8907 5TH AVE W 2023-04-11 - Laserfiche WebLink

JBLIC WORKS PERMITIOPPLICATION 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 https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:8 EVERETT WA 98204 Ca orr*- c at (.() SITE WORK FOR PROJECT TYPE: ❑✓SFR-DETACHED LITOWNHOUSE ❑DUPLEX ❑ADU EMULTI-FAMILY ❑COMMERCIAL P1INDUSTRIAL IF APPLICABLE: J 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 30 FT WIDE ❑ Combined Sewer ❑ASPHALT/CONCRETE PAVING SF E 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: Z CLEARING/GRADING/FILL/EXCAVATE 8 CY El MR2 Only ✓❑ MR1-5 El MR1-9 ❑CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: 1,736 SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape:2,376 SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced:4,112 SF SS stub exists onsite. Connection to water line does not require pavement cut. 30' driveway apron proposed. CONTACT INFORMATION OWNER/APPLICANT NAME: BOYKO ROSTISLAV OWNER/APP. MAILING ADDRESS: STREET 12029 24TH AVE SE CITY Everett STATE WA ZIP 98208 OWNER/APP. PHONE:425-344-6348 OWNER/APP. EMAIL:interiorwa©gmail.com *Required for Work in Public Right-of-Way CONTRACTOR NAME: Unknown at this time CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: n OWNER /APPLICANT ❑ CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE:425-344-6348 BOYKO ROSTISLAV CONTACT EMAIL:interiorwa@gmail.com 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# A/e 04-04-22 PW 2-1O1-- '' 0 1 Owner/Authorize Agen ignature Date (Revised 1/72019)