2325 TAYLOR DR 2022-05-23 - Laserfiche WebLink

PUBLIC WORKS PERMIT APP ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 OLT (P)425-257-8810 I FAX 425-257-8857 i (E)everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2325 Taylor Drive, Everett WA 98203 SITE WORK FOR PROJECT TYPE: VSFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.) SS 18-003 C _ '11�CRp 1$'001 J IF APPLICABLE: 0 FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB#: JOB# DESCRIPTION OF SITE WORK/RIGHT-OF-WAY WORK FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: O FENCE IN ROW FT IN HEIGHT DRIVEWAY APRON/CURB CUT 14 FT WIDE O ASPHALT/CONCRETE PAVING SF ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT "CLEARING/GRADING/FILL/EXCAVATE 250 CY O CUT/BORE IN PAVEMENT(PARALLEL) LF ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF ❑ POLE WORK/AERIAL/OVERLASH LF ADDITIONAL DESCRIPTION(AS NEEDED): CONTACT INFORMATION OWNER 1 APPLICANT NAME: MV3, LLC OWNER 1 APP. MAILING ADDRESS: STREET 728 3rd St,Ste D CITY MUkilte° STATE WA ZIP 98275 OWNER I APP. PHONE: 4257506315 OWNER 1 APP.EMAIL: Chad(C7�,tm171S.COm CONTRACTOR NAME: TBD CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: DOWNER /APPLICANT ❑CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: 425.750.6315 Chad Scott CONTACT EMAIL: chad@tmms.com ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# (/1 vtr 7k/ PW 130-7--o1 Owner/Authorized Agent Signature Date (Revised 1/52017)