1416 RUCKER AVE 2023-11-30 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EV E R E T T SUBMITTAL INSTRUCTIONS: Emal appl-catlon & submittal documents to PermllServlces@overottwo.gov or drop oil at 3200 Ceder Street 2nd Floor Drop Box WAr W JHnrnN CONTACT INFORMATION: (P) 425-267.88101 (E) PemillServiceseeverettwa.gov I (W) everettwa.gov/permits `�Y-eii"!�?Y�-ty`5��,�[ti��l�`fJ l :..'-� .ti-- �l"'-#".4� �� -�^K+L_-%-='r:5 ]}4t�1+�.�-, i'�� 1J-„'c >'exlY •Tid'i y' PROJECT ADDRESS: 1416 Rucker Ave, Everett WA 98201 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 #: '`•'�f:�'�.i+".t _;�,iiK'; (n�:l :-;��.lr..• - - >~ ,� �., �.�:��: Kz=�.�. ,s .�i - iiTia�a i •�>•�iiin='#3,•t...� -- r rEY.y,rLxn'fie s=i .:.��.�il��:�..s�.: FILL IN ALL QUANTITIES OF WORK BELOW, AS APPLICABLE: ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON / CURB CUT FT WIDE ■ ASPHALT / CONCRETE PAVING 33 SF ❑ RETAINING WALL / ROCKERY IN RIGHT-OF-WAY LF ❑ RETAINING WALL / ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT ❑ CLEARING / GRADING / FILL / EXCAVATE CY ❑ CUT/BORE IN PAVEMENT (PARALLEL) LF 0 CUT/BORE IN PAVEMENT (NON -PARALLEL) LF ❑ POLE WORK / AERIAL / OVERLASH LF ADDITIONAL DESCRIPTION AS NEEDED): DRAINAGE MITIGATION QUESTIONS: STORMWATER DISCHARGES TO: ❑ Combined Sewer ❑ Separated Storm Sewer Ca Direct Discharge to Snohomish River or Puget Sound TRIGGERED REQUIREMENTS: ❑ MR2 only O MR1-5 0 MR1.9 QUANTITY OF PROPOSED HARD SURFACES: Proposed Roof Area: SF Proposed Hardscape: 33 SF Total Wow+ Replaced: 33 SF Remove grass and use concrete pavers to create path from parking area along the street curb to sidewalk, approx. 3 tt wide, 11 R long �J," .` :`. .`v": s;xi(_ =ia _ .. r i '•. ?ir�- r Si'i-' ' f- - '.ti•. _i:i .:•iT y: - _., Jl'.,T, j;: ;.\ s:.�. --iS�rie'x"r�is2'�is'C- 4rX'krL�.*`!-��. t�S'� .k. -�-:trc�i`. �S�%?' �Mf =� ��-.i:{JL, ?>• .,..i-Z .6.v.. .�•i.�...- :�• �;i OWNER I APPLICANT NAME: Mike Papa OWNER / APP. MAILING ADDRESS: STREET 1416 Rucker Ave CITY Everett STATE WA LP 96201 OWNER / APP. PHONE:425-314.0309 OWNER / APP. EMAIL: mcpapa56@gmail.com 'Required for Work In Public Right -of -Way CONTRACTOR NAME: Owner CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE #(REQUIRED): Owner EVERETT BUSINESS LICENSE #(REQUIRED): Owner PRIMARY CONTACT: ® OWNER / APPLICANT ❑ CONTRACTOR 13 OTHER (Architect, Engineer, Etc.) CONTACT NAME: Mike Papa CONTACT CONTACT PHONE: 425-314-0309 EMAI L: mcoavase(l;q—I cam ACKNOWLEDGEMENT: I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with current federal, state, and locallaw. The granting of a permit only authorizes approved ltnrk and no deviations therefrom. Deviations must first be authorized in wiling from the Building Official before being authorized urldor any circumstance. l am the owner, or I an) authorized by the owner of this property to perform the %vork for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Onf W_Alez PER TI !! , 4 2 3 PW Owner/Authorized Agent Slgn uro Dale (Revised 4/2112022)