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ABLIC WORKS PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.qov I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2202 100th St. SW Everett, WA SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI -FAMILY ❑✓ COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑✓ LAND USE PROJECT # (SEPA, PRE-APP, SS, ETC.) REV II 19-017, REV 1 19-015, SEPA 19-013 IF APPLICABLE: ❑ FRANCHISE/UTILITY COMPANY, ANNUAL BLANKET PERMIT # UTILITY COMPANY'S NAME & JOB #: Snohomish PUD #1 JOB # TBD t b.ESCRIPTION OF SITE WORK% RIGHT-OF-WAY FILL IN ALL QUANTITIES OF WORK BELOW, AS APPLICABLE: ❑ FENCE IN ROW FT IN HEIGHT ❑✓ DRIVEWAY APRON / CURB CUT 26 FT WIDE ❑✓ ASPHALT / CONCRETE PAVING 17,700 (SITE) + 8,600 (ROW) SF ❑ RETAINING WALL / ROCKERY IN RIGHT-OF-WAY LF ✓❑ RETAINING WALL / ROCKERY OVER 4FT IN HEIGHT 7.5 FT TOTAL HEIGHT (] CLEARING / GRADING / FILL / EXCAVATE 1,800 (NET) CY ❑ CUT/BORE IN PAVEMENT (PARALLEL) LF ❑ CUT/BORE IN PAVEMENT (NON -PARALLEL) LF ❑ POLE WORK / AERIAL / OVERLASH LF ADDITIONAL DESCRIPTION AS NEEDED): ( ) WORK' DRAINAGE MITIGATION QUESTIONS: STORMWA TER DISCHARGES TO: ❑ Combined Sewer © Separated Storm Sewer ❑ Direct Discharge to Snohomish River or Puget Sound TRIGGERED REQUIREMENTS: ❑ MR2 Only ❑ MR1-5 ©MR1-9 QUANTITY OF PROPOSED HARD SURFACES: Proposed Roof Area: 12,370 SF Proposed Hardscape: 26,300 SF 38,670 Total New+ Replaced: SF above Site Work/Right-of-Way Work data from submitted Civil Plans as provided by DEA CONTACT INFORMATION OWNER / APPLICANT NAME: Kelly Stephens OWNER / APP. MAILING ADDRESS: STREET PO Box 1243 (�fj r� CITY Edmonds STATE WA ZIP 98020 OWNER / APP. PHONE: (206) 660-8383 OWNER / APP. EMAIL: kandjstephens@msn.com 'Required for Work in Public Right -of -Way CONTRACTOR NAME: TBD CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE #(REQUIRED): EVERETT BUSINESS LICENSE #(REQUIRED): PRIMARY CONTACT: ❑ OWNER /APPLICANT ❑ CONTRACTOR © OTHER (Architect, Engineer, Etc.) 2812 architecture CONTACT NAME: Danielle Fowler ICONTACT A /'`VAI/lIA/I t-n/�Arnir. CONTACT PHONE: (425) 252-2153 EMAIL:danlelle@2812arChiteCtUre.Com "�- t_ ✓VL l—v I. I ,lave /evlaweu ❑us applcarion and confirm the mrormatlon 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 / am authorized by the owner of this property to perform the work for which application is made, and / comply with the State Contractors Law 18.27 RCW and 296.200A WAC. Danielle Fowler DigitallyDate: 2igned 609:1by Danielle:53-0 '00' 06 April 2020 Date: 2020.04.06 09:10:53-07'00' Owner/Authorized Agent Signature Date City of Everett Official Use Only PERMIT #. Pw -- -dl (Revised 1172019)