1532 51ST PL SW 2019-09-10 - Laserfiche WebLink

q\td PIJ IC WORKS PERMIT L,ICATION �/.fidCITY OF EVERETT PERMIT SERVICES • �1 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits + PROJECT SITE INFORMATION: r P_. - �^� camCJ PROJECT ADDRESS: 15 .3„:,.Q. 5 f (0[_ 1.,J E.veciP, -t �O- IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.) SITE WORK FOR PROJECT TYPE:' SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? 10 0 YES, FROM TO NEW WATER/SEWER SERVICE NEEDED? X NO 0 YES,TYPE SIZE SITE WORK/ RIGHT-OF-WAY APPLICATION INFORMATION DESCRIPTION OF WORK: Re_r'n p va, 1 O t- Oconrraus ""\--`f-E'-e S ❑ FENCE IN ROW FT IN HEIGHT Per aNtacts4-1 — ❑ DRIVEWAY APRON/CURB CUT FT WIDE n 0 ASPHALT/CONCRETE PAVING SF Oa_ 4djoi viniyi 9 ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF pro P Zt f y 1.9Wher$ ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT are. Ih COree,is ki-1- ❑CLEARING/GRADING/FiLL/EXCAVATE CY 0-441) "Me free. feiwoVaL, ❑CUT/BORE IN PAVEMENT(PARALLEL) LF ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT INFORMATION OWNER NAME: ien.0,r e u .&- KCRr>d Yom. \-k-i\\.5 OWNER MAILING ADDRESS: STREET 15 3 .. 5' 1 1L_ S L'`-'3 CITY V Veit,.p `_ STATEA ZIP q".1$°.19.45-2 OWNER PHONE 7t5 _ 1 OWNER EMAIL Kcure.v\lll t tks 0..4) CCJWra5A .. net` u,.,,... ....M.., ,....��g.5 APPLICANT NAME: A. r E APPLICANT MAILING ADDRESS: STREET CITY STATE ZIP APPLICANT PHONE: APPLICANT EMAIL: PRIMARY CONTACT: -6WNER 0 APPLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: 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.lam 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# ,,, , 0,0&..c.... r s i4-t ice i-7 PW 1706 — 004- Owner/Authoriz Agent Signature Date (Revised 10/12/2015)