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la <br /> G`�Y o� 2.0 <br /> PLANNING, COMMUNITY, &ECONOMIC DEVELOPMENT DEPARTMENT <br /> DEMOLI u DOO N & OIL TANK DECOMMISSIONING PERMIT CHECKLIST <br /> Mailing Address:P.O. Box 547,Anacortes, WA 98221 <br /> -.9c0it Ig! <br /> Office Location: 904 6th Street,Anacortes WA 98821 U 9 ` � ' � <br /> Phone: (360)293-1901 <br /> JAN 2 8 2019 <br /> 11 <br /> UTILITY DISCONNECTION: 0 N/A CITY OF ANACORTE, <br /> WATER DEPARTMENT: 0 YES ❑ NO ELECTRICITY: 0 YES ❑ NO <br /> GAS: ❑ YES 0 NO CABLE TV: ❑ YES ❑ NO <br /> PERMIT TYPE: <br /> cf2fFO O <br /> ° B o: y <br /> A, to <br /> ... r4 d ce <br /> eD <br /> SUBMITTAL REQUIREMENTS: "r CJ <br /> (The number indicates the number of copies for CD <br /> 2 <br /> submittal-if applicable). <br /> o p o <br /> o � <br /> E. <br /> va <br /> Demolition Permit&Oil Tank Decommissioning Application 1 1 1 <br /> Site Plan 1 1 1 <br /> Pedestrian Safety Plan(for Demolition Permits) 1 <br /> Asbestos Survey—Prepared by a Washington State Certified Asbestos 1 1 <br /> Abatement Contractor(for Demolition Permit) <br /> Provide Proof of NWCAA Demolition Permit Approval �/ 7 <br /> City of Anacortes Fire Department Tank Removal Permit2 <br /> If the building is 50 or more years old,provide evidence that the ./ ./ <br /> Department of Archaeology and Historic Preservation(DAHP)has <br /> determined the building to be insignificant/significant. If the building is <br /> determined to be significant, SEPA environmental review may be required. <br /> NOTE: l93b P� j S5eS5 <br /> or <br /> 1. Please contact the Northwest Clean Air Agency(NWCAA) located in Mount Vernon,Washington at <br /> (360)428-1617 or online at http://nwcleanairwa.gov. Unless deemed exempt by the NWCAA, all city <br /> required demolition permits also require a demolition permit from the NWCAA. You can also contact <br /> - ,the NWCAA for a list of WA State Certified Asbestos Abatement Contractors if needed. <br /> 2. Oil Tank Decommission Permits also require a"Tank Removal Permit"from the City of Anacortes <br /> Fire Department. Please contact the Fire Department at(360) 293-1925 to obtain a permit application. <br /> Page 2 of 2 <br />