7913 TIMBER CIR 2020-01-30 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES Nal(0, -- 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE.INPORMATIOM PROJECT ADDRESS: -7' I3 -n.4a E 12_ ( c- . SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY ❑COMMERCIAL DINDUSTRIAL IF APPLICABLE: D LAND USE PROJECT#(SEPA,PRE-APP,SS, ETC.) IF APPLICABLE: ❑ 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: DRAINAGE MITIGATION QUESTIONS: ❑FENCE IN ROW FT IN HEIGHT STORMWATER DISCHARGES TO: /DRIVEWAY APRON/CURB CUT 3 c FT WIDE 0 Combined Sewer ❑ASPHALT/CONCRETE PAVING SF a Separated Storm Sewer ❑RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF 0 Direct Discharge to Snohomish River or Puget Sound ❑RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: 0 CLEARING/GRADING I FILL/EXCAVATE CY al MR2 Only 0 MR1-5 0 MR1-9 ❑CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: v SF 0 POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: ( 5-0 SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: 1 5 CD SF J, .,..,i T� z--+.)�...� 4- '11-0,..) ) CONTACT INFORMATION . ;' . :' iOWNER/APPLICANT NAME: \ VOWNER/APP. MAILING ADDRESS: STREET - T4 Cri-aaf Cr -,�1 CITY STATE V f A ZIP OWNER/APP.PHONE. IQ )d"1 �1�( 0 OWNER/APP. EMAIL: ot....9 Nick-co,Ccrr, *Required for Work in Public Right-of-Way \ - , l CONTRACTOR NAME: JL�aA��•C c e a- V�j� LL_ s Al CONTRACTOR ADDRESS: STREET I i-)on ' \/u 1': �G - 31 -3cd-I � CITY t�U 1 ""+O 11--c° STATE ZIP"''7Y�F� CONTRACTOR PHONE: n -'fl-l? H CONTRACTOR EMAIL: 11' 611 .0 tar • • r _A (!� s/hhJ�� CONTRACTOR LICENSE#(REQUIRED):-,A .cPS- EVERETT BUSINESS LICENSE#(REQUIRED) PRIMARY CONTACT: 0 OWNER /APPLICANT 5cCONTRACTOR 0 OTHER(Architect, Engineer, Etc.) CONTACT NAMEc + BG •l(> CONTACT PHONE: Lid-E- 133Lj CONTACT EMAIL: i (5) AA k(ri-fib i t r ,C0r m 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 perfothe work for which application is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. t..—__C_L s City of Everett Official Use Only PERMIT# I Ian I 1� PW i! '7 0 5- c 33 Owner/Authorized Agent Signature Date (Revised 1/72019)