3214 BROADWAY BROADWAY KINECT APARTMENTS 2021-08-11

PleLIC WORKS PERMIT WLICATION umi CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE`INFORMATION PROJECT ADDRESS: 21 ZT3A AL] * 2 2 Z' . -kid--WA 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: NtNCE IN ROW FT IN HEIGHT STORMWATER DISCHARGES TO: ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑ Combined Sewer ❑ASPHALT/CONCRETE PAVING SF ❑ Separated Storm Sewer ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ 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 ❑ MR1-5 ❑ 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: SF ADDITIONAL� DESCRIPTION(AS NEEDED): Total New+Replaced: SF C-, /1%Si?'(/G 1 TCi' / - rD Sa&60ce%/V A/ G4-Si;_ STT CONTACT INFORMATION OWNER/APPLICANT NAME: hAVL.V\ S;/✓A40- OWNER/APP. MAILING ADDRESS: STREET 11 C� - /c� Av, A rVS--S D CITY f ��L Vu�� STATE i - ZIP g J7 OWNER/APP. PHONE: _206, ;ZSS 7S7 ) OWNER/APP. EMAIL: b,S,z. A4v6"77-e_ 'Required for Work in Public Right-of-Way CONTRACTOR NAME: AN/1-/g-a-/y /4-9,lrz J1,471— CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER /APPLICANT ❑CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: 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 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 7/787,9 PERMIT# Own uthorized Agent S nature Date (Revised 4/15/2019)