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4errPLIC WORKS PERMIT PLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 f FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE:INFORMATIONh <br /> PROJECT ADDRESS:2215 PINEHURST AVE <br /> IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.) <br /> SITE WORK FOR PROJECT TYPE: =SFR-DETACHED =SFR-ATTACHED =DUPLEX MULTI-FAMILY COMMERCIAL <br /> CHANGE OF USE? O NO O YES, FROM TO <br /> NEW WATER/SEWER SERVICE NEEDED? O NO O YES,TYPE SIZE <br /> SITE WORK/;RIGHT OF WAYAPPLICATION INFORMATION <br /> DESCRIPTION OF WORK: CONSTRUCT NEW DETACHED GARAGE AND NEW DRIVEWAY <br /> O FENCE IN ROW FT IN HEIGHT <br /> O DRIVEWAY APRON/CURB CUT FT WIDE <br /> =ASPHALT/CONCRETE PAVING SF <br /> O RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF <br /> O RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT <br /> O CLEARING/GRADING/FILL/EXCAVATE CY <br /> O CUT/BORE IN PAVEMENT(PARALLEL) LF <br /> 0 CUT/BORE IN PAVEMENT(NON-PARALLEL) LF <br /> CONTACT INFORMATION <br /> OWNER NAME: TIMBOE ELSIE E REVOCABLE LIVING TRUST <br /> OWNER MAILING ADDRESS: STREET 2215 PINEHURST AVE SE <br /> civ EVERETT STATE WA ZIP 98203 <br /> OWNER PHONE: (OWNER EMAIL: <br /> APPLICANT NAME: TIMBOE ELSIE E REVOCABLE LIVING TRUST <br /> APPLICANT MAILING ADDRESS: STREET 2215 PINEHURST AVE SE <br /> crr' EVERETT STATE WA ZIP 98203 <br /> APPLICANT PHONE: APPLICANT EMAIL: <br /> PRIMARY CONTACT:— O OWNER —CI APPLICANT LI OTHER(Architect, Engineer, Etc.) <br /> CONTACT NAME: REAVES ANDY CONTACT PHONE:4254866533 <br /> CONTACT EMAIL: <br /> ACKNOWLEDGEMENT.1 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. I am the owner,or I am authorized by the owner of this property to <br /> perform the work for which application is made,and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> PW1811-026 <br /> Authorized Agent/Owner Date (Revised 10/12/2015) 1 (/�� <br />