9430 HOLLY DR 2020-05-06 - Laserfiche WebLink

PUIPLIC WORKS PERMIT LIGATION _ --- _ CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P) 425-257-8810 ( FAX 425-257-8857 I (E) everetteps©everettwa.gov I www.everettwa.gov/permits A P/ JECT SITE INFORMATIONPROJECT ADDRESS: t, y�3 � fle IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE APP,SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY DCOMMERCIAL El INDUSTRIAL CHANGE OF USE? 0 NO 0 YES, FROM TO - NEW WATER/SEWER SERVICE NEEDED? 0 NO 0 YES,TYPE SIZE SITE WORK/ RIGHT-OF-WAY APPLICATION 1'NFORM4ITION DESCRIPTION OF WORK: CYF'ENCE IN ROW FT IN HEIGHT ❑DRIVEWAY APRON/CURB CUT FT WIDE ❑ASPHALT/CONCRETE PAVING SFsf. ,, `_` fvii F�; 1 ❑RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ; ip 1 i ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT A:. I s ❑CLEARING/GRADING/FILL/EXCAVATE CY _ Ct . O !EVERETT ❑CUT/BORE IN PAVEMENT(PARALLEL) LF Permit Sac,ices ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT INFORMATION _ OWNER NAME: fiefif 4 / /fi OWNER MAILING ADDRESS: STREET rGf... a �� ++��•' fpiV #4 CITY .e;af p/e.-- t STATE bir..if ZIP f if Z- c-/ OWNER PHONE 75 7 Z gWNER EMAIL: ,p/7/1/1„/ 3 (2 6-0/17 APPLICANT NAME: Jj6/'i(yii -r APPLICANT MAILING ADDRESS: STREET/V )'r,/ CITY STATE ZIP APPLICANT PHONE: APPLICANT EMAIL:ryv r PRIMARY CONTACT: CI OWNER w 0 APPLICANT 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.lam the owner,or lam authorized by the owner of this property to perform the work for which application is made,and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# _.,r% PV i sci,-- 02 ,/ 0 ^'mi r.ut Orized Agent Signature Date (Revised 10/12/2015)