6601 CADY RD 2022-01-11 - Laserfiche WebLink

PIiLIC WORKS PERMIT ALICATION 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,INFORMAT`iON PROJECT ADDRESS: 6 6 i ( &0(y (/6.6( / -Q.*t (� (� C 4...0.3 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.) ,DESCRIPTION.OF;,SITE iNORK.i,'RIGHT l F.-WAY.WORK.. FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: °FENCE IN ROW FT IN HEIGHT STORMWATER DISCHARGES TO: KDRIVEWAY APRON/CURB CUT t 5 FT WIDE ❑Combined Sewer ❑ASPHALT/CONCRETE PAVING SF Separated Storm Sewer ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF 0 Direct Discharge to Snohomish River or Puget Sound ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: ❑CLEARING/GRADING/FILL/EXCAVATE CY UIR2 Only ❑MR1-5 ❑ MR1-9 0 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: 7 SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: -7 5 1 SF CONTACT INFORMATIIlN,........,. OWNER/APPLICANT NAME: 5c,t Criven \RA-5�ske..Z OWNER/APP. MAILING ADDRESS: STREET 6b o/ 12-0c.c r CITY LV�c STATE OC ZIP / 6).';"13 G q�^1 OWNER/APP. PHONE: 4� ! I [r�a 3 OWNER/APP EMAIL C She \"`S ! / co < <M *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: s1 OWNER /APPLICANT 0 CONTRACTOR 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: ad—g 9'-7 I 9 9-a.3 5,4o:vv." \PA 5"L'(-.tt CONTACT EMAIL: i)o S 'J 5C 1 & jC O . 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.lam the owner,or 1 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# Owner/Authorized Agent Sigpfiture Date (Revised 4/15/2019)