4953 ELM ST B 2025-01-06 - Laserfiche WebLink

PUBLIC 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 https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:4953 Elm Street SITE WORK FOR PROJECT TYPE: ❑✓SFR-DETACHED ❑TOWNHOUSE EDUPLEX 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 12 FT WIDE ❑ Combined Sewer IZ ASPHALT/CONCRETE PAVING 10 SF ❑ Separated Storm Sewer E 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: E CLEARING/GRADING/FILL/EXCAVATE CY ❑ MR2 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: 1288 SF ❑POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape:700 SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: 1988 SF CONTACT INFORMATION OWNER/APPLICANT NAME:Marcos &Silvia Santana OWNER/APP. MAILING ADDRESS: sTREEr4953 Elm Street CITY Everett STATE WA Z,P 98203 OWNER I APP.PHONE:425.770.5387 OWNER I APP.EMAIL:marcossan 1974@gmail.com "Required for Work in Public Right-of-Way CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑ OWNER /APPLICANT ❑ CONTRACTOR L1 OTHER(Architect, Engineer, Etc.) Agent for Owner CONTACT NAME: CONTACT PHONE:425.238.6324 Stacy Smith.Smith Land Development Services.LLC CONTACT EMAIL:stacy@stacysmith.net 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# Stacy Smith • 07/14/2021 PW iA tl 1 -Q 3 Owner/Authorized Agent Signature Date (Revised 1/72019)