HomeMy WebLinkAboutPermit File BLD-2020-0516 1213 10th Street 0 Cityof Anacortes
Invoice/Permit #: BLD-2020-0516
904 6th Street
"*"10016ftellsor. Applied date: 09/03/2020
P.O.Box 547 issue date: 09/03/2020
.„ Anacortes, ^dam 9�L21-054 7
__: •r „ Expire date: 03/02/2022
(360) 293-1901
Job Address: 1213 10TH ST Permit Type: Mechanical Permit
ANACORTES WA 98221-1922 Project:
APN: P55412
Remarks: INSTALL VENTING MICROWAVE ABOVE STOVE AND VENT THROUGHT ROOF.
Owner: HAL ROOKS Contractor: OWNER
Address: 1219 10TH ST Address:
ANACORTES WA 98221-1922
Phone: (360) 293-5171 Phone:
License #:
General Information: Fees:
# of Ventilation Fans 1 Mechanical Permit Fees 30.75
Total Calculated: 30.75
Deposits/Receipts: 0.00
Total Due: 30.75
filY is 1Rg Irbsrp - 8LD- th2 airg.- O if e g�anttng o ris�permrt s a not be construed to be a permit for, or approval of, any violation of this Code or any other ordinance or order of
t 0Cit�; t ttit@1ibr-fA�gi1`� a to nY order, proclamation, guidance advice or decision of the Governor of this State. To the extent the issuance or
t' :;, iL it is int&I—p cted to allow constr Ctio,, Cctiv;y ww;-ing any period of time when ouch conct;ucticn is prohibited or rcct-icted by any state
teacraj ►� r r r ro to guidance advice or decision c- the Governor of tnis State, rots permit snail not authorize such work and shall not be
va#k3: �bi r �e r}i s utorized to prevent occupancy or use of a structure where in violation of this Code, any other City ordinances of this
r r rn (Mai is au
jlgavdteUitrAt t :other ordinangggr5executive order of the City, or of any state or federal law, or of any order, proclamation, guidance advice or decision of
ttpaaounr puAn'ohgipuilding offs jjtal75 authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect,
inaccu�rrte,R,� ncomplete information, or in violation of any City ordinance, regulation or order, state or federal law, or any order, proclamation, guidance or
c pst�e 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 ex- ed is application and know the same to
be true and correct.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY
PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT
PLUMBING & MECHANICAL PERMIT APPLICATION
-4 860°
-„....-.
Iii!livr
Mailing Address:P.O. Box 5474nacortes, WA 98221
Office Location. 904 611'Street, Anacortes WA 98821
Phrie: (360) 293-1901
PLEASE REFER TO THE PLUMBINTG&MECHANICAL PERMIT CHECKLIST FOR SUBMITTAL REQL,TIREAIEATS
PROJECT ADDRESS(Street,Suite#): : PARCEL(S)#: P4OJECT VALUATION:
ILIb t 5t . f„..)
subdi t sion/Lot --1
RESIDENTIAL 27 COMMERCLU, 0
APPLICANT: Phone:
Pa-t, 1Z00
• Address(Street,City,State,Zip): : Email Address:
1 7,1f la 4' 5,c--. ti 4,%(.-e....7v-4-e.., £,-,$r 4,01.-F:e„(ot- ,rp,o.L - e--csyn
PROPERTY OWNER: i Phone:
>11.......,_
Address(Street,City, State,Zip): i Email Address:
: -
CONTACT PERSON: Phone:
Address(Street,(Street,City, State,Zip): Email Address:
CONTRACTOR:* Phone:
5C-44A_A--
Address(Street,City, State,Zip): Email Address:
Professional License#: Exp.Date:
*All Contractors& subcontractors must have a valid Citl.,of -
Anacortes business license prior to doing work in the City.
Business License#: 1 Exp.Date:
Contact the City's Finance Department at(360)299-1968.
Is this work,associated with another project? Yes 0 No V If yes,specify:
PROPOSED WORK: _Tok,4-6.i_t_ y et.4-4-itkA in:e-4-4)1...)4r-ste, 42.100t1 - /740s1 e-, a...A- Ve.44.t e-r
4-4 oF,, 1 ..,.1.4_,.„.1 it val....4%7,-5 to;pr.... -. -ro 4-44._ .4.-
rP C-11-- Lae Fri5;441 e.k.-.
I" at,e4,0_ vo 4ry.t.-' ve.—tiv,1 p.-pe_ -,Cirt ow". 14 0..A"-i-ais He-Ai-1%1 .
a ef-e:pf ..,..1 • Lt v't _____ 1
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
applicFrion to the City of Anacortes .
Print Name: 14 0..."z t..1-, 9.,. zoo k.,,, Owner VAgent 0 (specify):
Signature: .4+44„...- CZ-. (2—.....„--k Date: ttin,1 , ' t
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