3600 SMITH AVE 2022-03-11 - Laserfiche WebLink

Pli-BLIC WORKS PERMIT A� LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 00;L (P) 425-257-8810 1 FAX 425-257-8857 i (E) everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 3600 Smith Ave, Everett, WA 98201 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI -FAMILY 1000MMERCIAL ❑INDUSTRIAL IF APPLICABLE: EfLAND USE PROJECT # (SEPA, PRE-APP, SS, ETC.) PREAPPI8-022 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 fiff ASPHALT / CONCRETE PAVING 49,974 SF RETAINING WALL / ROCKERY IN RIGHT-OF-WAY 400 LF 9RETAINING WALL / ROCKERY OVER 4FT IN HEIGHT 5 FT TOTAL HEIGHT ea w' CLEARING / GRADING / FILL I EXCAVATE 10,070 CY i?fCUT/BORE IN PAVEMENT (PARALLEL) 753 LF lf`,�.; �. iZCUT/BORE IN PAVEMENT (NON -PARALLEL) 325 LF C '!_ Yf OF EVERETT ❑ POLE WORK /AERIAL / OVERLASH LF Permit %S'er w'es, ADDITIONAL DESCRIPTION (AS NEEDED): CONTACT INFORMATION OWNER / APPLICANT NAME: Everett Transit OWNER I APP, MAILING ADDRESS: STREET 3201 Smith Ave c,TY Everett STATE WA zip 98201 OWNER / APP. PHONE: 425-257-7777 OWNER / APP. EMAIL: thin SOn everettwa. ov CONTRACTOR NAME: TBD CONTRACTOR ADDRESS: STREET TBD c,Tv TBD STATE TBD Zip TBD CONTRACTOR PHONE: TBD CONTRACTOR EMAIL: TBD CONTRACTOR LICENSE #(REQUIRED): TBD EVERETT BUSINESS LICENSE #(REQUIRED): TBD PRIMARY CONTACT: 0 OWNER / APPLICANT ❑ CONTRACTOR ❑ OTHER (Architect, Engineer, Etc.) CONTACT NAME: Tom Hingson CONTACT PHONE: 425-257-7777 CONTACT EMAIL: thingson@everettwa.gov 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. Owner/Authorized Agent Signature Date City of Everett Official Use Only PERMIT # z PW 1$nT - 018 (Revised 1152017)