2532 ROCKEFELLER AVE 2020-06-30 - Laserfiche WebLink

PLIC WORKS PERMIT A'LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT ADDRESS: 2.2c-3 Z �_ jt, • `— 'VSA 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.) IF APPLICABLE: 0 FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB#: JOB# FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: ❑FENCE IN ROW FT IN HEIGHT STORMWATER DISCHARGES TO: ❑DRIVEWAY APRON/CURB CUT FT WIDE 0 Combined Sewer ❑ASPHALT/CONCRETE PAVING SF 0 Separated Storm Sewer (RETAINING WALL/ROCKERY IN RIGHT-OF-WAY (c) 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 0 MR2 Only 0 MRI-5 0 MRI-9 ❑CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HAD SURFACES: ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: SF ❑POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: SF OWNER/APPLICANT NAME: ' kV p'I -yt - # I� ti sr't I q OWNER/APP. MAILING ADDRESS: STREET 2._s- Co Az-FPL -v `�i + /� CITY ��J STATE IAA ZIPqkLO' OWNER/APP.PHONE: OWNER/APP.EMAIL: *Required for Work in Public Right-of-Way CONTRACTOR NAME: Le-0 r�; �.�„ticl.r c ``1):'‘A) p, CONTRACTOR ADDRESS: STREET I. � a-31 g 1��J ' 2- 3 J' Bbx l 1, "1 9 CITY I/h.f) V8 STATE iV i ZIPli41272— CONTRACTOR PHON' ` 2 5.42,2—I,p(An CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): NIM {'j 1w EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER /APPLICANT 0 CONTRACTOR 0 OTHER(Architect,Engineer, Etc.) CONTACT NAME: yyt k e.,(/yt Qlyv CONTACT PHONE: ''''31p f ""32_2_— 3L.�Z 1 3(00 322 l G 3402— CONTACT EMAIL: `';vy_ nj j �-OYI� v►.C7-, cowl. ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contain-gl herein is true and tiorrect 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 l 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# lq PW 1a0q -0s`/ Own: • orized Agent Signature Date (Revised 1/72019)