1501 BAKER AVE 2020-05-04 - Laserfiche WebLink

im PI -_IC WORKS PERMIT Ar 04LICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 15-6` \,)�jo.ke,g >/) e- SITE WORK FOR PROJECT TYPE: jASFR-DETACHED ❑TOWNHOUSE ❑DUPLEX DADU ❑MULTI-FAMILY ❑COMMERCIAL DINDUSTRIAL IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) DESCRIPTION OF S1TE ORK./.RIGHT OF-WAY WORK.. .,. FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: I FENCE IN ROW (, tz L . S S FT IN HEIGHT STORMWATER DISCHARGES TO: O DRIVEWAY APRON/CURB CUT FT WIDE 0 Combined Sewer ❑ASPHALT/CONCRETE PAVING SF 0 Separated Storm Sewer O 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 MR1-5 0MR1-9 ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: C SF O POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: a SF ADDITIONAL DESCRIPTIONc �(AS NEEDED): Total New+Replaced: C SF fF_r-i L c o — VF-a,u . :CONTACT;INFORMATION OWNER/APPLICANT NAME: ( f cS.. 6CI.A.C.t. OWNER/APP. MAILING ADDRESS: STREET i d 1 „1 tQ- 4-Aie- CITY STATE to4_ ZIP 79.21)( OWNER/APP.PHONE: OWNER/APP.EMAIL: ......:.. .x. .....: .. .�.. ...e........, ..yy.,.. a...:. ...-..,. ::.:., a....e.,..a. ...�......... oaie,. ..�....a•C. H, ...�•e. ...v^c.m sro..'+x..+u. .........'a sura..... d�c,.cska a.....n xm . ..e>r R. `Required for Work in Public Right-of-Way CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): __PRIMARY CONTACT: 0 OWNER /APPLICANT 0 CONTRACTOR 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: 3 I }��- t ‘j DA, , Scr+A L.cz c),..6CONTACT EMAIL: 4 ? gci)k-i i I •CZ Vkit ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.! ork 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 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 4 .... i PERMIT# ,� psi �- `t- /? PW '9o4-04.5 Own uthorized Agent Signatu - lDate (Revised 4/15/2019)