9916 2ND AVE SE 2023-12-06 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMRT INSTRUCTION Emall applkeRn S wommi daumenbW Permne.rvlm¢Mee'i.nlMa.go, or Ertp AS at 3200 WANT Mi 2nd Earn prop So WASIVINGTON CONTACT INFORMATIOM (P) 425 25T 88 10 1 (E) PermllServlcesgovemmak.pw I lW)evmetlxa.pw/Pormlls PROJECT SITE INFORMATION PROJECT ADDRESS: 9916 2nd Ave SE SITE WORK FOR PROJECT TYPE: NSFR-DETACHED OTOWNHOUSE (Ipuvl rx OADU DMW TI-FAMILY OCOMMERCIAL OINDUSTRIAL IF APPLICABLE: O )AND USE PROJECT N (SEPA, PRE-APP, SS. ETC.) IFAPPLICABLE: [DFRANCHISENTILITY COMPANY, ANNUAL BLANKET PERMIT UTILITY COMPANY'S NAME a JOB Y: JOB C: DESCRIPTION OF SITE WORK / RIGHT-OF-WAY WORK FILL IN ALL QUANTITIES OF WORK BELOW, AS APPLICABLE ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON I CURB CUT FT WIDE D ASPHALT I CONCRETE PAVING 101297 SF ❑ RETAINING WALL I ROCKERY IN RIGHT-0E-WAY LF ❑ RETAINING WALL I ROCKERY OVER JET IN HEIGHT FT TOTAL HEIGHT ❑ CLEARING) GRADING) FILL I EXCAVATE CY ❑ CUTWRE IN PAVEMENT(PARALLEL) LF O CUUBORE IN PAVEMENT( NON -PARALLEL) LF ❑ POLE WORK I AERIAL I OVERLASH LF ADDITIONAL DESCRIPTION (AS NEEDED): DRAINAGE MITIGATION QUESTIONS: STORMWATER DISCHARGES TO: OOombined Saawr ■ Seperalad Slam Smw O Direct Distllarpe To SmMmism River or FrUet Sound TRIGGEREDREQUIREMENTS: QMR2anly [3MRU5 Oki QUANTITY OF PROPOSED HARD SURFACES: Proposed Roof Area: SF Replaced Handsome: 1012.87 BE Total Nary a Replaced. SF Adding a concrete pad to the side/rear of the garage CONTACT INFORMATION OWNER I APPLICANT NAME: Katie , Itagai OWNER IMR. MAILING ADDRESS: ear 99162nd Ave SE Everett ATATE WA ZIP 98M08 OWNER IMP. PHONE: 4252322711 OWNER I APP. EMAIL karlee.imarga@gmail.cdm 'Required for WPM In Public Rigdto! Way CONTRACTOR NAME: LIST Asphalt and Concrete CONTRACTOR ADDRESS: ATTEU CITY STATE 11 CONTRACTOR PHONE: A25268-3084 CONTRACTOR EMAIL:prehasphallconcrete@jobnimbusmail.com CONTRACTOR LICENSE LNREQUIRED): Jirehli N5 EvsaETr BuslNEss ucexsE gREDmRED): 55005 PRIMARY CONTACT: p OWNER I APPLICANT ❑CONTRACTOR ❑ OTHER(Annhitect, Engineer, Etc.) CONTACT NAME:Karlee Ikebara CONTACT PHONE: <25YJ22]IG ranx.lks CONTACT EMAIL w4manmm ACKNOWLEDGEMENT I have reviewed this application and wnlirm Me iMonnation conhimd hei is hae aM wnxl. Work drew pxsuanlro Mis Pormx must remelt aim surreni lsderel, orate, and bcsl lawOn grenfmg wa proper only compares approved vo xaw rm diewawns marermm. 0evianaki mwrn nee aNlMmd M w Taft hmn Me Bulldmg OMcbl behre being SNlMmtl undarany cirtumsranro. lam Cry owner, ai am wMofdedby Ma oworerdlM1ispmpaty to Emblem for work for wNcn recreation is made, and I comply lam the Stale Connecfom' Law 1827 ROW rear 2 UMMA VAC. Cry ofOnerett OMnal Use QMy, FIEKIMI Karlee Ikebara 8/1/2023 IPW 19 Ownerbiumhorized Agent slgnamn Date (ReWed MLUJg22)