127 BARBARA LN 2020-05-06 - Laserfiche WebLink

P-3LIC WORKS PERMIT __ 'PLACATION Lim 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: j -2-7 SITE WORK FOR PROJECT TYPE: DSFR-DETACHED ❑TOWNHOUSE ❑DUPLEX DADU ❑MULTI-FAMILY DCOMMERCIAL DINDUSTRIAL IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) YDESCRIPTION,OF.S1TE'WORK./`RICHT OF=WAIFWORK . FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: O FENCE IN ROW FT IN HEIGHT STORMWATER DISCHARGES TO: ❑ DRIVEWAY APRON/CURB CUT FT WIDE 0 Combined Sewer 14,ASPHALT/CONCRETE PAVING 6.7 C" SF 0 Separated Storm Sewer ❑ 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: ❑CLEARING/GRADING/FILL/EXCAVATE CY ❑ MR2 Only 0 MR1-5 0 MR1-9 ❑CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: 0 CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: SF O POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: SF ; �_ CONTACT INFORMATION .. OWNER/APPLICANT NAME: 1`•- _. ! e" '1 CiJ\ S OWNER/APP. MAILING ADDRESS: STREET i--/q Zc2 L75 /- 5 CITY V�A`1/1,1 %. ) f"�U STATE L14- ZIP 9 8-2:75 OWNER/APP. PHONE: OWNER/APP. EMAIL: *Required for Work in Public Right-of-Way CONTRACTOR NAME: 07.A./11.E 4' CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: y75- 7 72-Ty "-s CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: gOWNER /APPLICANT 0 CONTRACTOR 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: 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# 6-- zZ-1 `7 PW I q 05--Cr/ Owner/Authorized Agent Signature Date (Revised 4/15/2019)