1507 WALL ST 2022-04-06 - Laserfiche WebLink

PUBLIC WORKS PERMIT APLICATION 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: 1507 WALL STREET SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU I]MULTI-FAMILY ❑COMMERCIAL ['INDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) 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 [1 ASPHALT/CONCRETE PAVING 5400 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: 5400 SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: 5400 SF Overlay new asphalt onto existing with a small area (200 sq ft +/-) to be repaired before overlay. CONTACT INFORMATION , OWNER I APPLICANT NAME: Archdiocesan Housing Authority dba Catholic Housing Services of Western Washington OWNER/APP. MAILING ADDRESS: STREET 2929 Hoyt Ave CITY Everett STATE WA ZIP 98201 OWNER/APP. PHONE: 425-258-9503 OWNER/APP. EMAIL: MOnteCCIStO@CCSWW.Org *Required for Work in Public Right-of-Way CONTRACTOR NAME: Highline Pavement Maintenance CONTRACTOR ADDRESS: STREET PO Box 606 CITY Mt Vernon STATE WA ZIP 98273 CONTRACTOR PHONE: 360-424-0478 CONTRACTOR EMAIL: office@highlineservices.com CONTRACTOR LICENSE#(REQUIRED): 602 243 908 EVERETT BUSINESS LICENSE#(REQUIRED): 52590 PRIMARY CONTACT: ❑✓ OWNER /APPLICANT ❑CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: 425-258-9503 Victoria Mason CONTACT EMAIL: MonteCristo@ccsww.org 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 t u ing 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 w ' h application is made,and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only "/./ PERMIT# � u � � �z l P W i ^ o zz Owner/Authorized Ag nt S' nature Dat (Revised 1/72019)