HomeMy WebLinkAboutPermit File 1119 12th Street .0 X C>a, City of Anacortes Permit#: BLD-2009-0269
904 6th Street Issue date: 07/30/2009
P.O.Box 547 Expire date: 09/28/2009
02„' Anacortes, WA 98221-0547
::9 paR�s: " (360)293-1901
Job Address: 1119 12TH ST Permit Type: Demolition Permit
ANACORTES WA 98221-2103 Project:
APN: P55252
Remarks: Demolish house and haul debris to transfer station and the concrete will go to Lakeside Industries.
Owner: SECURITY INVESTORS INC Contractor: SCIMITAR CONSTRUCTION
Address: 12155 BAYHILL DR Address: PO BOX 1720
BURLINGTON WA 98233-3640 ANACORTES WA 98221-6720
Phone: (360)757-1701 Phone: 293-8387
License#: SCIMIC053KA
General Information: Fees:
Total Calculated:
Adjustments:
Deposits/Receipts:
Total Due:
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
MlehelE.O 76n
SIGNATURE OF OWNER OR AUTHORIZED AGENT IS ED BY
07/28/2009 16: 34 360293B352 SCIMITAR CDNSTRUCTID PAGE 03/64
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;tre '` ,� DEMOLITION PERMIT .APPLICATION
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Site Address: ' I I 19 (2 r+i Sr i
Assessors Account No.: f.FSZS Z• Date:_4 al /en
Lot(s): w Block Addition: ,
Owners Namc:SG-,Gutrt""77j J i1t/eLa Contractors Name: •�f1n-p{C G A% S'f
Address:JzI SS SRyfiru- � Suet. Address: P 0. Bnc 17Z° _.
State:144 rp:q_Z33 State: WA Zip: Cige_f
Phone: 31,1) 15/-1701 Contractors License: SC(f,4,-Xos3/C4
Phone: SJ,o tR —g387
Have Utilities Been Notified? Description of proposed demolition. How will materials be
disposed? I I ''
Water Dept.: Yes No �EMV I s— . f}A 1 */L L ewes
Electric: Yes No
Cable: Yes o —1-0 I fakSsr-a S`rtmrv,q Ai-lb
Gas: Ye No
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BARRICADES TO BE PROVIDED PO PUBLIC TB ON, AREA MUST BE
ROPED OFF! 1
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Applicant's or Agent s Signature
ASBESTOS WARNING
Breathing asbestos is hazardous CO 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.2"d Street,Mt. Vernon, WA 98273 (360) 428-1617.
Fire Department Approval: Date:
Police Dept. Approval: Date: / �.p,
Public Works Department Approval: �<V� . Date: `7/?C1 /c
Comments: 10111 t- Cj {
Address // (9 / Z sA
Leg31 Description j-5 '7 73LL S7 recta ,
Assessors Account No. T I?? ooS —000c(
Permit No. Date Description Date Finaled
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