5228 EAST DR 2022-04-14 - Laserfiche WebLink

PftLIC WORKS PERMIT A01PLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 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: °j Z Z C 45'i o k C C 'i 11 7 C c C C L-C (" SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED -]TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI -FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: LAND USE PROJECT # (SEPA, PRE-APP, SS, ETC.) LAPPLICABLE: —1 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: FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON / CURB CUT FT WIDE ❑ ASPHALT / CONCRETE PAVING SF ❑ RETAINING WALL / ROCKERY IN RIGHT-OF-WAY LF ❑ RETAINING WALL / ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT CLEARING / GRADING / FILL / EXCAVATE iL C CY ❑ CUT/BORE IN PAVEMENT (PARALLEL) LF ❑ CUT/BORE IN PAVEMENT (NON -PARALLEL) LF ❑ POLE WORK / AERIAL / OVERILASH LF ADDITIONAL DESCRIPTION (AS NEEDED): DRAINAGE MITIGATION QUESTIONS: STORMWA TER DISCHARGES TO: ❑ Combined Sewer ❑ Separated Storm Sewer ❑ Direct Discharge to Snohomish River or Puget Sound TRIGGERED REQUIREMENTS: ❑ MR2 Only D MR1-5 ❑ MR1-9 QUANTITY OF PROPOSED HARD SURFACES: Proposed Roof Area: 2' 3 11 SF Proposed Hardscape: 1 O SF ITotal New + Replaced: 1 C.° SF New SFR Lc T Mo-,T e SQL-x-r CONTACT INFORMATION OWNER I APPLICANT NAME: Haack Brothers Homes OWNER / APP. MAILING ADDRESS: ITRIET3922 87th AVE NE C,n Marysville STATE WA ZIP 98270 OWNER / APP. PHONE:425-2090-2429 OWNER I APP. EMAIL:IOel@haackbrothers.com 'Required for Work in Public Right -of -Way CONTRACTOR NAME: Haack Brothers Homes CONTRACTOR ADDRESS: ITREET3922 87th AVE NE CITY Marysville STATE WA ZIP 98270 CONTRACTOR PHONE:425-290-2429 CONTRACTOR EMAIL:joel@haackbrotherS.COm CONTRACTOR LICENSE #(REQUIRED): HaackBI012DZ EVERETT BUSINESS LICENSE #(REQUIRED): 053967 PRIMARY CONTACT: ❑ OWNER / APPLICANT 7 CONTRACTOR ❑ OTHER (Architect, Engineer, Etc.) CONTACT NAME: Joel Haack CONTACT PHONE:425-290-2429 CONTACTEMAIL: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. rized Agent Signature Date City of Everett Official Use Only PERMIT # PW (Revised 1172019)