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PUBLIC WORKS PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />EVERETT 32M CEDAR STREET, EVERETT, WA 98201 <br />(P)425-257-81HO I FAX 425-257-88571(E) everetleps@ewretMa.govl hUpa:l/everetWa.g0v/permit$ <br />- -`. PROJECT ititsiNFORMATION --- <br />PROJECT ADDRESS: 2MMiSION�2215 Pine Street, Everett, WA 98201 <br />SITE WORK FOR PROJECT TYPE; OSFR-DETACHED OTOWNHOU8E ODUFLEX OAW OMULTi-FAMILY MO MMERCIAL ❑INDUSTRIAL <br />IFAPPLICABLE: ❑LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC)N/A <br />IFAPPLICABLE; ❑ FRANCHISEIKMUFTY COMPANY, ANNUAL BLANKET PERMIT#NIA <br />UTILITY COMPANY'S NAMES JOB#: JOB# <br />DESCRIPTION OF 31`JE WORK? RIONT-GP-WAY <br />FILL IN ALL QUANTITIES OF WORK BELOW, AS APPLICABLE: <br />[I FENCE IN ROW FT IN HEIGHT <br />❑ DRIVEWAY APRON I CURB CUT FTWIDE <br />D ASPHALT I CONCRETE PAVING 1jS�SF <br />O RETAINING WALL ROCKERY IN RIGHT-OF-WAY _UP <br />Cl RETAINING WALL/ ROCKERY OVER 4FT IN HEIGHT _FT TOTAL HEIGHT <br />❑ CLEARING /GRADING I FILL/EXCAVATE CY <br />El CUTIBORE IN PAVEMENT(PARAAEL) LF <br />❑ CUTIBORE IN PAVEMENT (NON -PARALLEL) LF <br />❑POLEWORKIAERIALIOVERIASH LF <br />ADDITIONAL DESCRIPTION AS NEEDED: <br />WORK'°: <br />DRAINAGE MITIGATION QUESTIONS: <br />STORMWATER DISCHARGES TO: <br />❑COmMned Sena <br />❑SmrtMeBSmm Semr <br />❑Nmcl DsM eb SnMmlM1Rww wM Ow,M <br />TRIGGEREDREQUIREMENM <br />CIMR20I4 OMR14 11MR19 <br />QUANTITY OF PROPOSED HARD SURFACES: <br />pfop NRol Ame' SF <br />Propoemi XeMEwy: 9F <br />zNew+ftoe .. SF <br />within the ROW at two sites for the <br />Removal & replacement of approximately472e98f of sidewalk located <br />Everett School District. 36 516- 6 r X 61 <br />CONTACT INFORMATION <br />OWNER/APPLICANT NAME:Everetl School Dietdct No. 2, Damy Walker <br />OWNERIAPP. MAILINGADDRESS: naFET3900 Broadway <br />Cm Everett 6rA,e WA 98201 <br />OWNERIAPP. PHONE:425-385-4197 JOWNER IAPP. EMAIL; dwalker@everettsd.org <br />'RepNreE Im NbM1In PUN'p RipM1FIX Way <br />CONTRACTOR NAME: Spee West Construction <br />CONTRACTOR ADDRESS: MMMT307 Bell $treat, Suite 101 <br />m Edmonds MTE WA Zp 98020 <br />CONTRACTOR PHONE:208-284-7733 CONTRACTOR EMAJI-i righ(QSpeewest.wrn <br />CONTRACTOR LICENSE #(REQUIRED), SPEEWCC1 01 MF EWIR BUSINESS LICENSE WEDUIREDI: 58415 <br />PRIMARYCONTACT: ❑OWNERIAPPLICANT OCONTRACTOR ❑ OTHER(ATchW EIMImer, EM) <br />CONTACT NAME: <br />Matt Rasmussen <br />CONTACT PNONE:206-719-0991 <br />coNTACT ENUIL:mmsmussen@speewesLCOm <br />CevlNbrumual MafOa <br />Cky d EVaell DMdEI Lke Omy <br />PVV 2202 -o6y <br />(ROMaW f/lPefB) <br />