514 VERALENE WAY SW 2022-10-28 - Laserfiche WebLink

illini P�►. ALM WORKS PEFT imi T •PUUCAT ON mg CITY OF EVERETT PERMIT SERVICES EVE E T T 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,S1 '.E.ItiFOR! A "1O.lel _.::Mg:.... ..., is..,. __ N w :=• , --*PROJECT ADDRESS: !j 14 \I t'z-A tea*'..- \IJ A'? - SITE WORK FOR PROJECT TYPE: JSFR-DETACHED ❑TOWNHOUSE ❑DUPLEX DADU OMULTI-FAMILY ❑COMMERCIAL DINDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.) '. ` DESCRtIPTION OF SITE.WOR C/.:,RIGH T.Or-WA 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 O.ASPHALT/CONCRETE PAVING * 4 6 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 IN.VMR2 Only ®MR1-5 ® MR1-9 0 CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: 0 CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: d SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: 4-to s SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: 4 to SF 0#4 S%vf. Ps.•-4-7 --,bAc `1 4'11-5> Pr-v—c.,Pt OWNER I APPLICANT NAME: ici Av.. J< R Pr-- 1 � 1 , l �! OWNER/APP. MAILING ADDRESS: STREET ) q I) (2 r G\ C Ir )Q- W G l --) t.1,) `. CITY I_ () i,r-P STATE (;., ZIP`l 2 c)3 OWNER/APP. PHONE: q 23-Z C> 00 2() OWNER/APP.EMAIL: *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): ` g /APPLICANT A PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: J f / h RI_ K k rl CONTACT EMAIL: 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 lam 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 ROW and 296.200A WAC. City of Everett Official Use Only PERMIT# /241A 4J/ 3 -- 7_ 2 2 Pw '2_ 0 - © 0O e/Authorized A eature Date (Revised 4/15/2019) wn r g