4801 VIEW DR 2020-06-05 - Laserfiche WebLink

PLIC WORKS PERMIT ; . ' LICATION lizi CITY OF EVERETT PERMIT SE"!""' S 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: Q$O I �. •; .a, ,z. SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY ❑COMMERCIAL :INDUSTRIAL IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) DESCRIPTION OF SITE:WORK/:RIGHT-OF=WAY WORK, FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: IFENCE IN ROW 4 / FT IN HEIGHT STORMWATER DISCHARGES TO: ❑ DRIVEWAY APRON/CURB CUT FT WIDE piCombined Sewer ❑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: 0 CLEARING/GRADING/FILL/EXCAVATE CY ill-RAR2Only 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: C SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: C SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: L' SF '' . toisitAdt INFORMATION '- OWNER/APPLICANT NAME: A C(-.4.,M)- �, l -.Ur 1-� (6'��\-- OWNER/APP. MAILING ADDRESS: STREET 'C. ( J f�(,-. _1) 2-CL% C.,, / f^ V ll `- CITYSTATE // ' a LJ ZIP 2<,3 3 '�: OWNER/APP PHONE: * f5 - 3 -'2.,2?-(., OWNER/APP EMAIL ��b 0 V.Y1 , CD :ti ui q r ... Re ( q ed for Work in Public Right-of-Way f CONTRACTOR NAME: Cl de_ /`� �4V CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): -' PRIMARY CONTACT: 0 OWNER /APPLICANT ❑CONTRACTOR 0 OTHER(Architect, Engineer, Etc.) , / C �T NNVIE: CONTACT PHONE: 415 -- 23S„,— 7W `'t C��( ' n � (td () /H CONTACT EMAIL: Li y6 06�(c,k gYYt GILL . C6)/v-' ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true arld 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 perfor 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 OA.- 26 - 2011' Pw#e ?08— 041 Owner/Authorized Age ignature Date (Revised 4/15/2019)