Laserfiche WebLink
FBLIC WORKS PERMIT APPLICATION <br /> 47TCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I https://everettwa.gov/permits <br /> PROJECT SITE INFORMATION A' ,L �/ <br /> PROJECT ADDRESS: Intersection of Hewitt Avenue and Bond Street /062 #Lt(, �1 , <br /> SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY „COMMERCIAL DINDUSTRIAL <br /> IF APPLICABLE: 0 LAND USE PROJECT#(SEPA,PRE-APP,SS,ETC.) <br /> IF APPLICABLE: 0 FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# <br /> UTILITY COMPANY'S NAME&JOB#: JOB# <br /> DESCRlPTIONOFSilt'WORK%Ri16HTOF-`�IA1(W0RK' <br /> FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: <br /> ❑FENCE IN ROWFT IN HEIGHT - s <br /> ❑DRIVEWAY APRON/CURB CUT FT WIDE D <br /> a L iJr <br /> ❑ASPHALT/CONCRETE PAVING SF <br /> ❑RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF NOV 3 0 2018 <br /> ❑RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT CITY OF EVERETT <br /> ❑CLEARING/GRADING/FILL/EXCAVATE CY Permit Services <br /> 6*CUT/BORE IN PAVEMENT(PARALLEL) (o 0 LF <br /> ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF <br /> ❑POLE WORK/AERIAL/OVERLASH LF <br /> ADDITIONAL DESCRIPTION(AS NEEDED): n S-{s 11 a, QnJYt),, {,‘ ,ivtnn. fvc1 ) ...ie.I t S l t (i) <br /> loc,ft,( OA rw✓f.(f,A (.79( 01- 06,e1.1 skec l-- GIn 4'4.P- .<ccatd (Dec k5 <br /> '�`'►e S+J�'rt.Un 5.11 c r4- ({,P_v4;4t Ave^vL . (SO-k ✓;43.k m p L'- s-h((S. <br /> ti.A 4.r c. L ej +v re telk, O p e-r1. <br /> CONTACT INFORMATION <br /> OWNER/APPLICANT NAME: <br /> OWNER/APP. MAILING ADDRESS: sTResT <br /> CITY STATE ZIP <br /> OWNER/APP.PHONE: OWNER/APP.EMAIL: <br /> CONTRACTOR NAME: SoundEarth Strategies, Inc. <br /> CONTRACTOR ADDRESS: STREET 2811 Fairview Avenue East,Suite 2000 <br /> cnY Seattle STATE WA ZIP 98102 <br /> CONTRACTOR PHONE: 206-306-1900 CONTRACTOR EMAIL: spleskac@soundearthinc.com <br /> CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER /APPLICANT VI CONTRACTOR 0 OTHER(Architect,Engineer,Etc.) <br /> CONTACT NAME: CONTACT PHONE: 404-660-6776 <br /> Clare Tochilin CONTACT EMAIL: ctochilin@soundearthinc.com <br /> ACKNOWLEDGEMENT..I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must <br /> 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 <br /> 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 <br /> perform the work for which application is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> /3b/7&) w " PW IS11 - 001 <br /> Owner/Authorized Agent Signature Date (Revised 1/52017) <br />