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Home My WebLink AboutPermit File BLD-2022-0844 2100 O Avenue C3 City of Anacortes Invoice/Permit#: BLD-2022-0844 G 904 6th Street Applied date: 10/28/2022 P.O.Box 547 Issue date: 10/28/2022 Anacortes, WA 98221-0547 Expire date: 04125/2024 (360) 293-1901 ;.0p Job Address: 2100 O AVE Permit Type: Mechanical Permit ANACORTES WA 98221-2535 Project: APN: P57380 Remarks: Replace gas water heater. Owner: LUTHERAN CHURCH OF ANACORTES Contractor: BERENTSON PLUMBING Address: 2100 O AVE Address: PO BOX 635 ANACORTES WA 98221-2535 BURLINGTON WA 98233-0635 Phone: (360)293- Phone: (360)708-9484 License#: General Information: Fees: #of Gas Water Heaters— 100k 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 exami d1his plication and know the same to be true and correct. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY �t"v Y o� PLANNING,COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location: 904 6t" Street, Anacortes WA 98821 Gw� Phone: (360) 293-1901 coR PLUMBING & MECHANICAL PERMIT APPLICATION Please complete all applicable information and submit to buildinspermit@cityofanacortes.o PROPERTY INFORMATION PROJECT ADDRESS ASSESSORS PARCEL NUMBER 2100 O Avenue PROJECT VALUATION ,tgnnn ❑RESIDENTIAL FX COMMERCIAL PROPERTY OWNER OWNER PHONE Anarnrtac I i ithprnn ( hi irrh (300) 410-9849 OWNER ADDRESS OWNER EMAIL 9100 n AvPnuP h1h1173*1nnmail_rnm APPLICANT INFORMATION ❑X PROPERTY OWNER CONTRACTOR OTHER: NAME PHONE Anacnrtes Lutheran Church SamP ADDRESS EMAIL .amP amP CONTRACTOR INFORMATION NAME PHONE Berentsnn Plumhinn 3 C) a -7 ° q ot"-tR ' CONTRACTOR'S BUSINESS LICENSES* STATE LICENSE# EXPIRATION *All Contractors & Subcontractors must have a valid V§X Q f.12 U T4-142 Lf 17 2-q City of Anacortes business license prior to doing work UBI LICENSE# t JGL EXPIRATION in the City. Cji 0 � 5^'�,S � �( ?j 5131 23 ADDRESS(STREET,CITY,STATE,ZIP) EMAIL eo svq �3S ►fit �..u,a ri�dL33 -Es. eb i clo,-J i, ca PROJECT INFORMATION DESCRIPTION OF PROPOSED WORK: Replace defective water heater and correct plumbing IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? YES X NO If YES,provide the permit/application number: Plumbing/Mechanical Permit Application Updated December 2021 Page 1 of 3 MECHANICAL APPLIANCE/EQUIPMENT INFORMATION (NEW AND RELOCATED) EQUIPMENT TYPE Indicate the number of fixtures for each equipment type TOTAL GAS 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 FIXTURE TYPE(NEW AND RELOCATED) 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:[]Floor []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 COMMERCIAL RESIDENTIAL o SUBMITTAL REQUIREMENTS = _ n Z Z W Z W m Z 3; D G) n m r r Plumbing&Mechanical Permit Application ✓ ✓ ✓ ✓ Mechanical Plans ✓ Structural Calculations ✓ State Non-Residential Energy Code Compliance Form ✓ Manufacturer's Specifications/Cut Sheets ✓ ✓ ✓ Plumbing Plans ✓ Listed &Tested Fire Stopping Assemblies ✓ Elevation View for Roof Mounted Equipment ✓ ✓ Existing Floor Plan ✓ ✓ `� `� 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. ACKNOWLEDGEMENTS &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 b estof my knowledge and abilities. Q4AL O-12iV' 22 SIGNATURE DATE Plumbing/Mechanical Permit Application Updated December 2021 Page 3 of 3