2602 81ST PL SE 2023-06-20 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL INSTRUCTIONS li subm,ttai documents to PermdServicesaevefettwa gov or drop off at 3200 CA-da, .--:rc :. �a I Ioor Drop Box WASHINGTON CONTACT INFORMATION �P,4" - gy,� EPe,mrtSe-�ces�everettwagovI^everettwagowpermis PROJECT SITE INFORMATION PROJECT ADDRESS:2602 81ST PL SE SITE WORK FOR PROJECT TYPE: NSFk-uLTACHED ❑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$1 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 9 ASPHALT/CONCRETE PAVING 3000 SF Separated Storm Sewer 8 RETAINING WALL ROCKERY IN RIGHT-OF-WAY 169 LF ❑Direct Discharge to Snohomish River or Puget Sound ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: 9 CLEARING/GRADING/FILL/EXCAVATE 10 CY 0 MR2 Only ❑MR1-5 ❑MRI-9 ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACE ❑CUT;BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area_ SF ❑ POLE WORK i AERIAL/OVERLASH LF Proposed Hardscape SF ADDITIONAL DESCRIPTION(AS NEEDED)- Taa.New Replaced SF 1500 SF of new paver surface and 1500 SF of concrete replaced by pavers with 169 LF of 2 FT high retaining wall. CONTACT INFORMATION OWNER/APPLICANT NAME.Galina and Eli Warner OWNER)APP MAILING ADDRESS 11W2602 81ST PL SE cf-• EVERETT WA 98203 OWNER/APP- PHONE.8016805942 OWNER J APP EMAIL.EWARNER9@YAHOO.COM 'Required for Work in Public Rignl-of-Way CONTRACTOR NAME: NIEVEZ GONZALEZ CONTRACTOR ADDRESS: STREET 11000 16TH AVE SE c,T-. EVERETT - WA r,, 98208 CONTRACTOR PHONE 4255283277 CONTRACTOR EMAIL- CONTRACTOR LICENSE MRFOUIRED RAINCCF819D2 EVERETT BUSINESS LICENSE il(REQUIRED; UB1604398292 PRIMARY CONTACT: ❑OWNER r APPLICANT ❑CONTRACTOR ❑OTHER(Architect Engineer. Etc CONTACT NAME N I EVEZ GONZALEZ CONTACT PHONE:4255283277 CONTACT EMAIL. ACKNOWLEDGEMENT i have reviev ed this appucabcn ana 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 Budding Official before being authorized under any circumstance 1 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 Co tactors La/ 18 27 RCW and 296 200A WAC ^ r "rry of Everett Official Use Only P�W Owner/Authorized Agent Signature Dat (Kevised 4,21/2022)