1531 RAINIER AVE 2022-02-15 - Laserfiche WebLink

PLIC WORKS PERMIT AIIPLICATION 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: / < / / ��r K�� /-c I / G ��/C ��1 �L r �r �l / SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU OMULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.) DESCRIPTION F S1,TE.INORK:/RIGHT OI~,WAY..1 O K FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: FENCE IN ROW 4.2 it [n r I 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 ❑ 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 ❑ 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 CONTiACT INFOR.MA`I'ION . OWNER/APPLICANT NAME: 4/ t2,/ t/ I T C-E OWNER/APP. MAILING ADDRESS:(( STREET 2 f I fG C i2c—ti Lf/( ' 5/2- f �CITY (� /G L / 1 _ STATE PI)/1 ZIP 97F,( 1 OWNER/APP.PHONE 2 OWNER/APP EMAIL: *Required for Work in Public Right-of-Way / CONTRACTOR NAME: /44,14/G L� (c L/4—Kg- CONTRACTOR ADDRESS: STREET 2C`)(�j� (a J� �//4/) _ 1 CITY ft,7 STATE 14_,,y --: ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED) PRIMARY CONTACT: ❑OWNER /APPLICANT ❑CONTRACTOR 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: 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.lam the owner,or I am authorized by the owner of this property to perform the work for which ap ication is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# �Gt z Ct,� - - �� Pw 2 0 01 - m O ner/ t razed A nt Signature Date (Revised 4/15/2019)