4849 SPIRE LN 2023-11-30 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL INSTRUCTIONS: Email application & submittal documents to Perm itServices@ever attwa,gov or drop off at 3200 Cod ar Street 2nd Floor Drop Box wASHINOTnN CONTACT INFORMATION: (P) 425-257-5810 1 (E) Perm ltServicesaeverettwa_aOV I (W) everettwa.aovloermlts PROJECT SITEANFORMATION . PROJECT ADDRESS:4849 Spire Ln SITE WORK FOR PROJECT TYPE: NSFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑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 M DESCRIPTION"OFSITE;WORk-°!'RIGHT OF-WAY.WORK.. FILL. IN ALL QUANTITIES OF WORK BELOW, AS APPLICABLE: ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON / CURB CUT FT WIDE ❑ ASPHALT / CONCRETE PAVING SF ❑ RETAINING WALL 1 ROCKERY IN RIGHT-OF-WAY LF ❑ RETAINING WALL 1 ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT B CLEARING / GRADING I FILL / EXCAVATE 400 CY ❑ CUT/BORE IN PAVEMENT (PARALLEL) LF ❑ CUT/BORE IN PAVEMENT (NON -PARALLEL) LF ❑ POLE WORK I AERIAL / OVERLASH LF ADDITIONAL DESCRIPTION (AS NEEDED): DRAINAGE MITIGATION QUESTIONS: STORMWATER DISCHARGES TO: ❑ Combined Sewer ❑ Separated Storm Sewer ❑ Direct Discharge to Snohomish River or Puget Sound TRIGGERED REQUIREMENTS: El MR2 Only ❑ MR1.5 ❑ MR1-9 QUANTITY OF PROPOSED HARD SURFACES: Proposed Roof Area: SF Proposed Hardscape: SF Total New+ Replaced: SF Project involves excavation of approximately 400CY of petroleum contaminated soil from previously removed CONTACT INFORMATIBN . ; ::. OWNER I APPLICANT NAME: Jeff Schuler and Mary Lee OWNER / APP. MAILING ADDRESS: IIET2901 Douglas Blvd Suite 101 ,,,,- Roseville STATE CA ZIP 95661 OWNER / APP. PHONE: OWNER / ARP. EMAIL: *Required for Work in Public Right -of -Way CONTRACTOR NAME: Wyser Construction CONTRACTOR ADDRESS: s,,,,Tl9015 109th Ave SE Snohomish STATE WA ztn 98926 CONTRACTOR PHONE:425-742-0898 CONTRACTOR EMAIL:andreW@Wyserdlrt.com CONTRACTOR LICENSE #(REQUIRED):"SE RC1045N9 EVERETT BUSINESS LICENSE #(REQUIRED): 34326 PRIMARY CONTACT: ❑ OWNER / APPLICANT IN CONTRACTOR ❑ OTHER (Architect, Engineer, Etc.) CONTACT NAME: Andrew Hinton CONTACT PHONE;206-�678-5122 CONTACT EMAIL: andrew:7a wyserdirt.com 1 11— mWou limi dNNucduuri dnu conrrrrn ine inrormanon conrameo 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 perfor the work for which application is made, and / comply with the State Contractors Law 18.27 RCW and 286.200A WAC. City of Everett Official Use Only r r�i blglla- S E= nd Andrew Hinton PER I 4t Andrew Hi ntot� DaE¢.^�'�202303a301330:27 �0700er, CN A dew Hinton PS n Ow 0r! uthorized Agent Signature Date (Revised 412112022)