HomeMy WebLinkAboutPermit File BLD-2021-1024 4122 Clyde Way (6)PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
Marling Address: P.O. Box 547, Anacortes, WA 98221
Office Location: 904 61h Street, Anacortes WA 98821
f I ` Phone: (360) 293-1901
Residential Building Permit Application
Submittal Packet
New Single Family Residences (SFR) Duplexes Additions and Remodels (sm & Duplex)
Accessory Dwelling Units Manufactured Homes Residential decks and retaining walls
SuBw-rAL
CHECKLIST
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Residential Building Permit
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Submittal Requirement Checklist
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See pages 2-3 of this handout for information about each
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submittal item listed below.
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Residential Building Permit Appi!cation Form
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(FORM BP-1—attached)
Structure & Site Information Form
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(FORMBP-2-attached)
Mechanical & Plumbing Fixtures Form
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X
X
(FORM BP-3 —attached)
Architectural Plans
X
X
X
X
X
(requirements listed on FORM BP-4 - attached)
Stormwater Management Minimum Requirements
Determination
X
X
X
X
iFORM SP-5, attached)
Stormwater Site Plan
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X
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Site Plan & Landscape Plans
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(requirements listed on Form BP-6)
Structural Plans & Calculations
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Energy Code Plans & Forms
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Manufacturer's Specifications/Cut Sheets
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Copy of recorded survey
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Technical Reports
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Other Required Permits
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X
X
X
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AD Affidavit of Owner Occupancy (signed)
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Required Number of Copies and Plan Size
Fees
2 paper copies of each item above
• Plan review deposit is taken at time of
Plans must be minimum 11" x 17", to scale, and legible
application submittal.
1 reduced size copy Lmaximum size 11" X 17") of the Site
' Permit fees are paid prior to building
Plan, Floor Plan and complete Building Plans
permit issuance.
Page 1 of 18
Res. Building Permit Application 5ubmlttal Checklist
Updated October 10, 2019
r1 PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
` Marling Address: P.O. Box 547, Anacortes, WA 98221
Office Location: 904 61h Street, Anocortes WA 98821
f1 +, Phone: (360) 293-1901
t
. PERMIT APPLICATION
FORM is RESIDENTIAL
1. PROPERTY INFORMATION
Project Address (Street, Suite #):
Assessor Parcel Number:
ly 1 e We,
Subdivision/Lot #-.1
Zoning esignation:
Lot area (size):
a 0 sq. ft.
Z. TYPE OF PROJECT
❑ New SFR ❑ New Accessary Dwelling Unit: ❑ Deck/porch (new/repair)
❑ New Duplex ❑ Attached to Primary Unit ❑ Interior remodel
❑ Detached from Primary Unit
❑ New Addition to SFR A Garage, carport or accessory bu1Iding ❑ Fence or retaining wall
or duplex new repair)
❑ Other.
Project Summary:
f
1 G Pto n 5)160 10 0ark tk
Project Valuation: $T�C�O•
3. PROPERTY OWNER INFORMATION
Name: n �] rya �c �
Lf p p
Phone: q 7 — f ` ! �o I
Address (Street, City S ate, Zip :
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Email Address:
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4. CONTRA OR INFO MATION
Name:"
Phone:
e V^
Contractor's Business Licenses
State License #:
City License #:
%1 Contractors & Subcontractors musthave a valid City
ExpEra ' ate:
Expiration Date:
of Anocortes business license prior to doing workln the
City.
Address (Street, City, State, Zip):
Email Address:
S. CONTACT PERSON
Select one person the city will contact for anything
❑Applicant ❑ Property Owner ❑Contractor
related to this project:
❑ Other (list below)
m Nae:
Phone: c L
❑
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Address (Street, City, State, lip):
Email Address:
,5o/(fi e o-5 q, bov e-
Res. Building Permit Application Submittal Checklist
Updated October 10, 2019
Page 5 of 18
PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
`.' Mailing Address: P.O. Box 547, Anacortes, WA 98221
Office Location: 904 61r' Street, Anacortes WA 98821
�r i Ph r one: (360) 293-1901
6. LENDER INFORMATION
RCW 19.27.095 requires the City to obtain information with regard to lenders. If there are no lenders involved with your project,
write "no lenders" on the Pame lane below.
Name:
Phone:
Address (Street, 0 q state, Zip):
Email Address:
7. ACKNOWLEDGEMENTS & SIGNATURE
Read and initial each of the following statements prior to signing this application:
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.
i understand that if I submit incomplete, inaccurate, and/or erroneous information it will take the
City longer to process my permits.
nderstand 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.
I understand and acknowledge that Special Inspections could be required as part of my project, and
if needed I will be required to pay for the cost of these inspections.
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.
l 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 I am either the owner of the property listed on this application orthe 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 wedge and be#ief.
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Signatu re Date
Printed Name
Res. Building Permit Application Submittal Checklist
Updated October 10, 2019
Page 6 of 18
y r� PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
Mailing Address: P.O. Box 547, Anacortes, WA 98221
Office Location: 904 61h Street, Anacortes WA 98821
fit293-1901
I r 5ti x ` Phone: (360 }
FORM BP-2: STRUCTURE AND SITE INFORMATION
1. PROPERTY WHERE WORK IS OCCURRING
ADDRESS,.
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PARCEL
NUMBER(S)
2. DETAILED PROPOSED STRUCTURE INFORMATION
Complete the following information as it relates to your project. Mark items that are not applicable with
"N/A",
Structure height: 1 y rr
AREA
SQUARE FOOTAGE
OCCUPANCY GROUP
CONSTRUCTION TYPE
OCCUPANT LOAD
I" Floor:
------------
2"d Floor:
3rd Floor:
Basement:
Garage:
Total deck:
Total porch:
Other:_
Other:
Other:
3. QUESTIONS
ABOUT THE PROPOSED STRUCTURE
Is a fire sprinkler system being installed?
❑ YES NO
Is a monitored fire alarm Tieing installed?
❑ YE5 19 NO
Are retaining waI1(s) being built?
❑ YES LR NO
Are structural plans required?
® YES ❑ NO
4. PROJECT SITE INFORMATION
A. Is work within the City's right-of-way proposed? If yes, you will be required
to submit a right-of-way permit application.
If you have already submitted a ROW permit, list the permit number here:
❑ YES 19 NO
B. Is the property located in a flood zone?
If yes, list the flood zone designation:
❑ YES ONO
C. Are there slopes In excess of 15% on or abutting the site? if yes, a
geotechnical report will likely need to be submitted.
❑ YES 12� NO
Res. Building Permit Application Submittal Checklist
Updated October 10, 2019
Page 7 of 18