3709 FRIDAY AVE 2022-02-14 - Laserfiche WebLink

P3LIC WORKS PERMIT APPLICATION 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 INFORMATIQN ... . . . . ., PROJECT ADDRESS: . 7 C e 4-4 SITE WORK FOR PROJECT TYPE: EIS F R-D ETAC H E D ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) DESCRIPTION CIF SITE:WORK/RIGHT;Qf: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 E4 eombined Sewer ,'ASPHALT/CONCRETE PAVING G 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 CI-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: 9 SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: ZO a SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: Zb$ SF Ga cLY-,A�tL i�L_p+►IU %.=t•:-,...<�., �. ',L s:. c-, C:t i. IOWNER/APPLICANT NAME: -1 cc iv( k ' OWNER/APP. MAILING ADDRESS: STREET 4(8 (2e Air S } Gt'M i 7 '/t c L CITY STATE ZIP <�� OWNER/APP. PHONE: `;.95 �� Z' 7 3 OWNER/APP.EMAIL: w,__ .. .. .. ..... ._._� .< s . �31 -. .. __,_ .. ,. �... ,k ....._,..a t. .._�- _S v im.. .. ,a... e __<_.,..�.,� r.. •,� *Required for Work in Public Right-of-Way CONTRACTOR NAME: 1/z vt A(Z C D , . A/ C- CONTRACTOR ADDRESS: STREET y 5 rrok'y PT- R.. ,, ] � G A-RL tN l e/y CITY STATE 11', +�/ ZIP /? 3 CONTRACTOR PHONE: `) 5 S ' 4>I 41 5 CONTRACTOR EMAIL: k1f /-ice11A(2 t L e �I CONTRACTOR LICENSE#(REQUIRED): j2 u�2L )a .3 P EVERETT BUSINESS LICENSE#(REQUIRED): 3 Z 9�� PRIMARY CONTACT: ❑OWNER /APPLICANT - CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: `J 5C MA/ Z 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# ,)r 6 a PW .0o r - ®os Own /Author' ed Agent Signature Date (Revised 4/15/2019)