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COL PUIILIC WORKS PERMIT A 'LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 2319 COLUMBIA AVE <br /> IF APPLICABLE: IO LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) <br /> SITE WORK FOR PROJECT TYPE: O SFR-DETACHED O SFR-ATTACHED O DUPLEX Ti MULTI-FAMILY O COMMERCIAL <br /> CHANGE OF USE? Ti NO O YES, FROM TO <br /> NEW WATER/SEWER SERVICE NEEDED? O NO O YES,TYPE SIZE <br /> SITE WORK I RIGHT-OF-WAY APPLICATION INFORMATION <br /> DESCRIPTION OF WORK: NEW SFR TO INCLUDE AN AFH <br /> Ski 1 <br /> O FENCE IN ROW FT IN HEIGHT l <br /> O DRIVEWAY APRON/CURB CUT FT WIDE w U,, 5 ,� <br /> "� <br /> OASPHALT/CONCRETE PAVING SF t IY'prvSW1 '/�" — <br /> O RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF //,ZS_Z 7— ZO.OUl <br /> RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGH ' � � <br /> O CLEARING/GRADING/FILL/EXCAVATE CY )� I�,�I e <br /> spi <br /> O CUT/BORE IN PAVEMENT(PARALLEL) LF <br /> Ti CUT/BORE IN PAVEMENT(NON-PARALLEL) LF <br /> CONTACT INFORMATION <br /> OWNER NAME: ANIGILAJE OLUWAROTIMI &OLAJUMOKE <br /> OWNER MAILING ADDRESS: STREET 2319 COLUMBIA AVE <br /> cTv EVERETT STATE WA ZIP 98203-5352 <br /> OWNER PHONE: (OWNER EMAIL: <br /> APPLICANT NAME: ANIGILAJE OLUWAROTIMI &OLAJUMOKE <br /> APPLICANT MAILING ADDRESS: STREET 2319 COLUMBIA AVE <br /> up( EVERETT STATE WA ZIP 98203-5352 <br /> APPLICANT PHONE: (APPLICANT EMAIL: <br /> PRIMARY CONTACT: O OWNER O APPLICANT O OTHER(Architect, Engineer, Etc.) <br /> CONTACT NAME: ANIGILAJE OLUWAROTIMI & CONTACT PHONE: 6466574508 <br /> OLAJUMOKE <br /> CONTACT EMAIL: ANIGILAJEJEROTIMI@YAHOO.COM <br /> ACKNOWLEDGEMENT I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must <br /> 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 <br /> 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 <br /> perform the work for which application is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> PW1 807-045 <br /> Authorized Agent/Owner Date (Revised 10/12/2015) <br />