607 SE EVERETT MALL WAY BASE FILE 2022-01-21

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 607 SE Everett Mall Way SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE EDUPLEX ❑ADU EMULTI-FAMILY ®COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP,SS,ETC.) IF APPLICABLE: ❑ FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB#: JOB# DESCRIPTION OF SITE WORK/ RIGHT-OF-WAY WORK 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 ❑ Combined Sewer ASPHALT/CONCRETE PAVING 900 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 370 CY LI 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: 0 SF ❑POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: 900 SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: 900 SF Demolish existing concrete tank pad (900 sf), excavate and stockpile overburden soil (135 cy), remove three USTs, import structural fill (100 cy), place back overburden (135 cy), and resurface using 3"thick HMA (900 sf). CONTACT INFORMATION OWNER/APPLICANT NAME: WYSER Construction Co., Inc. OWNER/APP. MAILING ADDRESS: STREET19015 109th Ave SE cnv Snohomish STATE WA ZIP 98296 OWNER/APP.PHONE:425.742.0898 OWNER/APP.EMAIL: darren@wyserdirt.com *Required for Work in Public Right-of-Way CONTRACTOR NAME: WYSER Construction Co., Inc. CONTRACTOR ADDRESS: STREET 19015 109th Ave SE CITY Snohomish STATE WA ZIP 98296 CONTRACTOR PHONE:425.742.0898 CONTRACTOR EMAIL:darren@wyserdirt.com CONTRACTOR LICENSE#(REQUIRED):WYSERCI045N9 EVERETT BUSINESS LICENSE#(REQUIRED):34326 PRIMARY CONTACT: ❑OWNER /APPLICANT ❑CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: Darren Ness CONTACT PHONE: 425.742.0898 CONTACT EMAIL: darren@wyserdirt.com 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. Digitally signed by Darren Ness City of Everett Official Use Only DN:C=US,E=darren@wyserdirt.com, PERMIT# Darren Ness 0="WYSER Construction Co.,Inc.", OU=PM,CN=Darren Ness Date:2020.03.17 14:07:43-07'00' 3/17/2020 PW Owner/Authorized Agent Signature Date (Revised 1/72019)