low-E)over 1/8"Clear with Gray Foam Spacer
Glazing=Dual Glaze with Argon
Hardware=SmartTouch Lock
Other Options=Glass Breakage Warranty,Glazing Policy:This Window may ship open due to its
e size. Please contact your Milgard Sales Representative for more information.
Screen=Standard with Fiberglass Mesh
Ratings=STC: No Rating,OITC: No Rating, PG: R20
Clear Opening=W 23 1/2"x H 62 1/2"Sq. Ft. 10.2, Egress:Yes
Other Ratings=CPD: MIL-A-224-07447-00001
Viewed From Exterior Customer Approval:
Quote Number: SQPEV1041022_1 Print Date:7/29/2022 Page 1 of 2
HIDE-Lynnwood kYjJ-7jLAA-
CT B 2902A Lincoln Way
Lynnwood,WA 98087
Submitted By:
Accepted By:
Date:
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
For warranty information please visit www.milgard.com/warranty/
Please note that actual NFRC energy values may vary from those reported in CTB Quote Plus due to variations that may occur during the
manufacturing process. In most cases variations will be minimal. Please contact your Milgard location with questions or concerns
regarding this potential variation.
Painted Vinyl Note: For stucco applications,please follow the Milgard Stucco Tape Guidelines
https://www.milgard.com/sites/default/files/u/u57666/stucco taping guidelines 0920.pdf.
Handing is viewed from outside looking in.
ADDITIONAL INFORMATION:
Quote Number: SQPEV1041022_1 Print Date:7/29/2022 Page 2 of 2
Tacoma Order Acknowledgement
I t 253-582-9500
9213 51stAvenue SW Order No 2476284
o (PO Box 98828 Zip 98496) Order Date 08/15/2022
Tacoma,WA 98499
Customer HOMDEP03
Invoice Address Delivery Address Contact FIDE Lynwood Confirmations @ IK
Home Depot-HIDE HIDE SE#545-Lynnwood Your PO 11160444
Vendor 40006318 Dept 030 Hansen Bros Shipping On 09/06/2022
PO Box 723020 2810 Lincoln Way Taken Sy Administrator
Atlanta, GA, 31139-0020 Lynnwood,WA,98087 Sales Rep TAG-290 House
Ship Via: Delivered
III(IIIII IIIII IIIII IIIII IIIII IIII IIIII III II IIIII IIII III II(I)IIII
Page 1 of 1
Special instructions Notes
KAROLICK MP#1727292
11169444 KARLICK
Line Product Code Description Oty/Footage i Per 1
1 Heather Hill Heather_Hill@homedepot.com
2 zz_SODrTTPFPHSSOec_ 6'0"x 6'8"-Custom Rough Opening Height 81 1/2"-Right 1 Ea Ea
12419 Hand Inswing-S2AX-Exterior FlnishKote Therma-Tru
Double Prehung/Double Active-3/0 x 6/8 Smooth-Star Art
3-Lite Axis Black Nickel Scrolled Ltle Frame-Paint Exterior
Sides of Doors Dragonfly-Paint Interior Sides of Doors
Alpine-Paint Frame Both Sides Alpine-Paint Exterior Trim
Alpine-Vintage Bronze Durango Knob/Contemporary
Deadbolt-4 9/16"Composite Smooth Jamb-Composite
Smooth Brickmould-1A Flat Stock Paintable Interior Trim
3 Durango Knob I Contemporary DB US11 P Dbl Set RH 1
4 SLCDUl1P ->COMBO-DURANGO ENTRY&DB 11P VINT BRZ 1 Ea Ea
5 SLDUM11P ->MATCHING DURANGO DUMMY VINT BRZ 11P 2 Ea Ea ..
6 SLPT115P ->BOLT FOR TWO-SIDED DUMMY TRIM 1 Ea Ea
7 Sidemark:, Note:StralghlPullltem
6 FECS43409 11/16"x 3-1/2"x 9'Prefinlshed White Finished Elegance 27 LF LF
MDF E2E Board
319
I AM AN AGENT OF THE CUSTOMER OF OREPAC,WITH AUTHORITY TO EXECUTE THIS ORDER ON ITS BEHALF,AND I
UNDERSTAND AND AGREE THAT THE ORDER WRITTEN ON ALL PAGES OF THIS ACKNOWLEDGEMENT IS
ACCURATE AND THAT NO SPECIAL ORDERS OR ASSEMBLED UNITS MAY BE RETURNED WITHOUT OREPAC'S
SPECIFIC WRITTEN APPROVAL.
ACCEPTED BY: DATE:
Subject to our terms and conditions or sale,unless agreed to In vnlGng.