2324 MAPLE ST 2023-08-23 - Laserfiche WebLink

DEMOLITION PERMIT APPLICATION E V E R E T T CITY OF EVERETT PERMIT SERVICES WASHINOTON CONTA - T INFORMATnINNPI rop A99-oR hard rcopy paper application &plan to 3200 Cedar Street 2nd Floor Intake Drop Box. (Blue or Black Ink Only Please) _ -- ---- ,. , •-- — -. I t=/ rnnouoervlcesLaevereuvia.gov I (W) everettwa.gov/permits PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STRI ET •Z GL } PARCELM CITY SUITE/UNIT #: STATE A zw IJ•/ FLOOR #: TENANT/BUSINESS NAME (If non -rest ADDITIONAL LOCATION INFORMATION: ential): CONTACT INFORMATION OWNER NAME: CAt�Y oY\ OWNER MAILING ADDRESS: STRE r 25Z- o k-e 5 CITY OWNER PHONE: �,j-(p 11.1-79 STATE W 1A ZIP (� Rck OWNER EMAIL: Mo% ,YVLC r G15pYl CONTRACTOR CONTACT NAME: OW S WA STATE CONTRACTOR LICENSE 9 (REQUIRED): CITY F EVERETT BUSINESS LI CONTRACTOR ADDRESS: STRE r CONTRACTOR PHONE: cm CONTRACTOR EMAIL: STATE z 202 PRIMARY CONTACT: ysl OWNER CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: _ (0 CONTACT EMAIL: Nt,p\ y C � t k DEMOLITION PERMIT INFORMATION VALUATION OF WORK: $ () (Valuation shall include the prevailing fair market valt ASSOCIATED PERMIT/LAND USE PROJECT # inapplicable): aof all labor,materials, and equipment needed to complete the work,whetheractuallypaid or not.) BUILDINGTYPE: ❑SFR ❑Townhouse DESCRIPTION OF WORK: ❑Duplex ❑ADU ❑Multi -Family -#Units: ❑Commercial ®Accesso Structure Re-fAciltp• # OF SQUARE FEET REMOVED: 7 XC 5tttrlci'n �aS� W`^fir a d t l;ke # OF DWELLING UNITS REMOVED: Y�fno�J`Gt , HISTORIC STRUCTURE: ❑Yes 14No (Contact Planning Division to learn about additional requirements for historic SHORELINEIFLOODPLAIN PROXIMITY: structures (on Historic Registry or located in a Historic Overlay)). ❑Yes ®NO (Contact Planning EXISTING UNDERGROUND TANK: ®No Division to learn about shoreline and floodplaln requirements Ifstructure being demolished is oMn either). Tank ❑Yes- tank will stay in place - type: ❑Yes- tank to be removed -type: UNDERGROUND TANK SIZE: KNo Ta ik ❑Under 10,000 gallons Ell o,000 gallons or over PEDESTRIAN PROTECTION NEEDED: ❑Yes fANo (Required when demolition is in close proximity to R.O.W. Include a pedestrian protection plan for review). CONSTRUCTION FENCING NEEDED: Yes L)i(Jo (If yes, show the temporary construction fencing location the on required site plan). DUMPSTER IN R.O.W. NEEDED: ❑Ye No (If yes, apply for a separate Traffic Street Use Permit online at pw.everettwa.gov). TRAFFIC CONTROL PLAN NEEDED: YesMNo (Required when sidewalk, parking lane, or travel lane closure Is needed. If yes, apply for a separate Traffic Street Use Permit online at pw.everettwa•gov). SEWER SERVICE CONNECTED TO BU LDING: ❑Yes No (If yes, a separate Utility Permit will be issued for side sewer cap off prior to demolition). WATER SERVICE CONNECTED TO BUILDING: ❑Yes 1N (If yes, cap at back side of meter prior to demolition and contact Utility Billing to slop billing). ELECTRICITY CONNECTED TO BUILDING: ❑Yes [AND (If yes, apply for separate Electrical Permit for disconnect and disconnect services prior to demolition). ABATEMENT ACKNOWLEDGMENTS: a applicant is responsible for compliance with all local, state, and federal laws, codes, and regulations whether or not described herein. By checking the box next to sch abatement type below, 1, the ownenapplicant, acknowledge my responsibility, agree to the terms and conditions of the inquire nen s, and will abide by the requiremer Is during construction. Asbestos Abatement: El Required in fine with Puget Sound Clean Air Agency (PSCAA) httpszl/pscleanair.gov/. An Asbestos/Demolition Notification must be submitted o PSCAA before any asbestos removal or demolition begins and have the appropriate abatement report documentation on -site during construction. Ll Lead Paint Abatement: Contact the Snohomish Health District (SHD) httpsJfwwvv snohd.org! for applicable lead paint abatement requirements. E" Rodent Abatement: Proper recent abatement shall be conducted prior to demolition. SITE PLAN REQUIREMENTS: Submit 2 h electronic site plan with permit application if su rd copies of site plan showing buildings to be demolished with permit application to Permit Intake Drop Box or attach milting electronically. Plans shall be in Address_ DemoPermitPlans. separate, compiled pdf, 8.5x11 or 11 x17 size. Naming convention: ACKNOWLEDGEMENT., I have reviewed this anrkinaunn and c„�r_ tea mr m,,.....,.,_r__�._-_r_ -.I--------....._.—••••m000„. cwlu�.vven, gonepursuantm rmspermitmust comply with current federal, state, and local law. The granting Pia permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized /n writing from the Building Official before being authorized under anj• circumstance. I am the owner, or I am authorized by the owner of this property to perform the work for which application /s made, and i comply with the State Contractors Law 16.2'{ RCW and 296.200A WAC. City of Everett Official Use Only PERMIT # Date (Revised 412112022)