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PUBLIC WORKS PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />EVERETT 32W CEDAR STREET, EVERETT, WA 98201 <br />WAAMINaTON (P)425-257-8810I FAX425-25]-885] (E)evere8eps®everethva.govl hUpsWeverethva.90WIDemits <br />PROJECT SITEINFO <br />PROJECT ADDRESS 2701 ROCKEFELLER AVE, EVERETT, WA 98201. <br />SITE WORK FOR PROJECT TYPE: OSFR-DETACHED OTOWNHOUSE ODUPLEX OADU RMULTI-FAMILY OCOMMERCWL OINDUSTRIAL <br />IF APPLIC#ALE: Z LAND USE PROJECT# (SEPA, PREAPP, SS. ETC.) <br />IFAPPLICABLE: ❑FRANCHISE/UTILITY COMPANY, ANNUAL BLANKET PERMIT# <br />UTILITY COMPANY'S NAME S JOB #: JOB # <br />DESCRIPTION OF SITE WORK / RIGHT-OF-WAY W <br />FILL IN ALL QUANTITIES OF WORK BELOW, AS APPLICABLE: <br />O FENCE IN ROW 6 FEET TEMP CONSTRUCTION/SECURITY FT IN HEIGHT <br />❑DRIVEWAY APRON/CURB CUT FT WIDE <br />❑ ASPHALT I CONCRETE PAVING SF <br />❑ RETAINING WALL I ROCKERY IN RIGHT-0E-WAY LF <br />❑ RETAINING WALL I ROCKERY OVER JET IN HEIGHT FT TOTAL HEIGHT <br />O CLEARING/GRADING/FILL I EXCAVATE H-S,000 CU CY <br />❑ CUTIBORE IN PAVEMENT (PARALLEL) LF <br />❑ CUTWRE IN PAVEMENT(NON-PARALLFI) LF <br />❑ POLE WORK I AERIAL I OVERIASH LF <br />d[ADTIONAL DESCRIPTION AS NEEDED): <br />DRAINAGE MITIGATION QUESTIONS: <br />STORMWATER DISCHARGES TO: <br />21Combined Saver <br />❑ Sepambeci Stoma stnar <br />❑Dead DbM to Snohomish Rivera lSound <br />TRIGGERED REQUIREMENTS: <br />OMR20nl ❑MM-5 ❑MRLQ <br />QUANTITY OF PROPOSED HARD SURFACES: <br />Proposed Immanent 0 SF <br />Proposed HaNscaps: 0 SF <br />Toltl New ♦ Re hoen:0 SF <br />LEGAL DESCRIPTION. PARCEL A: LOTS 1 THROUGH 8, INCLUSIVE, BLOCK 627, PLAT OF <br />EVERETT, ACCORDING TO THE PLAT THEREOF RECORDED IN VOLUME 3 OF PLATS, PAGE 32 <br />RECORDS OF SNOHOMISH COUNTY, WASHINGTON <br />CONTACT INFORMATION <br />OWNER APPLICANT NAME: EVERETT OZ DEVELOPER LLC <br />OWNER IAPP. MAILINGaIDRESS; Imam. 1420 FIFTH AVE, SUITE 2200 <br />rm, SEATTLE .p, WA Br 98101 <br />OWNER I APP. PHONE: 206-23A6543 <br />OWNER IAPP. EMAIL: bent@onelrentcom <br />'Required Mr Work In Pudic RghRaf-Way <br />CONTRACTOR NAME: BRASETH CONSTRUCTION <br />CONTRACTOR ADDRESS: a a. 3836 W MARGINAL WAY SW <br />DY SEATTLE mera WA 9Mu6 <br />CONTRACTOR PHONE: 206-937-5661 <br />CONTRACTOR EMAIL: mIb@Orasethconshuslion.com <br />CONTRACTOR LICENSE#(REQUIRED): BRASECC16202 <br />EVERETT BUSINESS LICENSE#(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER /APPLICANT ❑ CONTRACTOR D OTHER (Architect Engineer, Etc.) Cungemaas <br />CONTACT NAME: <br />MICHAEL HATCHER <br />CONTACT PHONE:360-244-4523 <br />CONTACT EMaL: mhmchM@ IalwaMKS.wm <br />ACKNOWLEDGEMENT I Mve felbwed Ms a yttebaWl aM confirm Me Mlomralnn confamecl homm Is sue end umect Wwk now tenement 0 We TanNf moat <br />coot wN, anent fehM,sAro. and beet law. The panting Me perm( only suhommat eppfovetl wak aM no ce"iata Mere/ .OeWfbv must first he <br />"onzetl M wfun9 own Me BvAMg OlMbl Oebn banner methodmduntlerany circumstance. l am Mat owear, or l am autlwn'mtl by new uwner of Mu pmpvr m <br />paYwm Ow,w/A(M1VcM1 applce[on to Mane. end I ranp'ywhW Sax ConrecMa ew 14.2T RCW entl 296,2roA WAG. <br />CydEwrett 'al Use OM <br />PERMIT# <br />z <br />/8May 20 PW <br />ISIBretve Dale (Revised f/12019f <br />