4620 SEAHURST AVE 2020-05-20 - Laserfiche WebLink

�'-- PL LCC WORKS PERI ff PPL C TON A % CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE II IF*RI IATION PROJECT ADDRESS: y6 .)DS(4�j,/rs- l+Ut, . LvGeott. Wn ��Q ?J IF APPLICABLE: ❑ LAND USE PROJECT##(SEPA,PRE-APP, .PP, SS, ETC.) S i I -CO I SITE WORK FOR PROJECT TYPE:E:ISFR-DETACHED ❑SFR-ATTACHED C)DUPLEX ❑MULTI-FAMILY ❑COMMERCIAL DINDUSTRIAL CHANGE OF USE? igi NO 0 YES, FROM TO_ - _ /1 INEW WATER/SEWER SERVICE NEEDED? ❑ NO ®YES,TYPE W;.,'r.-/;ewe— SIZE Ir'.N- SITE WORK/ ,'IG 9T-,e F WAY APPLICATION INF'?i':IV AT1ON OF • ❑ FENCE IN ROW FT IN HEIGHT LI DRIVEWAY APRON/CURB CUT FT WIDE ❑ ASPHALT/CONCRETE PAVING SF ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT ❑ CLEARING/GRADING/FILL/EXCAVATE CY ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT FORGVII ATI si Iz! OWNER NAME: �,,,, , i h0M �^•1 — OWNERMAILINGADDRESS: STREET cle).. - S0,014,(54- 4v<- o CITY ' ,qtr eil STATE 10.14 ZIP 1 gr)4.3 OWNER PHONE: )4R) - 01 aO- 30q O OWNER EMAIL i\o I Jj,:er ,AQ,6 r r1•G•'.(4"^ APPLICANT NAME: Ip,nrt) ( oAs`Fru(.f14p, ‘ lc, I APPLICANT MAILING ADDRESS: STREET 115- )4 60,0C.II1 R 1 //y !'/ crry .%1O�10/h'yk STATE (VR ZIP q a 1 p APPLICANT PHONE: aQ 6 ' 60.0- 13).� APPLICANT EMAIL Jill r �0�s 'a1 4, ,I riCO PRIMARY CONTACT: ❑ OWNER APPLICANT 0 OTHER(Architect, Engineer, Etc.) ONTACT NAME: CONTACT PHONE: 106 ='?)O - 13as C '., M X CONTACT EMAIL: S (a I , ' 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 I am authorized by the owner of this property to perform the work for which application is made,and!comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# _. (:/-) 7- 4 P`.'.' 10005-- 00(a --I Owner/Authorized Agent Signature Date (Revised 10/12/2015) l/ )12 ‘`1 I \1 7/_