7401 LARIMER RD 2021-12-21 - Laserfiche WebLink

smi IBLIC WORKS PERMIT II ►'PLICATION 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: �, g - 715t0 / tf' Mk- RA pk!'Cd d f t( l o%. b co( L I iGC' SITE WORK FOR PROJECT TYPE: ESFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑IADU ❑MULTI-FAMILY }COMMERCIAL ['INDUSTRIAL IF APPLICABLE: D LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) }[�/'!T , Ss fir) 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 ❑ Combined Sewer ❑ASPHALT/CONCRETE PAVING SF ❑ Separated Storm Sewer ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF El Direct Discharge to Snohomish River or Puget Sound ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: El CLEARING/GRADING/FILL/EXCAVATE CY ❑ MR2 Only ❑ MR1-5 ❑ MR1-9 ❑CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: SF ❑POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: SF .y (lei Sc�? << <<lt / s A; I*` � , Lrr.7d, � srsrl p / CONTACT INFORMATION re//APPLICANT NAME: Vt •.cs �i Q�r�l?✓� «��E%� 1'C t�^,/ttS / ( /U/c k / e/ /76 a/1 OWNER/APP. MAILING ADDRESS: STREET Wc lie' jail n 2 e (/ CITY j�'L�1..r-% oe,1� /�/� ,I �L`•l• �� ZIP �� ;/ OWNER/APP.PHONE: ('( ((" ,`t -6/ �'.�) 'OWNER/APP.EMAIL: l'(( (.%i l ta (a,-) *Required for Work in Public Right-of-Way CONTRACTOR NAME:_.Cl/FL'C_ e, ( ; . ./ CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: t❑ OWNER /APPLICANT El CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: (4 ? - , ,� Ik t1 (eifoc6/2 F CONTACT EMAIL: /! 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 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 U ow 02.43 Owner/Authorized Agent Signature Date g g (Revised 1/72019)