4920 24TH AVE W 2023-06-22 - Laserfiche WebLink

PLAILIC WORKS PERMIT AOLICATI N O CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:4920 24th Ave. W., Everett, WA 98203 SITE WORK FOR PROJECT TYPE: ❑✓SFR-DETACHED ❑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# 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 20.75 FT WIDE ❑ Combined Sewer O ASPHALT/CONCRETE PAVING 1348 SF ❑✓ Separated Storm Sewer ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF El Direct Discharge to Snohomish River or Puget Sound ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: CLEARING/GRADING/FILL/EXCAVATE 200 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:2804 SF ❑POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: 1348 SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced:4152 SF CONTACT INFORMATION OWNER/APPLICANT NAME:4900 24th Ave W., LLC OWNER/APP. MAILING ADDRESS: STREET 526 N. West Ave. #147 CITY Arlington STATE WA ZIP 98223 OWNER/APP.PHONE:360-631-5922 x 3 OWNER/APP.EMAIL:officemanager@fullwilerconstruction.com *Required for Work in Public Right-of-Way CONTRACTOR NAME: Fuliwiler Construction Inc. CONTRACTOR ADDRESS: STREET same as above CITY STATE ZIP CONTRACTOR PHONE:same as above _CONTRACTOR EMAIL:same as above CONTRACTOR LICENSE#RE UIRED:FULLWCI903M2 EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER /APPLICANT Q CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: - - - - 360 631 5922 x 3/425 344 7803 Mallorie Hefley or Jerry Fullwiler CONTACT EMAIL:officemanager@fullwilerconstruction.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# C1 L1 Cr ),_ (4 ZvZ-I PW 1-A0G --� Owner/Authorized Agent Signature Date (Revised 1/72019)