HomeMy WebLinkAboutPermit File 2107 Creekside Circle (2) �T. Y O 31. LCity of Anacortes InvoicelPermit #: BLD-2018-0682
G 904 6th Street
Applied date : 10l30l2018
P . O .Box 547 Issue date : 10/30/2018
tp Anacortes , WA 98221 -0547 Expire date : 04/27/2020
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OO VL (360) 293- 1901
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Job Address: 2107 CREEKSIDE CIR Permit Type: Mechanical Permit
ANACORTES WA98221 -2461 Project:
APN : P84013
Remarks: Install new gas zero clearance fireplace to existing gas.
Owner: DAVID WENNING Contractor: CRAFT STOVES INSTALLATIONS, IN
Address : 2107 CREEKSIDE CIR Address : 900 W DIVISION ST
ANACORTES WA 98221 -2461 MOUNT VERNON WA 98273-3226
Phone : Phone: (360) 336-2532
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General Information: Fees:
# of Gas Fireplace 1 Mechanical Permit Fees 34. 15
Total Calculated: 34. 15
Deposits/Receipts: 0.00
Total Due: 15
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THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 aYf� OR 19F
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COM4F W FJ I
HEREBY CERTIFYTHAT I HAVE READAND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUEAND CORRECT. ALL Ffft RRS
OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN O� T;il'F�E
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHEV ,(j:[KS 9R
LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. G pl pro
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SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED B �i V1 TT
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AV L1 PANNING, COMllILTIVITY7 & ECONOMIC DEVELOPMENT DEPARTMENT
PLUMBING & MECHANICAL PERMIT APPLICATION
101. 5 Jfailing- Address: P. O. Box 5471 Anacortes, WA 98221
zcQ Office Location: 904 6r7' Street, Anacortes WA 98821
Phone: (360) 293-1901, Fax: (360) 293-1938
PLEASE REFER TO THE PL UMBING & MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #) : Parcel(s) #:
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Subdivision/Lot #:
L...a 3�6 i Residential Commercial ❑
APPLICANT: Phone:
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Address (Sheet, City, State, Zip) : 3 o'33tn -.ZS 32 3 (06 � �CZ- VS
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P OPERTYOWNER: Phone:
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Address (Street, City, State Zip) . 3 U —25(3 -225�
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CONTACTP Phone:
�RSON:pJJ ev Fax:
Address (Street, City, State, Zip) : E-Mail Address :
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clk� Ju �' l¢ IFF 1Q -2S3z Address (Street, City, State, Zip) : E-Mail Address
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*A" Contractors & subcontractors must have a valid City of Contractor's License # Exp. Date:
Anacortes business licenseprior to doing work in the City. >r��k . - �31 CAiF\ rc ' 31 ' � q
Contact the 0 ) s Finance Departrnentat (360) 299.1968. Business License 4: Exp. Date:
Is this work, associated with another project? Yes ❑ No Lf If yes, specify:
PROPOSED WORK: vJ u ccvrcuhL
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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 apermit
application to the City of Anacortes.
Print Name: Lt - Q Owner ❑ Agent FO (specify) : A n
Signature: Date: I D . I ^ IF)