HomeMy WebLinkAboutPermit File 1905 10th Street rGt 1'Y 0 :. City of Anacortes Permit#: BLD-2012-0004
904 6th Street
{. Issue date: 01/04/2012
P.O.Box 547
Anacortes, WA 98221-0547 Expire date: 07/02/2013
et 4F (360) 293-1901
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Job Address: 1905 10TH ST Permit Type: Mechanical Permit
ANACORTES WA 98221-1419 Project:
APN: P56070
Remarks: New gas insert
Owner: BARNEY CAROLYN L Contractor:
Address: 1905 10TH ST Address:
ANACORTES WA 98221-1419
Phone: Phone:
License#:
General Information: Fees:
#of Gas Fireplace 1 Mechanical Permit Fees 38.90
#of Gas Piping 1
Total Calculated: 38.90
Deposits/Receipts: 0.00
Total Due: 38.90
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THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. I
HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL
PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR
NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER
STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
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SIGNATURE OF OWNEIR AUTHORIZED AGENT nISSUED BY
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11950 ._1 0001 07/14,''2011 n01 1
Engineering and Deveioo xignt Se v+rpes 4
CP(_\ p O4 PO Box 547 Anacortes�'W,4kf 822r'r c .. sU
er.;9 386Si. A , Gt
TN 360.293 1920 FAX 360.293 1938 , - "'
EMAIL engineering@cityofanacortes org v ,
S v RIGHT-OF-WAY PERMIT APPLICATION `; , e ,
RCW 19.122 Underground Utilities
l' 4CoW CALL BEFORE YOU DIG -(800)424-5555 "f•p�";"W�'
Applicant shall submit application 5 days prior to start of work and application shall include:
o (1) Payment of assessed fee
ri (2) Drawing illustrating proposed work and its location. See checklist on
Page 2 of 2.
Li (3) Liability insurance CG 2026 or similar. City named as additional insured. Minimum$1,000,000 each
occurrence,$2,000,000 general aggregate and$2,000,000 products-completed operations aggregate limit.
I_, (4) Proof of both state and city business licenses
Li (5) Performance Bond—Construction cost x 150% before work begins
❑ (6) Encroachment Agreement Required To be completed by City: [1 Yes Li No
Site Address: City Approved Exemption ri Yes I No
1 7t 5 /e 4449
e,®ic 5, Wiog EDENc ASSIGNED PERMIT NUMBER: 11�t;:: - , fit
Parcel No. K
Owner Information (Required) Contractor Information (Required) N
Name �y��1- eif�AiLey Name 04 ke�
Address G Address
7t'5 i ow .9iz r
City Alin; Cd, rz,�,. u i z f City
'
Phone 6602 9, r le,7.5-- Phone i
Email Email
Address Address
Work.Includes (check all that apply)
L Curb Cut ❑ Water Sewer- Storm i-' Street Guth Sidewalk L1 Phone - Other
Describe Work to be Performed: (Notification of Utility Companies is Required)
/ ` 4. 491M-4 j,x./ -- me°fiAeit r a, //°I'di r ry
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AI 4- A. 4-Ls i.0 e i-Li Pr- C— 60 Pi P/ 2;- el,-51, ,eu1O &R A OIL,
'ty Approval Signature D e
By signature below Applicant concurs that the Applicant shall defend, indemnify and hold the City, its officials,em-
ployees and volunteers harmless from any and all claims, injuries, damages, losses or suits including attorney fees,
arising out of or in connection with activities or operations performed by the Applicant or on the Applicant's behalf
out of issuance of this Permit,except for injuries and damages caused by the sole negligence of the City.
644,1,,L`o(//f.3 ck,i,„,i 7'( 2, -1
Applicant Signatur Date
Final Inspection Approval Signature Date tt
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NON-REFUNDABLE PERMIT FEE: (To Be Completed by City)
❑ Curb Cut $50.00
❑ Street Cut $50.00
❑ Inside Travel Way $50.00
• Outside Travel Way $20.00
❑ Sewer Inspection Fee $50.00
❑ Sewer Re-Inspection Fee $25.00
TOTAL FEE ASSESSMENT $
A Site Plan (to scale) must be attached that include all of the following:
This checklist will aid the applicant in preparing a site plan. Permits that require installation of substantial improve-
ments may require plans drawn and designed by a licensed engineer. Please check with City staff prior to submit-
ting your application.
• Draw the plan to a standard Engineering Scale j1"=10', 1"=20"etc.)on a minimum size sheet of 8 1/2 x 11
and a maximum size of 11x17.
• Include the owners name,the parcel ID number,site address, north arrow, drawing scale and date.
• Include the contractor's name, address and phone number.
• Existing Right-of-Way lines, property lines, edge of pavement,curb/gutter. sidewalks,driveways and plant-
ing strips with dimensions between each.
• Adjoining street name(s)to the reference property. ;
• All existing public and private utilities in the area of the proposed project( �y�', Sewer, Storm, Phone,TV,
Gas and Power), dimensioned to the edge of pavement,curb/gutter, sidewalk,driveways, planting strips.
. -• If applicable show easements, critical areas such as streams,wetlands and steep slopes.
• Proposed new construction.The proposed improvements shall be shown in heavier line type than the ex-
isting information
• Dimension the proposed new construction to the edge of pavement,curb/gutter, sidewalks, driveways,
planting strips, or another identifiable site feature that will help identify the proposed improvements in the
field.
• • Erosion Control Plan.
• Traffic Control Plan per current MUTCD(See standard drawings at http://mutedtfhwa.dot.gov). If the work
requires any lane or street closures,the City of Anacortes Public Works Inspector must be notified a mini-
mum of 48-hours prior to scheduled work for proper public notification by the City of Anacortes.
Work within the City Right-of-Way is permitted by approval of the City Engineer. All work in the right-of-way must be
bonded. The applicant and owner must use warning signs,traffic control, and barricades as necessary to ensure
public safety in the work area. The applicant and owner must restore the right-of-way to previous condition. Perma-
nent restoration may include overlays of portions of the right-of-way and restoration of landscaping which have been
disrupted by excavation work The applicant and owner are liable for damage to public and private property.
Page 2 of 2
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BUILDING PERMIT
CITY OF ANACORTES PERMIT NO. : BLD93-0537
P.O. BOX 547 APPLIED: 12/21/93
ANACORTES, WA 98221 ISSUED: 12/23/93
(206) 293-1901 EXPIRES: 12/23/94
SITE ADDRESS: 1905 10TH ST
ASSESSOR' S PARCEL NO. : 3772-202-003-0009
PROJECT DESCRIPTION: Remodel kitchen and den, remove existing wall
between kitchen and den, extend kitchen wall, ad atrium door.
— OWNER — CONTRACTOR — LENDER ICI
CAROLYN BARNEY KREIDER CONSTRUCTION
1905 10TH STREET 1725 HWY 9, M
ANACORTES WA 98221 MT VERNON WA 98273
k
293-9075 422-5329
KREIDC*1010G
TYPE OF WORK •ADD AREA (sf) VALU. . . $: 4500
TYPE OF USE ' SF LOT • 0 REQUIRED SETBACKS----
CENSUS CATEGORY •434 1ST FLR • 0 FRONT 0 ft
ZONING 2ND FLR • 0 SIDE • 0 ft
:7 BASEMENT • 0 REAR • 0 ft
OCCUPANCY GROUP GAR/CARPORT. . . : 0 REQUIRED PARKING--
:R3 :7 : 2 : 7 OTHER 0 TOTAL • 0
TYPE OF CONSTRUCTION HANDICAPPED: 0
:5N : 2 : 7 : 2 NUMBER OF UNITS • 0 COMPACT • 0
OCCUPANT LOAD STORIES • 0 IMPRV SURF. : 0 sf
. 0: 0: 0: 0: BUILDING HEIGHT. : 0 ft
— FEES — NOTES
Code Amount---- By- Date---- Receipt
PRMT $ 50. 50 MD 12/23/93 1830
STBC $ 4.50 MD 12/23/93 1830
TOTAL $ 55.00
I hereby acknowledge that I have read this permit and state that the above information is correct, and agree to comply with all
ordinances and laws regulating activities covered by this permit.
Issued by Applicant or Owner ' s Signature
24 Hour Notice Required For All Inspections
bld_prmt, Rev: 06/11/92
. f
0 0
FOR INSPECTIONS CALL: CITY OF ANACORTES PERMIT NI gels
293-1901i BUILDING PERMIT
1905 10th Street
24 Hrs. Notice Requested Site Address
NAME(OR NAME OF BUSINESS) PLUMBING
arry Wien
MAILING ADDRESS t Na TYPE OF FIXTURE OR ITEM FEE
1905 10th Street
CITY I TELEPHONE NUMBER Water Closet S
Anaaorte WA 98221 i 29:.3-2/WS. Bathtub
NAME Lavatory ,
Shower
ADDRESS Kitchen Sink
Dishwashet
CITY TELEPHONE NUMBER Laundry Tray
Clothes Washer
NAME Water Heater
FOSS & CO Urinal
I ADDRESS Drinking Fountain
e 91 Padilla Hts Floor Sink or Drain
CITY " TEEM?, NUMBER Slop Sink ,
uo WA `3(3221 knacortee, 8b4 Water Piping
STATE LICENSE NUMBER CITY LICENSE NUMBER
?.U{)
El Residential ❑ Non-Residential PERMIT $ 3•UU
O New ❑ Add ❑ Alter ❑ Repair TOTAL FEE $
❑ Building tt] Plumbing d Mechanical ECHANICAL
❑ Sign 0 Demolition ❑ Other 0 GAS ❑ OI 0 ELECT. 0 OTHER
Legal Description of Property or Tax Account Number
Lot Block of No. TYPE F EQUIPMENT FEE
Air Cond. Unit S
Refrigeration Unit— HP
t Boiler— HP 9 UU
Forced Air System— BTU/KW
Describe Work Floor Furnace
Gas Water Heater and Piping Wall Heater
Unit Heater
Clothes Dryer
Occupancy Use Ventilation Fan
D Single Family Residence 0 Multi-Family Residence Range Hood
❑ Office ❑ Retail ❑ Storage 0 Church Air Handling Unit— CFM
❑ Restaurant 0 Other i Pre-manufactured Stove or Fireplace 3.OU
NOTICE Gas Piping 1
This permit is issued by the Building Official and,under the provisions
of the Uniform Building Code,shall expire by limitation and become null 15.00
and void if the building'or work authorized by such permit is not corn- PERMpp $ 27.00
menced within 180`days from the date of permit issuance,:or if the building TOTAL. E S
or work authorized by such permit is suspended or abandoned at any time - - :4 ... - ,
after the work is commenced for a period of 180 days. TOTAL FEES VALUAI#''ION FEE
• By affixing my signature, I hereby certify that I ani the owner of the Building S C .UU
property for which this permit is issued or am an authorized represen-
tative of the owner. Plan Check
Plumbing 2 / .00
All provisions of laws and ordinances governing this type of work will Mechanical
be complied with whether specified herein or not,including routine calls
for inspections, Sign
/4 L--/ / Demolition
7 c./J/ _,l1 7 c.% - M // Energy Surcharge i '
i Sigowm oPOarer or*valorized Agent (Date) State Surcharge
Street Setback Side Yard Setback Rev Yell Setback Other 36.00
TOTAL $
Use Zone Occupmcy Group Type of Conet. Conditions:
Lot Area Vacant Site Duelling Units
❑Yes ❑No
Fire Sprinkkn Required No.of Stories Bedrooms Occupant Load
❑Yes ❑No
Size or Bldg. Plans Checked By:
maw SIGNED AND DA7t£b BELOW,me pa root PEBaDT
Permbaioa Y Matter,to do the above described tfak,awarding to the conditions
Wawa and*tali*to-the approveiplas and specifications pertaining Warta abject to
tompWme with the ordinances of the CITY OF ANACORTES.
06/03/91
Permit Issued By It ; s i ti 4' l -• (( :I S.
Building Official (Date)
Edwin Frank
I PERMIT
Address /9 ,5
Legal Description Jr y 5 3 -5— /3( /C /c4F 04(c
Assessors Account No. 3`) `72- /( - coi--ODOc�
Permit No. Date Description Date Finaled
211-41 zerx39Add.
38—G //-zr-2-3 , c op
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