HomeMy WebLinkAboutBill and Bonnie Master Bath Permit App (1).pdfPLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
PLUMBING & MECHANICAL PERMIT APPLICATION
7ti►��. 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 PLUMBING & MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #):
PARCEL(S) #:
PROJECT VALUATION:
2S19 3o-i;,
Subdivision/Lot #:
RESIDENTIAL );� COM MRCIAL ❑
APPLICANT:
Zach eke
Phone:
360 321 7
Address (Street, City, State, Zip):
Email Address:
Z i an . co
PROPERTY OWNER:
� Bow
Phone:
�3bo) jog--Q3�5
;u ke.
Address (Street, City, State, Zip):
Email Address:
23�a 3lukN,, S k .
CONTACT PERSON:
Phone:
Address (Street, City, State, Zip):
Email Address:
22ra k�De► ,, -6(- A
CONTRACTOR:* IPhone:
Zac,h
Address (Street, City, State, Zip):
Email Address:
� S 0. 6 a
*All Contractors & subcontractors must have a valid City of
Professional License #:
Exp. Date:
Anacortes business license prior to doing work in the City.
Business License #:
Exp. Date:
Contact the City's Finance Department at (360) 299-1968.
G p 517
Is this work, associated with another project? Yes ❑
No El If yes, specify:
PROPOSED WORK:
' .y ,,ll,.ytl -- - .PeVScY�ti rio,n �,ona
A I I.kx. C&A .,CaAks
-
1 Z" W W ' —
�a ,1.. ,_,�LjaY�—_2
s
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: Zack) C,p TJ, r,�
Owner ❑ Agent P� (specify):
Signature:
Date: 3Zt [9.-j 9 1
PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
PLUMBING AND MECHANICAL PERMIT CHECKLIST
7 � Mailing Address: P.O. Box 547, Anacortes, WA 98221
� o Oytce Location: 904 6th Street, Anacortes WA 98821
Phone: (360) 293-1901
PROJECTADDRESS: Z 319 30-�n `- -r
Plans shall be of sufficient clarity to indicate the location, nature, and extent of the work proposed, and
conform to the provisions of the adopted International Codes and City Ordinances.
Cal
SUBMITTAL REQUIREMENTS:
The number indicates the number of
b
b
O
copies for submittal (if applicable).
c
C
r
Plumbing & Mechanical Permit Application
1
1
1
1
Mechanical Plans
1
0
0
0
Structural Calculations
1
0
0
0
State Non -Residential Energy Code Compliance Form
1
0
0
0
Manufacturer's Specifications /Cut Sheets
1
0
1
0
Elevation View for Roof Mounted Equipment
1
0
1
0
Plumbing Plans
0
0
1
0
Listed & Tested Fire Stopping Assemblies
0
0
1
0
Permit Fee
.
Existing Floor Plan
2
?
2
2
New Floor Plan
2
2
2
2
NOTES:
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.
--
Equipment Type:
Furnace:
A PP
Gas #:
Gas #:
#:
Elec #:
■€t
hancelEquipment Information (new and relocated):
Elec #: Other #: Location(s):
Elec #: Other: #: Location(s):
Location(s):
Other #: Location(s):
Total #:
Wall Heater:
Gas Water Heater:
Heat Pump:
Elec #:
Other: #: Location(s):
Air Conditioner /Handler:
Gas #:
Bath #:
#:
Elec #: Other: #: Locadon(s):
Laundry # Kitchen #: Other #:
Type 1 or 2 (Circle which one) Location(s):
Radiant /Hydronic Heating:
Exhaust Fans:
Range Hood:
Gas #:
Elec #: Other: #: Location(s):
Fireplace:
Gas #:
Elec #: Other: #: Location(s):
Clothes Dryer & Duct:
Gas #:
Elec #: Other. #: Location(s):
Stove/Range/Oven:
Refrigeration Unit:
Elec #:
Other: #: Location(s):
Gas Piping/ Outlet(s):
#:
Location(s):
Boiler:
Gas #:
Elec #: BTUs: Location(s):
Other:
#:
Location(s):
TOTAL MECHANICAL OUTLETS:
Fixture Type (new and relocated):
Total #:
Fixture Type (new and relocated):
Total #:
Water Closet (Toilet):
Refrigerator water supply (for water/ice dispenser):
Kitchen Sink:
Pressure Reduction Valve/Pressure Regulator:
Utility Sink:
Water Service Line:
Tub:
Water Piping:
Hand Sink:
Clothes Washer:
Shower:
Electric Water Heater: Tank -less? Yes ❑ No Lys
Dishwasher:
Backflow Prevention Device:
Urinal:
Hose Bib:
Floor Drain / Floor Sink:
Drinking Fountain:
Hydronic Heat in: Floor ❑
Wall ❑
Grease Interceptor:
Other:
Other:
TOTAL PLUMBING FIXTURES:
F $TATt,
6� f
V,``,y Leroy
STATE OF WASHINGTON
BUSINESS LICENSING SERVICE
Thank you for filing online
Our processing time generally takes up to 10 business days. Some endorsements may take more time for state or city
approval. You will receive your business license with approved endorsements in the mail. An updated business license
will be mailed to you when additional endorsements are approved.
Confirmation Number: 0-019-249-360 Filing Date and Time: 03/22/2021 09:03:35 AM
Payment Method: Credit Card ending in 7514
There is a 2.5% credit card convenience fee charged by a third party vendor.
Business Entity Information
Entity Type: Limited Liability Company
Name of Entity: ZACH GELEYNSE DESIGN LLC
Account ID.- 604490352-001-0001
Firm Name: ZACH GELEYNSE DESIGN LLC
Endorsement(s) Applied For Begin
Anacortes General Business - 03/22/2021
Non -Resident
Fee Type Begin
BLS Processing Fee 03/22/2021
Third Party Credit Card Fee
ktCOYS
End Count Fee
03/31 /2022 1 $40.00
$40.00
End Count Fee
1 $0.00
$0.00
$1.00
Grand Total: $41.00
6011 it
CLA-. -C- ,YJ--� Sat C)L,-
Tempered or safety
glass if within 60" of
floor.
Iz" >c 3L Wroclaw
4X8 header required
if trusses land on
header.
If trusses or rafters
are parallel to
window opening,
header may be
omitted. Call
1-360-391-1403 for
clarification. t�,tA�s 000�
N� w0a
VI �.
lVel---D
� New w �'ralb w
--yr- Tone* lea- doe s j)'-i
Mav c
CORTES
_1 o seA-
lay o��
ey 4-r)-m
aQe., da
wAty
CITY OF A
PLANNING AND I UILDING DEFT.
APPROVED PLANS
REVIEWED FOR CO E COMPLIANCE
PERMIT #: BLD-2021-0219
ADDRESS: 2319 30THST
APPROVED BY:
SUBJECT TO FIELD INSPECTION. APPROVED PL S SHALL NOT
BE ALTERED WITHOUT AUTHORIZA ON.