8925 AIRPORT RD MUKILTEO SCHOOL DISTRICT 2022-01-19

PALIC WORKS PERMIT APLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 OOL (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 8925 Airport Road, Everett, WA 98204 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE []DUPLEX ❑ADU ❑MULTI -FAMILY ✓❑COMMERCIAL [INDUSTRIAL IF APPLICABLE: ✓0 LAND USE PROJECT # (SEPA, PRE-APP, SS, ETC.) REVI118-008 EAPPLICABLE: ❑ 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 4,635 SF ❑ RETAINING WALL / ROCKERY IN RIGHT-OF-WAY LF ✓❑ RETAINING WALL / ROCKERY OVER 4FT IN HEIGHT 5801f of 5' FT TOTAL HEIGHT © CLEARING / GRADING / FILL / EXCAVATE FIII 300 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: STORMWATER DISCHARGES TO: ❑ Combined Sewer Separated Storm Sewer ❑ Direct Discharge to Snohomish River or Puget Sound TRIGGERED REQUIREMENTS: ❑ MR2 Only TIMR1-5 ❑ MR1-9 QUANTITY OF PROPOSED HARD SURFACES: Proposed Roof Area: SF Proposed Hardscape: SF lTotal New+ Replaced: i (036 SF CONTACT INFORMATION OWNER / APPLICANT NAME: Mukilteo School District -- Keith Stefanson, Director of Facilities OWNER / APP. MAILING ADDRESS: STREET 8925 Airport Road CITY Everett STATE WA ZIP 98204 OWNER / APP. PHONE:425-356-1330 OWNER / APP. EMAIL: stefansonki@mukilteo.wednet.edu 'Required for Work in Public Right -of -Way CONTRACTOR NAME: TBD after Bid Process CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE #(REQUIRED): EVERETT BUSINESS LICENSE #(REQUIRED): PRIMARY CONTACT: ✓❑ OWNER / APPLICANT ❑ CONTRACTOR ❑ OTHER (Architect, Engineer, Etc.) CONTACT NAME: Keith Stefanson CONTACT PHONE:425-356-1330 CONTACT EMAIL:stefansonki@mukilteo.wednet.edu 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. 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 # y t PW 4o a-W Signature W, Da (Revised 1172019)