4330 HOYT AVE 2022-03-01 - Laserfiche WebLink

P*LIC WORKS PERMIT ISPLICATION iz 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: 433 P, 1i SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE pr.DUPLEX DADU 0 MULTI-FAMILY ❑COMMERCIAL 0 INDUSTRIAL IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) = DESCRIPTION OF SITE WORK FRIGHT-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 11.Combined Sewer .ASPHALT/CONCRETE PAVING 4 S cf 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 clIMR2 Only 0 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: cl SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: 4S 9 SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced:' 4 6 9 SF V.-F:7LAc_r-: . 'DiZ,Vtiz\NA- 6 .3tJLWA`vc ALo.-tLi I-VoY-r. A-'.J - ,.CONTACT INFORMATION.. ,OWNER/APPLICANT NAME: �i2 h 4 5—ic vL;`101-'c-/ ) f OWNER/APP. MAILING ADDRESS: STREET 7_'�`�3/ y`��/8(c U ev'( �/ c / , CITY . OC*"V e C 1 STATE (/(�/1� ZIP CiR &. OWNER/APP. PHONE: OWNER/APP. EMAIL: *Required for Work in Public Right-of-Way CONTRACTOR NAME: 5Gi yH t CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER /APPLICANT ❑CONTRACTOR 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: L / J 9 h VI �r vi L ' Uf CONTACT EMAIL: •f p`-yr S 7 -i,,,, t c vv c-/Zo 62 a q. rr4c ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant(o 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 )es /// —�,i� /� PERMIT# /.Z T-. j 0 er/Authorize Agent Sig ure Date (Revised 4/15/2019)