11400 EVERGREEN WAY 2020-01-13 - Laserfiche WebLink

47terr PLIC WORKS PERMIT 'PLICATION CITY OF EVERETT PERMIT SERVICES 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 PR ECT MITE IEt 1 t R > Tlt lel PROJECT ADDRESS: 11400 WA-99, Everett WA 98204 IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY i;LICOMMERCIAL ❑INDUSTRIAL CHANGE OF USE? 0 NO cd YES, FROM General Parking TO Electric Vehicle Charging/Parking NEW WATER/SEWER SERVICE NEEDED? 04 NO 0 YES,TYPE SIZE DESCRIPTION OF WORK: Installation of Electric Vehicle Charging Station in existing Wal-Mart Parking lot. ❑ FENCE IN ROW NA FT IN HEIGHT ❑DRIVEWAY APRON/CURB CUT NA FT WIDE ❑ASPHALT/CONCRETE PAVING NA SF ❑RETAINING WALL/ROCKERY IN RIGHT-OF-WAY NA LF ❑RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT NA FT TOTAL HEIGHT ❑CLEARING/GRADING/FILL/EXCAVATE NA CY ❑CUT/BORE IN PAVEMENT(PARALLEL) LF ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF ,�C✓l�+t7ACT l<N�fSIRMl��t71�# OWNER NAME: Wal-Mart Real Estate Business Trust OWNER MAILING ADDRESS: STREET 2001 SE 10th Street c,Tv Bentonville STATE AR ZIP 72716 OWNER PHONE: OWNER EMAIL: APPLICANT NAME: Black & Veatch for Electrify America APPLICANT MAILING ADDRESS: STREET 5885 Meadows Rd Suite 700 ciTr Lake Oswego STATE OR ZIP 97035 APPLICANT PHONE: 5414903080 APPLICANT EMAIL: suarezc@bv.com PRIMARY CONTACT: 0 OWNER APPLICANT 0 OTHER(Architect,Engineer, Etc.) CONTACT NAME: CONTACT PHONE: 5414903080 Christina Suarez CONTACT EMAIL: suarezc@bv.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.lam the owner,or lam 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# a$.,t PW (30b-v39 Owner/Authorized Agent Signature Date (Revised 9/23/2016)