HomeMy WebLinkAboutPermit File BLD-2022-0696 2000 R Avenue City of Anacortes
Invoice/Permit#: BLD-2022-0696
` 904 6th Street
P.O.Box 547 Applied date: 09/01/2022
Issue date: 09/01/2022
Anacortes, WA 98221-0547 Expire date: 08/27/2023
Job Address: 2000 R AVE Permit Type: Commercial Demolition Permit
ANACORTES WA 98221-2537 Project:
APN: P32917
Remarks: REMOVE EXISTING BUILDING AND RELOCATE IT TO GUEMES ISLAND.
Owner: MJB PROPERTIES LLC Contractor: ANACORTES BRASS WORKS, LTD
Address: 5050 1 STAVE S Address: 4453 EDENS RD
STE 102
SEATTLE WA 98134-2400 ANACORTES WA 98221-9594
Phone: (206)255-5153 Phone: (360)941-1332
License#:
General Information: Fees:
Dwelling Units 0 State Building Code Fee Comm 25.00
Demolition permit 60.00
Total Calculated: 85.00
Deposits/Receipts: 0.00
Total Due: 85.00
The issuance or granting of this permit shall not be construed to be a permit for, or approval of, any violation of this Code or any other ordinance or order of
the City, of any state or federal law, or of any order, proclamation, guidance advice or decision of the Governor of this State. To the extent the issuance or
granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or
federal law, or order, proclamation, guidance advice or decision of the Governor of this State, this permit shall not authorize such work and shall not be
valid. The building official is authorized to prevent occupancy or use of a structure where in violation of this Code, any other City ordinances of this
jurisdiction or any other ordinance or executive order of the City,or of any state or federal law, or of any order, proclamation,guidance advice or decision of
the Governor. The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect,
inaccurate or incomplete information, or in violation of any City ordinance, regulation or order, state or federal law, or any order, proclamation, guidance or
decision of the 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--eXamint�d this application and know the same to
be true and correct.
SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSIdf�l3 6
PERMIT APPLICATION FORM
PROPERTY INFORMATION
PROJECT
ADD AVRESS(STREET,SUITE#): ASSESSOR PARCEL NUMBER:P329 w 7
TYPE OF STRUCTURE r I
❑ Single Family ❑ Multifamily,#of Dwelling Units: ❑X Commercial/ Industrial
❑ Duplex ❑ Other Use Type: ❑ Underground Fuel Tank
STRUCTURE INFORMATION
FOR BUILDINGS:
Description of Work: Size of structure: 3 736 sq.ft.
Relocation of existing structure
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Method of Disposal: Date of original construction of structure:
N/A - Reuse 1926
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HISTORIC RESOURCES INFORMATION:
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Is the structure listed on the City of Anacortes Local, If identified prior to demolition,are you
State, or National register of historic places? ! willing to salvage from the structure
historically significant architectural features?
YES* X NO
Designation: YES ENO
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*If yes,SEPA review is required prior to issuing a demolition permit.
Note: Check with the City of Anacortes Museum and/or the WA State Dept. of Archaeological and Historic
Preservation's WISSARD system to answer this question.
UTILITY&SERVICES DISCONNECTION/INTERRUPTION INFORMATION
Identify which City services you would like to disconnect/stop:
Water r�Disconnect ❑Retain StormDisconnect ❑Retain
------------------------- ------- ------------------------------ ----------------
Sew�XDisconnect Otetain ' Garbage XDiscontinue ❑Retain
For private utilities (gas, electricity, cable, etc.), you will need to contact the applicable companies if their
services are to be interrupted or disconnected.
FOR UNDERGROUND STORAGE TANKS:
DECOMMISSIONING TYPE:
❑Abandonment in place (Fire Dept. Approval required) ❑ Removal
Date of pump& rinse: N/A ! Disposal Location:
Type of inert fill:
Approximate age of tank: ICC Certification#:
Deconstruction/Demolition Permit Application Submittal Checklist
Updated December 2021
Page 3 of 4
PROPERTY OWNER INFORMATION
NAME: PHONE:
MJB Properties, LLC 206-255-5153
ADDRESS(STREET,CITY,STATE,ZIP): EMAILADDRESS:
5050 1 st Ave S, Suite 102, Seattle, WA 98134 jblais@gmccinc.com
CONTRACTOR INFORMATION
NAME:* PHONE:
Glen Veal 360-941-1332
CONTRACTOR'S BUSINESS LICENSES STATE LICENSE#: CITY OF ANACORTES
*All Contractors&Subcontractors must have a N/A - Removal by Owner ENDORSEMENT?
valid City of Anacortes business license prior to EXPIRATION DATE: DYES NO
doing work in the City.
ADDRESS(STREET,CITY,STATE,ZIP): EMAILADDRESS:
4453 Edens Road
FINANCING INFORMATION (Required if project valuation exceeds$5,000, per RCW 19.27.095)
Lender administering the construction financing or firm issuance a payment bond (if any) on behalf of
the prime contractor for the protection of the owner, if the bond is for an amount not less than 50%of
the total amount of the construction project (if owner is self-financing, please indicate).
Completion of this information may be deferred until permit issuance.
NAME: PHONE:
N/A
ADDRESS(STREET,CITY,STATE,ZIP):
CONTACT PERSON
Select one person the city will contact for anything related to this project:
PROPERTY OWNER CONTRACTOR OTHER(LIST BELOW)
NAME: PHONE:
Glen Veal 360-941-1332
ADDRESS(STREET,CITY,STATE,ZIP): EMAILADDRESS:
4453 Edens Road, Anacortes N/A
SIGNATURE
I hereby declare that I am either the owner of the property listed on this application, or the owner
of this property has authorized me to be their representative to act for them. I also declare under
penalty of perjury under the laws of the State of Washington that all of the statements and answers
contained herein, and the information submitted with this application form is in all respects,true,
correct, and complete to the best of knowledge and belief.
8 9-1 -22
S NATURE DATE
Deconstruction/Demolition Permit Application Submittal Checklist
Updated December 2021
Page 4 of 4
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