2614 COLBY AVE 2022-01-26 - Laserfiche WebLink

PILIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASH ING TON (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@eve rettwa. gov I https://everettwa. gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2626 Colby Ave #1 SITE WORK FOR PROJECT TYPE: SFR-DETACHED I_ ]TOWNHOUSE 1DUPLEX ❑ADU I1VULTl-FAMILY ,rICOMMERCIAL [JINDUSTRIAL IF APPLICABLE: --LAND USE PROJECT # (SEPA. PRE-APP, SS, ETC.) IF APPLICABLE: .-I FRANCHISE/UTILITY COMPANY. ANNUAL BLANKET PERMIT # UTILITY COMPANY'S NAME & JOB #: JOB # (DESCRIPTION OF SITE WORD / 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): DRAINAGE MITIGATION QUESTIONS: STORMWATER DISCHARGES TO: ❑ Combined Sewer ❑ Separated Storm Sewer ❑ Direct Discharge to Snohomish River or Puget Sound TRIGGERED REQUIREMENTS: ❑ MR20nly D MR1-5 ❑ MR1-9 QUANTITY OF PROPOSED HARD SURFACES: Proposed Roof Area SF Proposed Hardscape SF Total New + Replaced SF CONTACT INFORMATION OWNER / APPLICANT NAME: ZhuXiong Liu OWNER / APP. MAILING ADDRESS: STREET CITY OWNER / APP. PHONE: 425-985-6668 OWNER / APP. EMAIL: xiong6668.yahoo.com 'Required for Work in Public Right -of -Way CONTRACTOR NAME: Steve Da0 CONTRACTOR ADDRESS: STREET 1520 N 149th Ci cn, Shoreline STATE WA :,„F 98133 CONTRACTOR PHONE: 206-226-2557 CONTRACTOR EMAIL: amyd524@comcast.net CONTRACTOR LICENSE #;REQUIRED): Daoprpd833p; EVERETT BUSINESS LICENSE #(REQUIRED): 62875 PRIMARY CONTACT: —j OWNER / APPLICANT ❑ CONTRACTOR _ OTHER (Architect. Engineer. Etc.) CONTACT NAME: Steve Dao CONTACT PHONE: 206-226-2557 CONTACT EMAIL: amyd524@comcast.net Hi_nivvwLtuutmtiv i s r nave 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 # PW tikot-tk OwnerlAuthorized Agent Signature Date (Revised 1172019)