2600 FEDERAL AVE KIMBERLY CLARK 2022-02-04

El PI IC WORKS PERMIT AMPLICATION CITY OF EVERETT PERMIT SER 1 ES 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: 2600 Federal Avenue, Everett, WA 98201 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI -FAMILY ❑COMMERCIAL 0INDUSTRIAL IF APPLICABLE: ® LAND USE PROJECT # (SEPA, PRE-APP, SS, ETC.) SEPA 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: ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON / CURB CUT FT WIDE ❑ ASPHALT /CONCRETE PAVING SF rp- (�,� �: ❑ RETAINING WALL / ROCKERY IN RIGHT-OF-WAY LF ❑ RETAINING WALL / ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIG � NOV 0 6 2018 CLEARING / GRADING / FILL / EXCAVATE �$�j, CY CI ry OF EVERETT ❑ CUT/BORE IN PAVEMENT (PARALLEL) LF Permit Services ❑ CUT/BORE IN PAVEMENT (NON -PARALLEL) LF ❑ POLE WORK / AERIAL / OVERLASH LF ADDITIONAL DESCRIPTION (AS NEEDED): Up to 32 acres of soil disturbance for removal of existing crushed materials and proposed soil remediation activities. CONTACT INFORMATION OWNER / APPLICANT NAME: Kimberly Clark Worldwide Inc. c/ Bryan Lust OWNER / APP. MAILING ADDRESS: STREET 2600 Federal Avenue c,TY Everett STATE WA ziP 98201 OWNER / APP. PHONE: 425-210-3284 OWNER / APP. EMAIL: Bryan.C.Lust@kcc.com CONTRACTOR NAME: TBD CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE #(REQUIRED): EVERETT BUSINESS LICENSE #(REQUIRED): PRIMARY CONTACT: 6TOWNER / APPLICANT ❑ CONTRACTOR ❑ OTHER (Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: 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. l 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 # 7" f Agent Signature Date (Revised 1152017)