HomeMy WebLinkAboutPermit File 1419 16th Street (3) Y- C3 City of Anacortes Invoice/Permit#: BLD-2018-0639
904 6th Street
Applied date: 10/10/2018
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P.O.Box 547 Issue date: 10/10/2018
Anacortes, WA 98221-0547et, Expire date: 04/07/2020
(360) 293-1901
Job Address: 1419 16TH ST Permit Type: Single Family Alteration/Repair Permit
ANACORTES WA 98221-2228 Project:
APN:
Remarks: In upstairs bathroom change the door swing to be into the bathroom instead of out. Remove existing closet and frame in a
new shower stall that will be a tiled shower.
Owner: MICHAEL DELANEY Contractor: DOULOS CONSTRUCTION INC.
Address: 1419 16TH ST Address: 13539 TRUMPETER LN
ANACORTES WA 98221-2228 MOUNT VERNON WA 98273-8905
Phone: (410)279-7217 Phone: (360) 708-2601
License#: DOULOC*964MZ
General Information: Fees:
Building Valuation 6500 Building Permit Fee 139.25
#of Showers 1 Plan Review Fee 90.51
State Building Code Fee Resi 6.50
Plumbing Permit Fee 27.00
Total Calculated: 263.26
Deposits/Receipts: 0.00
Total Due: 263.26
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THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DA'S;_.{DR; IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMM tmE;
HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVfSION
OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR:1)ICLI,r:tH
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER;yS'.Tiik. 'C
LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. iz' ^ CO +J
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t SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY
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;�' PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
arm mari 1DENTIAL BUILDING PERMIT APPLICATION
1 i `!ir Vtild IS. 1. L. Mailing Address:P.O. Box 547,Anacortes, WA 98221
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i Office Location: 904 6th Street,Anacortes WA 98821
! 0 SS Phone: (360)293-1901, Fax: (360) 293-1938
PLEASE RE 'S daFT AEI L BUILDING PERMIT CHECKLIST BELOW FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS(Street,Suite : PARCEL(S)#:
I`/1 /b '`� �no,co,-/es
Subdivision/Lot#: PROJECT VALUATION:$
66-00J
APPLIC T: Phone: -� ,IJ(
LC(55 R 0'1 j6 /d- 0? Q,
Address(Street,City,State,Zip): Email Address:
l 9l 8 i✓" (7oi J lit 2 v uss t em t r c, ca41-t 02 el--
PROPERTY ccc•e.j o e I��e y Phone: 336,
- Ll()L/. 31/6
Address(Street,City,State,Zip): l / Email Address: I
CONTACT PE ON: Phone:
J Re-GI
Address(Street,City,State,Zip): Email Address:
LENDING AGENCY: Phone:
Address(Street,City,State,Zip): Email Address:
CONTRACTOR:*//�� n Phone:
L uss i e h ri i 0ow4U5 5fuc-6•0 36a - 70 '`..2 01
Address(Street,City,State,Zip): Email Address:
*All Contractors&Subcontractors must have a valid City of Professional License#: Exp.Date:
Anacortes business license prior to doing work in the City. Contact Business License#: Exp, Date:
the City's Finance Department at(360)299-1968.
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PROPOSED NEW SQUARE FOOTAGE:
Basement SQ': ❑ Finished Basement: ❑ Unfinished Basement
1"Floor SQ': Garage/Carport SQ':
2nd Floor SQ': Deck/Covered Porch/Patio SQ':
Fire Sprinkler: ❑ Yes 0 No Lot Area SQ':
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: (/\I,1-6S Re-h Owner ❑ Agent im1(specify):
Signature: Ra../-1-e, 4///� ((1 "�r�j�-� Date: id-id--jg
Page 1 of 5
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