3231 COLBY AVE 2020-02-06 - Laserfiche WebLink

mil Pr CLIC WORKS PERMIT I PLICATION CITY OF EVERETT PERMIT SERVICES EVERETT(P) 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON 425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE:.INFORMATION. . PROJECT ADDRESS: 3 CA- \' nuc-i F\,tro3-t clap C> 1 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU OMULTI-FAMILY COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) . 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 FT WIDE ❑Combined Sewer L ASPHALT/CONCRETE PAVING SF 0 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: ❑CLEARING/GRADING/FILL/EXCAVATE CY 0 MR2 Only 0 MRI-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: 0 SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: 2 6' SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: 2 SF J Corcr'A-4 ‘'X rap\no-Is- C-1) j p i r,-1 40 . i o i ri-1 CONTACT INFORMAT#ON.. OWNER/APPLICANT NAME: OWNER/APP. MAILING ADDRESS: STREET CITY STATE ZIP OWNER/APP. PHONE: OWNER/APP.EMAIL: *Required for Work in Public Right-of-Way t \ �+ CONTRACTOR NAME: , '-} 1cL E�nict V\Jcri LLC, , /,1 CONTRACTOR ADDRESS: 1 '' 100 STREET �t Alt t' S A Y --14--c�C I . CITY 1�LA .l-\-moi STATE` 1\J� ZIP��1 CONTRACTOR PHONE:LS_YIGI . 1f p3' - (j C J CONTRACTOR EMAIL: llcb ,,:x.:4 -11. ( rac L\f\ '►S ,try, J CONTRACTOR LICENSE#(REQUIRED)JC-F\11C\N j pi- EVERETT #(R D) BUSINESS LICENSE PRIMARY CONTACT: 0 OWNER APPLICANT aCONTRACTOR 0 OTHER(Architect, Engineer, Etc.) CO ACT NAME:C CONTACT PHONE: L5.. 39 -1- '1 a t- . ?=ka dit CONTACT EMAIL: fit— ft "� ..cv-i14 f 'G r( L 3 Yf&. • C6"`` 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 perforrm(he 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 ` 1( tc3 l �! PW # L Owner/Authorized Agent Signature Date (Revised 4/15/2019)