5034 OCEAN AVE 2021-11-18 - Laserfiche WebLink

puqpic WORKS PERMIT AISPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 5034 Ocean Ave, Everett WA 98203 SITE WORK FOR PROJECT TYPE: ESFR-DETACHED ❑TOWNHOUSE ['DUPLEX EADU ❑MULTI-FAMILY ['COMMERCIAL ['INDUSTRIAL IF APPLICABLE: 2 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: DRAINAGE MITIGATION QUESTIONS: ❑FENCE IN ROW FT IN HEIGHT STORMWATER DISCHARGES TO: ❑DRIVEWAY APRON/CURB CUT FT WIDE El Combined Sewer ❑ASPHALT/CONCRETE PAVING SF ❑Separated Storm Sewer ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ Direct Discharge to Snohomish River or Puget Sound El RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: ✓❑CLEARING/GRADING/FILL/EXCAVATE 8.7 CY El MR2 Only ❑ MR1-5 ❑ MR1-9 LI CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: 0 SF ❑POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: 234 SF ADDITIONAL DESCRIPTION (AS NEEDED): Total New+Replaced: 234 SF Excavate 18'x13'foot area to 1'deep. Install 4" pavers on top of 8"gravel/sand. Install 4"x6"x96" post to match the existing post. CONTACT INFORMATION OWNER!APPLICANT NAME: James Stafford OWNER/APP. MAILING ADDRESS: STREET 5034 Ocean Ave CITY Everett • STATE WA ZIP 98203 OWNER/APP. PHONE: 248-840-4981 OWNER/APP. EMAIL: jameSrStafford@gmail.com *Required for Work in Public Right-of-Way CONTRACTOR NAME: 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: James Stafford CONTACT PHONE: 248-840-4981 CONTACT EMAIL: jamesrstafford@gmail.com ACKNOWLEDGEMENT:I 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 f ication is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only f/ PERMIT# { /� �r � PW � � -OD Cc to (Revised 1/72019 Owner uthorize Agent Signature Da )