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PlapLIC WORKS PERMIT PLICATION I" 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 I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:57xx SEAHURST AVE, EVERETT, WA 98203 SITE WORK FOR PROJECT TYPE: ✓❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY EICOMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ✓❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) SS19-002 & REVI17-027 IF APPLICABLE: E 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 (X3) FT WIDE ❑ Combined Sewer ❑ASPHALT/CONCRETE PAVING 1 ,600 SF ✓❑ 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 8 FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: ❑ CLEARING/GRADING/FILL/EXCAVATE 4,400 CUT CY El MR2 Only ✓Q MR1-5 ❑ MR1-9 ❑CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) 150 LF Proposed Roof Area:3,506 SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape:3,170 SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced:6,676 SF SEE DRAINAGE REPORT FOR DISCUSSION OF CITY AGREEMENT WITH DEVELOPER FOR DETERMINING MINIMUM REQUIREMENTS FOR THIS PROJECT. CONTACT INFORMATION OWNER/APPLICANT NAME:JOSEPH SMEBY, P.E. - OMEGA ENGINEERING, INC. OWNER/APP. MAILING ADDRESS: sTREET2707 WETMORE AVE CITY EVERTT STATE WA ZIP 98201 OWNER/APP. PHO E:428.903.4852 OWNER/APP. EMAIL:joe@omega-eng.COm _ t *Required for Work in Public Right-of-W y CONTRACTOR NAME: CONTRACTOR ADDRESS: s CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ✓❑ OWNER /APPLICANT ❑ CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: 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 . 1-E// Pw ' . 0l OwnerlAuthorized Agent Signature Date (Revised 1/72019)