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PUBLIC WORKS PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(PI 425 257 8810 1 FAX 425-257-8857 1(E) everetleps@everettwa.gov l hfps /levemfta.gov)Wmits <br />PROJECT SITE INFORMATION <br />PROJECT ADDRESS: 1427100th St SW EverettWA 98204 <br />SITE WORK FOR PROJECTTYPE: ❑SFRDETACHEr ]TOWNHOUSE ❑DUPLEX ❑ADU ZMULTI-FAMILY —COMMERCIAL', IINDUS-RIAL <br />IF APPLICABLE: ❑ LAND USE PROJECT N (SERA, PRE-APP SS, ETC.) <br />IF APPLICABLE: ❑ FRANCHISENTILITY COMPANY, ANNUAL BLANKET PERMIT# <br />"I.Mf COMPANY'S NAME S JOB N: J01 <br />L' % -00CRIPTION OF SITE WORK I RIGHT-OF-WAY WORK <br />FILL IN ALL QUANTITIES OF WORK BELOW, AS APPLICABLE: <br />❑FENCE IN NEW O FT IN HEIGHT <br />❑DRIVEWAYAPRONICURa CUT 0 FTWIDE <br />0ASPHALT I CONCRETE PAVING 2,937 SF <br />❑ RUNNING WALL I ROCKERY IN RIGHT-OF-WAY 0 LF <br />[I RUNNING WALL I ROCKERY OVER KFT IN HEIGHT 0 FT TOTAL HEIGHT <br />❑ CLEARING I GRADING I FILL/EXCAVATE 0 CY <br />❑ CUTIDORE IN PAVEMENT(PARALLEL) 0 LF <br />❑ CUTIeORE IN PAWMENT(NONPARALLEL) 0 LF <br />❑ POLE WrORKIAERIALICVERIASH 0 LF <br />TENAL DESCRIPTION (AS NEEDED: <br />DRAINAGE MITIGATION QUESTIONS: <br />STOFMWATER DISCHARGES TO. <br />❑Oannlrea Sews <br />mSEMrebrl SbTm Bews <br />❑D'EMO mwb Svb RN aPMmS w <br />TRIGGERED REQUIREMENTS' <br />❑MR2UIry ❑MRIZ 0100-9 <br />QUANRTY OF PROPOSED HARD SURFACES: <br />ROpceed ROM Abe10 BE <br />propmed Hero...p.: 0 BE <br />TOW New-R NCN'.2937 SF <br />Existing concrete patio to be replaced with new. No net increase in impervious surface proposed. <br />CONTACT INFORMATION <br />OWNER I APPLICANT NAME: Lawrence Houston <br />OWNER I MP. MNLINOADDRESS: UWET1000217th Ave NE <br />cw Seattle STAR WA no 98125 <br />OWNERIMP. PNONE:2058191279 <br />JOWNERiAPP. EMNL:IBWIeOCehoust00 comcast.net <br />RI brW hPuNlc RpMar-Wry <br />CONI NAME: Bear Creek LandsGa In <br />CONTRACTOR ADMEN: "EET903 Redmond -Fall City Road NE <br />cm Redmond sAw WA ap 98053 <br />ONTRACTOR PHONE:425-549-5147 <br />ICMTRACTM EMNL: <br />ONTRACTOR LICENSE WREQUIRI BEARCCL882P3 ]EVERETT <br />BUSINESS LICENSE YIREQUIREQ: <br />PRIMI'mOWNERIAPPLICANT ❑Ibq, CONTRACTOR ❑01(N ENinwr Etc) <br />TACTNAME: <br />Lawrence HOU- <br />CONTACT PHONE:2088191279 <br />CONTACT EMAIL:lawrencehouston CUmcast.net <br />- mm epprroerron enp mnnm, mernmrmMron mMemedll.minbmbenem r. wolxmle pmvmlromb PamamuN <br />canon •tin amrmrMdael, uero..Ialo�N Pew. rile aena19 deFBm�a Omrevenwaw apProvea lwxendrro awlenane maenPm. cewelrorm mvc rlrAree <br />eft"Sm Wnpm APPIhS rg OTaMnirmf neirpev ft Snow enyu Lirn1l7 REW Mr, a lem eutlpaeanyme owne.Mmlf erq)ertYro <br />paMrm me wwk rw Mrcn apaMehen rs meW eM Im+rpy w+m lln sl.ro CcnlrMas L.w iSx7Rcw PM 393 XpA wac <br />clyaE�n onm.I Use omy <br />PERMIT# <br />-C'1 IZ�Te/Zr2/ PW <br />IJwml Rh� A"SMntum Deb (ryI <br />