7500 HARDESON RD 2021-06-09 - Laserfiche WebLink

PI4LIC WORKS PERMIT mPLICATION CITY OF EVERETT PERMIT SERVICES /11P0. :a 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:7500 Hardeson Road, Everett WA SITE WORK FOR PROJECT TYPE: ESFR-DETACHED ❑TOWNHOUSE EIDUPLEX EADU ❑MULTI-FAMILY ❑✓COMMERCIAL []INDUSTRIAL IF APPLICABLE: LI LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) 5-o Z-f 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: El DRIVEWAY APRON/CURB CUT FT WIDE ❑ Combined Sewer ❑ASPHALT/CONCRETE PAVING SF ❑ Separated Storm Sewer LI RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF n Direct Discharge to Snohomish River or Puget Sound ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: n CLEARING/GRADING/FILL/EXCAVATE 9,750 export CY ❑ MR2 Only ❑ MR1-5 ❑ MR1-9 LI 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 CONTACT INFORMATION OWNER/APPLICANT NAME: Bart Brynestad, PE AHBL OWNER/APP. MAILING ADDRESS: STREET 2215 N. 30th Street#300 CITY Tacoma STATE WA ZIP 98403 OWNER I APP. PHONE:253-383-2422 OWNER/APP. EMAIL:bbrynestad@ahbl.com 'Required for Work in Public Right-of-Way CONTRACTOR NAME: TBD CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ✓❑ OWNER /APPLICANT El 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# F�,P 3/25/2019 P W cv ` Owner/Authorized Agent Si ature Date (Revised 1/72019)