2730 FEDERAL AVE 2023-06-26 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL INSTRUCTIONS:Email application&submittal documents to PermitServices@everettwa.gov or drop off at 3200 Cedar Street 2nd Floor Drop Box WASHINGTON CONTACT INFORMATION:(P)425-257-8810 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:2730 Federal Avenue, Everett, WA 98201 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY ❑COMMERCIAL RINDUSTRIAL 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 / RIGHT-OF-WAY WORK FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: ❑ FENCE IN ROW FT IN HEIGHT STORMWA TER DISCHARGES TO: ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑ Combined Sewer ❑ASPHALT/CONCRETE PAVING SF 8 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): ITotal New+Replaced: SF At Phase 1 the 15-inch discharge line from the southerly limit to Federal Avenue requires a bypass (bypass 1). The protective measures during exposure include soft and/or hand digging techniques. The line will a cut at three i aeations, itist beyond both satitherly and martherly lirmits of the exeavation area and at Federal Aventie. The eut sections will be demoed and replaced following completion of excavation activities- The upstream ends will have a CONTACT INFORMATION OWNER/APPLICANT NAME:Innovative Construction Solutions OWNER/APP. MAILING ADDRESS: ST11IT575 Anton Boulevard, Suite 850 cITY Costa Mesa STATE CA Z,,92626 OWNER/APP. PHONE:480-600-9877 OWNER/APP. EMAIL:rtracey@icsinc.ty `Required for Work in Public Right-of-Way CONTRACTOR NAME: Innovative Construction Solutions CONTRACTOR ADDRESS: ST1EET575 Anton Boulevard, Suite 850 CITY Costa Mesa STATE CA ZIP 92626 CONTRACTOR PHONE:480-600-9877 CONTRACTOR EMAIL:rtracey@ICSlnc.ty CONTRACTOR LICENSE#(REQUIRED):CC INNOVCS781 K5 EVERETT BUSINESS LICENSE#(REQUIRED): 64660 PRIMARY CONTACT: ❑ OWNER /APPLICANT @ CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE:480-600-9877 Ryan Tracey CONTACT EMAIL:rtracey@icsinc.ty 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. 1 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 8/11/22* pW# Owner/W.uthorized Agent Signature Date (Revised 4/21/2022)