HomeMy WebLinkAboutPermit File 1815 10th Street (3) ' 4'` City of Anacortes Invoice/Permit#: BLD-2018-0661
904 6th Street
Applied date: 10/22/2018
`71•041119eamor P.O.Box 547
Issue date: 10122/2018
"?. Anacortes, WA 98221-0547
MI Expire date: 04/19/2020
`"_ (360) 293-1901
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Job Address: 1815 10TH ST Permit Type: Plumbing Permit
ANACORTES WA 98221-1417 Project:
APN: P56059
Remarks: Spot repair on side sewer.
Owner: ERIC &AMANDA BALTAZAR Contractor: CPI PLUMBING& HEATING
Address: 1815 10TH ST Address: 1900 RAILROAD AVE
ANACORTES WA 98221-1417 MOUNT VERNON WA 98273-4957
Phone: Phone: (360)428-5636
License#: CPIPLPH850MN
General Information: Fees:
#of Side Sewer 1 Plumbing Permit Fee 27.00
Total Calculated: 27.00
Deposits/Receipts: 0.00
Total Due: 27.00
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THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180-pAy/,S4;,0 IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COINhigN ' I
HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALIMPRibVISIDNS
OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN t f4pT,;ILHE
GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TH -PR VISIONS OF ANY OTHER'ST, T 'OR
LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. co 5\
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SIGNATURE OF OWNER OR AUTHORIZED AGENT IS '=' ' ' C
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OCT 2 2,201E ,
Co y, `CORTESLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
PLUMBING & MECHANICAL PERMIT APPLICATION
s Mailing Address:P.O.Box 547, Anacortes, WA 98221
't OfficeLocation:.904 6`h Street, Anacortes WA 98821
Phone: (360) 293-1901
PLEASE REFER TO THE PLUMBING&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS(Street,Suite#): RCEL S #: PROJECT VALUATION:
If 15 10� At S+ nY 5 0 0 5 r�
Subdivision I.of#: RESIDENTIAL t'J COMMERCIAL ❑
APPLICANT: Phone:
0 k 9\LAVOAP,C1 'it/Ito/41;9 30o-os-5-(#3(4,
Address(Street,City, State,Zip) E iail Address:
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00 ,a,Yt 0..d ,W - Veir►nrN _ 0 -ei; . e e�.1 A\oi , Doty,
PROPERTY OWNER: Phone:
e, tR ArVitintILL 13& aMY 3(pb- 2DA- LQ43o
Address(Street,City,State, ip): Email Address:
1 g 15 10$A S4 r 144 Al,40eD hir ilr 40
CONTACT RSO : Phon :
C,h V1,x ,nq .! O 319 b- gag -5-434
Addres (S�r et, Ci ,S te,Zip): Email Address:
jpb Tbazi taut* veitribyl WA- ilin 3 6.44,o1(6 cpipitianicifill. to,"
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Email Address:
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*All Contractors&subcontractors must Crave a valid Ci. f en #: pp. e:
ry of t 1Q1P1.1s,501.4,
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Anacortes business license prior to doing work in the City. BusWO
ess r iccense Epp Date
Contact the Gity's Finance Department at(360)299-1968. Oil 4 � xtattt"11
Is this work,associated with another project? Yes ❑ No 0 If yes,specify:
PROPOSED WORK: S.I3Q' - `'rail` Or, �L � seweX
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: ' Owner 0 Agent 0 e,,Sg.
Signature. Date: jo i i '°
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NI x a PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT
ct 0,
1 PLUMBING AND MECHANICAL PERMIT CHECKLIST
7 Mailing Address:P.O. Box 547, Anacortes, WA 98221
4
'-..`icoR-' Office Location: 904 6`h Street, Anacortes WA 98821
Phone: (360) 293-1901
PROJECT ADDRESS: i S I it)44 454-
Plans shall be of sufficient clarity to indicate the location,nature, and extent of the work proposed, and
confoi in to the provisions of the adopted International Codes and City Ordinances.
PERMIT TYPE:
et..
SUBMITTAL REQUIREMENTS: -1
n The number indicates the number of p
fts espies for submittal(if applicable).
a
Plumbing&Mechanical Permit Application 1 I 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 ICut 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 ✓ i ,F ✓
Existing.Floor Plan 2 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.backllow prevention device, it will need to pass test results of which will need to be
submitted to the city for review.