HomeMy WebLinkAbout21018 66TH AVE NE UNIT B_077396_2026 I !1
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Y °- - > DEMOLITIOV_
7 o PERMIT APPLICATION
4 ING"S Department of Community Development
City of Arlington • 238 N Olympic Ave. • Arlington, WA 98223 • Phone (360) 403 3431 • FAX (360)403 3447
THIS APPLICATION MUST BE ACCOMPANIED TWO(2)SETS OF FULLY DIMENISIONED PLOT PLANS AND SITE CLEAN-UP
PLAN, TWO(2) COPIES OF AN ASBESTOS ABATEMENT REPORT COMPLETED BY AN APPROVED AGENCY.
Type of Permit: (check one) ( )�Residential ( ) Commercial
Project Address: " `� Parcel ID#: 0n
Lot#: ��' Subdivision: � �L' L ��M
Building Area (Sq Ft) No of floors: Number of Buildings:
,,/ yam- 7
Owner: l 7 �}'Z�^ `�[-'' �/�� �"�'�l�T i( �L��S Phone Number: `�' 4
Address: ZIzo City: d�l ' �� State: l QA_ Zip Code:
Contact Person: 1 �� Phone Number:
Cell Phone: Fax: ,3 �761 It E-mail: 91X�11� A;ay,
Address: O c� 1 �= L City: State:Al,l ' Zip Code:
Scope of Work: ,�•1
Contractor: 6� �� Phone Number:
Address- _ City: State: Zip Code:
Contractor's License Number: Expiration:
I hereby ce that the above inforn ion is correct and that the construction on, and the occupancy and the use of the above-
described perty wi b cord nce with the laws, rules and regulations of the Stat of Washington.
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-� Applicant ig ure Date
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Print Applicants Name MAY 01 2007
PENT OEN R
FOR STAFF USE ONLY
Permit# Accepted By Amount Received Receipt# Date Received
WEB Forms—14 Page 1 of 1 5/05 dwa
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