5306 EAST DR 2023-05-31 - Laserfiche WebLink

PIOLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT WASHINGTON 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: S 3o(:� �--cks i ; ( - C? L-1 I1 07 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: ❑ 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 CY ❑ CUT/BORE IN PAVEMENT (PARALLEL) LF ❑ CUT/BORE IN PAVEMENT (NON -PARALLEL) LF ❑ POLE WORK / AERIAL / OVERLASH LF ADDITIONAL DESCRIPTION (AS NEEDED): New SFR C DRAINAGE MITIGATION QUESTIONS: STORMWA TER DISCHARGES TO: ❑ Combined Sewer ❑ Separated Storm Sewer ❑ Direct Discharge to Snohomish River or Puget Sound TRIGGERED REQUIREMENTS: ❑ MR2 Only Q MR1-5 ❑ MR1-9 QUANTITY OF PROPOSED HARD SURFACES. Proposed Roof Area: e'&' I SF Proposed Hardscape: 570 k-, SF Total New +Replaced: 2 3e'7 SF CONTACT INFORMATION OWNER / APPLICANT NAME: Ron Moir OWNER / APP. MAILING ADDRESS: 111EET5302 East Drive ,n/ CITY Everett STATE V A ZIP 98203 OWNER / APP. PHONE:425-2090-2429 OWNER / APP. EMAIL:joel@haackbrothers.com "Required for Work in Public Right -of -Way CONTRACTOR NAME: Haack Brothers Homes CONTRACTOR ADDRESS: STlEIT3922 87th AVE NE CITY Marysville STATE WA ZIP 98270 CONTRACTOR PHONE:425-290-2429 CONTRACTOR EMAIL:joel@haackbrotherS.001T1 CONTRACTOR LICENSE #(REQUIRED): HaaCkBl012DZ EVERETT BUSINESS LICENSE #(REQUIRED): 053967 PRIMARY CONTACT: ❑ OWNER / APPLICANT 71 CONTRACTOR ❑ OTHER (Architect, Engineer, Etc.) CONTACT NAME: Joel Haack CONTACT PHONE:425-290-2429 CONTACT EMAIL:Joel@haackbrothers.00171 ACKNOWLEDGEMENT. 1 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. 1 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. Agent --2�)CC- Date City of Everett Official Use Only PERMIT PW (Revised 1172019)