5132 ELM ST 2023-07-31 - Laserfiche WebLink

p.m WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES E VERETT 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 •, .�.:.t '• ! .t•: •w._ �.a• :.itt��i::,.•• •^y..:,�y:�..;'�y-..Li•.1�.t;t�;v.SSi ,.�w; •t�. PROJECT ADDRESS: 3 2- E rn . SITE WORK FOR PROJECT TYPE: d31SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: 5 FENCE IN ROW U f 1 FT IN HEIGHT STORMWATER DISCHARGES TO: ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑Combined Sewer ❑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 ❑ MR2 Only ❑ MR1-5 0 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): Total New+Replaced: SF GOrnm in ty a e � r '• T' - ., a'.: +t.-d r.y v �. K f mow•' d•+r � rr;; .•� 'r• -t: +;>:� ac rce.;t �r.♦a... .� •.M..• •W, 4 :t•••. .t'•' ri 7 �t 'hSN� .r a .t.. av,. t�,:':•v`.. t. a. =a•;.+�.y. ' :r.;:� ,. �•.`3i ; „)...: ' jh3« ur�, 1 �l4?.:i':•..11jj'',r'•1 t1:l. t1.1�".:L.�L'��,-i•,:t:l:t:.y.:•.��,N u•.�.L' : ..1:.i'' ` 1 ..I. `' r. �:' .1",�Ci S L' '.'" t� 0- . t .1.�:i}t.7lt�.•w�l� i•..•y .� f;'i 7 a t ....'..W Y: •.C,'e. .. ., ... .. .. .. "a:. .. 'l ..'i:t•\�• ... .h: t h1 � s .i•s. `:•�a..� !•=Y;..�t.. ..t_y,_:..7:3.•;ii:o ..r'.��'•• OWNER/APPLICANT NAME: 1C.� O) S OWNER/APP. MAILING ADDRESS: STREET �j Z £ , rn 7� CITY STATE lAjtj ZIP 7 2 OWNER/APP. PHONE: , r , 4 6- W 6 7 OWNER/APP.EMAIL: ♦• S Cp r' et /,r tell ..z�,v�s.s :+asa:.a:...�.ka..:...r.:'rk.r.1....,:..a.:�;i_a.-s3't�^�h.:t.xs.....:�.-sse.sr.�.a�ax:r,ar.�:..<a.+�,caw•exsm..,.=x..zs.�.;r'z.>va.-'w:x-w...r�:..r,.:.>wa.�.;.ns�s.ma'+;�..res: .a..-.:�.,•n.�.:w.z.:: ;.:.....,..�.. .. i.xs.:s.:.�-.wsw.:x:...�..w:a�::..:ss,zs'avn,..-. *Required for Work in Public Right-of-Way CONTRACTOR NAME: h d fi YYk k own ' r Ea pp l CONTRACTOR ADDRESS: STREET 3 1YV) S� CITY LAVI STATE 9' pe_o es 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: 2A3 6- 7 3( -7 66 '7 K c)c) S CONTACT EMAIL: CO os 6 6 0( t'hex r ACKNOWLEDGEMENT.I have reviewed this application and confirm the information contained herein is true and correct. Work done pettsuant 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# z 3 -- 2- 2 -- PW /1.2O 0 l (b caner/Authorized Agent Signatur Date (Revised 4/15/2019)