HomeMy WebLinkAboutPermit File 1211 6th Street Y City of Anacortes Invoice/Permit#: BLD-2016-1135
904 6th Street Applied date: 03/23/2016
P.O.Box 547 Issue date: 03/23/2016
'01 Anacortes, WA 98221-0547 Expire date: 03/18/2017
4" (360) 293-1901
Job Address: 1211 6TH ST Permit Type: Demolition Permit
ANACORTES WA 98221-1721 Project:
APN: P55398
Remarks: Demolish single family residence
Owner: JOHN CRARY TRUST Contractor:
Address: 10111/2 28TH Address:
ANACORTES WA 98221
Phone: (712)490-7955 Phone:
License#:
General Information: Fees:
Dwelling Units 1
Total Calculated:
Adjustments:
Deposits/Receipts:
Total Due:
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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 OWNER OR AUTHORIZED AGENT ISSUED BY
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DEMOLITION PERMIT APPLICATION
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Site Address: �� ��rP�� ,� ,/� S g-2 J
Assessors Account No.: /195 S ,T / '�' /177 2 -0 lY/_ 8Date:
Lot(s): &U f 2�y Block: ,. Addition: /ity, c9 7`�ir�f/4 hi e 0
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Owners Name:,7A4e iy ',hi) t E�/Contractors Name: /ds <zy 'G k9tP.J4G
Address/t//a )(5-7''.S/. /F15',��Z Address:
/`f/I a'� i) Wit Zip: %522) State: Zip:
Phone: 7/.2 - ry0 7, C Contractors License:
Phone:
Have Utilities Been Disconnected? Description of proposed demolition.
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Water Dept.: Yes 47,,%� -')/ /'1,/ c9q7:21/0, 1)/,-vCX
Electric: Yes 10 _
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Cable: Yes J�oi .�/ S Are"/�1/l �� f�G �'�)4C
Gas: Yes la How Will Materials be disposed?
BARRICADES TO BE PROVIDED1OR PUBLIC PROTECTION, AREA MUST BE
ROPED OFF!
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Applicant's., Agent's Signature
ASBESTOS WARN G
Breathing asbestos is hazardous to your health. Before starting a renovation or demolition project,
survey for friable asbestos materials. Notify Northwest Air Pollution Authority prior to asbestos
removal or containment 1600 S. 2nd Street, Mt. Vernon, WA 98273 (360) 428-1617.
Fire Department Approval: Date:
Police Dept. Approval: Date:
Public Works Department Approval: (2Arm.921 VA =U tWtD w• )ate: `5/Zs /
Museum: Date:
Comments: Cp.A-1)4e1Mi4 $ Itl ILUTAL -1/4 STtoLOA. .ar a fta es '8.
City of Anacortes
Invoice/Permit#: BLD-2016-1135
904 6th Street Applied date: 03/23/2016
411erw P.O.Box 547 Issue date: 03/23/2016Anacortes, WA 98221-0547
Expire date: 03/18/2017
4w71. (360) 293-1901 P yy c W r/
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Job Address: 1211 6TH ST Permit Type: Demolition Permit
ANACORTES WA 98221-1 72 1 Project:
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APN: P55398
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Remarks: Demolish single family residence
Owner: JOHN CRARY TRUST Contractor:
Address: 10111/2 28TH Address:
ANACORTES WA 98221
Phone: (712)490-7955 Phone: •
License#:
General Information: Fees:
Dwelling Units 1
Total Calculated:
Adjustments:
Deposits/Receipts:
Total Due:
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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.
6-21 03 /1///
SIGNATURE OF OWNER ORAUTH E OR ED AGENT
ENT ISSUED