3214 52ND PL SW 2021-12-20 - Laserfiche WebLink

M] PLOLIC WORKS PERMIT WLICATION CITY OF EVERETT PERMIT SERMCES 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: 3214 52nd PL SW, Everett WA 98203 SITE WORK FOR PROJECT TYPE: ❑✓ SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑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: ❑ 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 approx 110 Cy ❑ CUT/BORE IN PAVEMENT (PARALLEL) LF ❑ CUT/BORE IN PAVEMENT (NON -PARALLEL) LF ❑ POLE WORK / AERIAL / OVERLASH LF ADDITIONAL DESCRIPTION (AS NEEDED): DRAINAGE MITIGATION QUESTIONS: STORMWA TER DISCHARGES TO: ❑ Combined Sewer O'Separated Storm Sewer ❑ Direct Discharge to Snohomish River or Puget Sound TRIGGERED REQUIREMENTS: 9lMR2 Only ❑ MR1-5 ❑ MR1-9 QUANTITY OF PROPOSED HARD SURFACES: Proposed Roof Area: (D SF Proposed Hardscape: SF Total New + Replaced: SF Fill in in -ground swimminq pool (16' x 321 Pool is vinvl-lined with compacted sand base and metal support walls. Liner and wall material to be removed prior to fill. Fill materials and compaction to be code -compliant. Finish w/topsoil and Crass seed. CONTACT INFORMATION OWNER / APPLICANT NAME: David M Jackson OWNER / APP. MAILING ADDRESS: s.REET 3214 52nd PL SW `^' CITY Everett STATE V VA ZIP 98203 OWNER / APP. PHONE: 425-347-8728 OWNER / APP. EMAIL: dpjacksn@gmall.com 'Required for Work in Public Right -of -Way CONTRACTOR NAME: Homeowner CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE #(REQUIRED): EVERETT BUSINESS LICENSE #(REQUIRED): PRIMARY CONTACT: ✓❑ OWNER I APPLICANT ❑ CONTRACTOR ❑ OTHER (Architect, Engineer, Etc.) CONTACT NAME: David Jackson CONTACT PHONE: 425-347-8728 CONTACT EMAIL: dpjacksn@gmail.com 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 1 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 # Date, (Revised 1172019) 1/ 2