3008 18TH ST 2020-06-03 - Laserfiche WebLink

® Pl LIC WORKS PERMIT 141-PLICATION CITY OF EVERETT PERMIT SERVICES 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: -3 d o B'- I g '7 t-t S"i SITE WORK FOR PROJECT TYPE: 3SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX DADU ❑MULTI-FAMILY ❑COMMERCIAL DINDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) DESCRIPTION OF SITE'WORK I-RIGHT-OF-WAY WORK FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: .I FENCE IN ROW `ft 2 1 n1 FT IN HEIGHT STORMWATER DISCHARGES TO: ❑ DRIVEWAY APRON/CURB CUT FT WIDE 0 Combined Sewer El ASPHALT/CONCRETE PAVING SF 0 Separated Storm Sewer ❑ 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 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 ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: 9r. SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: ri SF CONTACT INFORMATION 4 OWNER/APPLICANT NAME: is G 1 L;A I L k--(2-{ Tr ( D'S til(v1 c 3 S OWNER/APP. MAILING ADDRESS: STREET DO 91'1 q S,r 1 CITY C v E T STATE 1,t )f—` ZIP j c/2 C) 1 OWNER/APP. PHONE: OWNER/APP.EMAIL a-.._... �. .e. a._. . . ..Na.. *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): 0 PRIMARY CONTACT: At OWNER /APPLICANT ❑ CONTRACTOR 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: L4 2 S • -34, Le 9. Sv A-13 L A l i C IT CONTACT EMAIL: o c V1i1 v �;-0 9 3 J 11L1 ck_ 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 1 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 A PERMIT# 111 Airy i, r 1 PW Jqo 7- 6/5 Owne thorized Agent Signature Date (Revised 4/15/2019) 9 9