1701 121ST ST SE 2022-05-02 - Laserfiche WebLink

mum PBLIC 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 INFORMATION PROJECT ADDRESS:1701 121ST ST. SE. EVERETT, WA 98208 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ETOWNHOUSE ['DUPLEX EADU ❑✓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 ❑ASPHALT/CONCRETE PAVING SF ❑Separated Storm Sewer ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ Direct Discharge to Snohomish River or Puget Sound _ El RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: ❑✓ CLEARING/GRADING/FILL/EXCAVATE 1 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 El POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: SF REPLANTING AND VEGETATION, FROM TREE TRIMMING PROJECT DONE ON-SITE, PER CITY OF EVERETT. CtNTACT INORMATION OWNER/APPLICANT NAME:BATUL HASHMI I CHARTER CLUB APARTMENTS OWNER/APP. MAILING ADDRESS: STREET1701 121st ST. SE. CITY EVERETT STATE WA zip 98208 OWNER/APP. PHONE:425-338-2588 OWNER/APP. EMAIL:BATUL.HASHMI@CUSHWAKE.COM *Required for Work in Public Right-of-Way CONTRACTOR NAME: GREEN THUMB LANDSCAPE SOLUTIONS CONTRACTOR ADDRESS: STREET10208 NE 140 PL c,, KIRKLAND STATE WA zip 98034 CONTRACTOR PHONE:206-949-4722 CONTRACTOR EMAIL:GREENTHUMBLS@LIVE.COM CONTRACTOR LICENSE#(REQUIRED): GREENTG889PR EVERETT BUSINESS LICENSE#(REQUIR ): 603-181-285 PRIMARY CONTACT: ✓❑OWNER /APPLICANT ✓❑CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE:425-338-2588 BATUL CONTACT EMAIL:BATUL.HASHMI@CUSHWAKE.COM 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# K , 01.13.2021 PW �� --- Q�A Owner/Authorized Agent Signatur Date (Revised 1/72019) I?)