4310 COLBY AVE 2020-05-05 - Laserfiche WebLink

P"-LIC WORKS PERMIT , PLICATION CITY OF EVERETT PERMIT St \�ES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: L/31 O C G/b7 /f ue, H e t9A SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED DTOWNHOUSE ❑DUPLEX DADU ❑MULTI-FAMILY MOMMERCIAL DINDUSTRIAL IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) /Y14' 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 0 Combined Sewer ❑ASPHALT/CONCRETE PAVING SF ®Separated Storm Sewer 0 RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF 0 Direct Discharge to Snohomish River or Puget Sound O RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: 0 CLEARING/GRADING/FILL/EXCAVATE CY ❑ 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: SF El POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: SF /3 z r- 04- S c e to ie ix() - '/ „ Pi/c-- pre e.0, -11--, -F'fo 2 7 0 .5;. 4 Y l Ace o, CONTACT INFORMATION OWNER/APPLICANT NAME: /Vtct� �•✓16i 4Lc-- OWNER/APP. MAILING ADDRESS: STREET /1 7 /� _� „: S T 23o J y� CITY S `/ea /� STATE Cv✓J ZIP 9 GAG. OWNER/APP. PHONE: 20 S OWNER/APP EMAIL: 11/e /X& / `Required for Work in Public Right-of-Way CONTRACTOR NAME: L CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: qOWNER /APPLICANT ❑CONTRACTOR 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: w(f.- SYS-- cz,96 T e OC'CCONTACT EMAIL: jr Gci; ct. A-. /Ye, 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 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# 7/zS1/7 PW . 'v7 - 51. Owner u orized Agent SignatureDate (Revised 4/15/2019) r4