1823 STATE ST 2022-11-03 - Laserfiche WebLink

PI*LIC WORKS PERMIT WLICATION CITY OF EVERETT PERMIT SERS 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:1823 State Street SITE WORK FOR PROJECT TYPE: ✓❑SFR-DETACHED CI-TOWNHOUSE ❑DUPLEX ❑ADU ❑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 I 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 ❑ 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:__ SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: SF CONTACT INFORMATION OWNER/APPLICANT NAME:Tracy Sublett OWNER I APP. MAILING ADDRESS: STREET 8429 14th Place SE cm' Lake Stevens STATE WA zip 98258 OWNER/APP.PHONE: OWNER/APP.EMAIL:tracybear2004@yahoo.com `Required for Work in Public Right-of-Way CONTRACTOR NAME: LEXAR Homes CONTRACTOR ADDRESS: STREET 3721 116th Street NE, Ste 9 crry Marysville STATE WA zip 98271 CONTRACTOR PHONE:360.657.1968 CONTRACTOR EMAIL:TRhynes@lexarhomes.com CONTRACTOR LICENSE#(REQUIRED):LEXARH*850NC EVERETT BUSINESS LICENSE#(REQUIRED): 61588 PRIMARY CONTACT: ❑ OWNER /APPLICANT ❑ CONTRACTOR ✓❑OTHER(Architect, Engineer, Etc.) Agent CONTACT NAME: CONTACT PHONE:425.238.6324 Stacy Smith, SLDS 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 WAG. City of Everett Official Use Only PERMIT# Stacy Smith 03.26.2021 pW Z l OBI D(rj Owner/Authorized Agent Signature Date (Revised 1/72019)