5222 EAST DR 2022-05-23 - Laserfiche WebLink

Now P.LIC WORKS PERMIT ALICATION 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: 6 2,Z Z e-C\c,'\- C"(7) y 7) 70 O O C% /' CI SITE WORK FOR PROJECT TYPE: 42116FR-DETACHED ❑TOWNHOUSE ❑DUPLEX EADU ❑MULTI-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 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 ;7C) ` 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: -3 I y SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: 1,.3 Z SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: j��5 � SF NewSFR . -T 's AA -.i ^ Si+o‘!'e-T CONTACT INFORMATION OWNER I APPLICANT NAME:Haack Brothers Homes OWNER/APP. MAILING ADDRESS: STREET3922 87th AVE NE `n, CITY Marysville STATE V A ZIP 98270 OWNER/APP. PHONE:425-2090-2429 OWNER I APP. EmAiLdoel@haackbrothers.com *Required for Work in Public Right-of-Way CONTRACTOR NAME: Haack Brothers Homes CONTRACTOR ADDRESS: sTREET3922 87th AVE NE CI Marysville STATE WA ZIP 98270 CONTRACTOR PHONE:425-290-2429 CONTRACTOR EMAIL:J0e1©haackbrothers.com CONTRACTOR LICENSE#(REQUIRED):HaaCkBI012DZ EVERETT BUSINESS LICENSE#(REQUIRED): 053967 PRIMARY CONTACT: ❑ OWNER /APPLICANT CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE:425-290-2429 Joel Haack CONTACT EMAIL:joel©haackbrothers.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. City of Everett Official Use Only PERMIT# Owner uth rized Agent�i atu Date (Revised 1/72019)