3219 WETMORE AVE 2023-07-28 - Laserfiche WebLink

• • mil uzi PUBLIC WORKS PERMIT APPLICATION 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 < : R'`, ,` £ tOe PROJECTT..SITEk1NFORMATI.ON.a` f A S µ °IS , ., ', . . PROJECT ADDRESS: /Z-1 \'i J 'x 7l prr A.L[ ' V � 7J � \\, m SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX EADU ❑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# g . aiN :'at SCRIPTIONtOFiS fitli root ° RIg,Hre otWAV WOR , , SI .R ._. . . FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: FENCE IN ROW ?,r 61 FT IN HEIGI-IT STORMWATER DISCHARGES TO: ❑DRIVEWAY APRON/CURB CUT FT WIDE ❑Combined Sewer Li ASPHALT/CONCRETE PAVING 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 FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: ❑CLEARING/GRADING/FILL/EXCAVATE CY El MR2 Only E] MR1-5 ❑MR1-9 ❑CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: Li CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: SF ❑POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: SF ADDITIONAL DESCRIPTION(AS NEEDED): x Total New+Replaced: SF • ,'. r n .7 IC N=Y t tli IFORIVIQTICN � s . ,- . .j � � . OWNER/APPLICANT NAME: �JIEt tq- .F. i 'Lt H� 1�� _ I OWNER/APP. MAILING ADDRESS: STREET Y 2_Cfr) ` r L�1 `z i V - �/. CRY V �h STATE ,� ZIP ` Z OWNER/APP.PHONE: n Cam" 2Z �� OWNER/APP. EMAIL: I 1-- 1 _C1w 7 oft:',-, ,ee Y,VVV c----) / ' ; ' 'Required for Work in Public Right-of-Way CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: OWNER /APPLICANT El CONTRACTOR ❑OTHER(Architect,Engineer, Etc.) CONTACT NAME: j�� /� f A tr-( t CONTACT PHONE: A't ( L) p:�'1i C \• 'fi l ' ��J �- I� L3 CONTACT EMAIL: 7_____,- 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 / 1 � , � PERMIT# cL.1 .71\0-1,_ 6 I P / — 03� Own /A th "zed Agent Signature Date (Revised 1/72019)