3505 UPLAND AVE 2020-09-08 - Laserfiche WebLink

41ETT PUBLIC WORKS PERMIT APPLICATION 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 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS 5J� O �L�►' 6L. 1 1 uk, IF APPLICABLE: Ll7 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) SITE WORK FOR PROJECT TYPE:DSFR-DETACHED ESFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY ECOMMERCIAL DINDUSTRIAL CHANGE OF USE? 0"NO 0 YES, FROM / TO NEW WATER/SEWER SERVICE NEEDED? 11 NO 0 YES,TYPE SIZE SITE WORK / RIGHT-OF-WAY APPLICATION INFORMATION DESCRIPTION OF WORK: VVAILIL -ti all ' `I�-OYk-- Y 3 --lvi- 614aV-1- 43 la* 1,1 -I I 1 i a .v1Ltt-, s*e e-f Wo 14k-- ❑ FENCE IN ROW FT IN HEIGHT ❑ 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 INFORMATION OWNER NAME: AtwL I Il ge,SL LZj OWNER MAILING ADDRESS: sTREIIO2 " 10D 1 1---, 6e' /// .1,-,6141 Y614 o 0 i.3IL STATE ' ZIP (/J �.�yd% 1 / OWNER PHONE: 25, /✓ , Dom,Z OWNER EMAIL:�,��litt,U,L/a ya I I , (r!7,)04 ,' APPLICANT NAME: A/2VI'/2.- fjt)tit. L, �kii-( aLo j&r vut kqQ APPLICANT MAILING ADDRESS: STREET/O 2.` ' ��'��'ggqqqq��A�J,�P)(�' t-- lA (/ CIry 3��nt� ,i STATE W ZIP(�J 32q� APPLICANT PHONE: 't b l R3I 0282_ APPLICANT EMAIL el�4 /�1 /1`�� l/ It`, �� ) PRIMARY CONTACT: OWNER ❑APPLICANT ❑ OTHER(Architect, Engineer, Etc.) ATACT NAME: CONTACT PHONE: f 2�L�� i U�")/}�� (4)1 ns CONTACTEMAIL:`/'�(ei'iv2ila '"ll iaC�,C..il'jvfl t.if . aWL__ ACKNOWLEDGEMENT I have reviewed this application and confirm the information contained herein fs true and correct. Work dine 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 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# -600 6v ill i kli)Havkialyyt‘,4,bt.:Ey, 6104 Owner/Authorized Agent Signature Date (Revised 10/12/2015)