8307 5TH AVE W 2023-04-07 - Laserfiche WebLink

FOBLIC WORKS PERMITOPPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits AveROJECT SITE INFORMATION PROJECT ADDRESS: Z;'3 J 7 S��k A _ IF APPLICABLE: LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) �SUPft J5—OO1 SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX 2MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? ❑ NO ( 'ES, FROM 4"N'`.i..i) wt � i‘,�~ TO I l f i J-1 - 1-1610n 1�J NEW WATER/SEWER SERVICE NEEDED? ❑ NO DYES,TYPE 4!. IA/itGdn✓Z4 ,A SITE WORK/ RIGHT-OF-WAY APPLICATION INFORMATION DESCRIPTION OF WORK: x'\& 1`JinA-€ �.fJJ; ` � ,� 4� 1 r t,\�� 1�-,.`-Cov(40. 1�,t Lyv►�\• y 11 ❑ FENCE IN ROW FT IN HEIGHT W'DRIVEWAY APRON/CURB CUT 77 FT WIDE ❑ASPHALT/CONCRETE PAVING SF ETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT ❑ CLEARING/GRADING/FILL/EXCAVATE CY ❑ CUT/BORE IN PAVEMENT(PARALLEL) �F ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT INFORMATION OWNER NAME: 1-1 V\Me/4 �4 I v A OWNER MAILING ADDRESS: STREET ' Ze j ?�`�v� SSA-_ C I r)1T CITY E:ifytt-ll1 STATE w A ZIP OWNER PHONE. L-2 S- S°1 - 4 1 OWNER EMAIL: V.k 1ck _ ez.01 DTh'1, 1» ZO APPLICANT NAME: A\\T k \ t Li &_ APPLICANT MAILING ADDRESS: STREET i 2 ^S. 13 _ S CITY _ �' STATE ZIP APPLICANT PHONE: 4-25 SO :tett_ APPLICANT EMAIL: t11 A pt A a� 111-11Gt4 PRIMARY CONTACT: t -O(11VNER ®APPLICANT ❑ OTHER(Architect, Engineer, Etc.) VJ CONTACT NAME: �, her L _ CONTACT PHONE: +2/ 206.-"(3,1 6 - 0 4-c 5 CONTACT EMAIL: Mu k �,,/e)at v,,,�; ,C0�.,,, 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 1 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# /'/e/74,/ PW ° - Owner/Authorized Agent Signature Date (Revised 10/12/2015)