1915 E GRAND AVE 2024-02-28 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL INSTRUCTIONS:Email application&submittal documents to PermitServices@everettwa.gov or drop off at 3200 Cedar Street 2nd Floor Drop Box WASHINGTON CONTACT INFORMATION:(P)425-257-8810 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: Intersection of E Grand Ave &20th St; City of Everett ROW(near 47.991209°, -122.180721') See Figures SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY RCOMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.) IF APPLICABLE: ❑FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB M JOB#: DESCRIPTION OF SITE WORK / RIGHT-OF-WAY WORK FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: ❑ FENCE IN ROW FT IN HEIGHT STORMWA TER DISCHARGES TO: ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑ Combined Sewer ❑ASPHALT/CONCRETE PAVING SF ❑ Separated Storm Sewer ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ Direct Discharge to Snohomish River or Puget Sound ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: ❑ CLEARING/GRADING/FILL/EXCAVATE CY ❑ MR2 Only ❑ MR1-5 ❑ MR1-9 ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: R CUT/BORE IN PAVEMENT(NON-PARALLEL) LF *Not through Proposed Roof Area: SF ❑ POLE WORK/AERIAL/OVERLASH LF Pavement Proposed Hardscape: SF ADDITIONAL DESCRIPTION (AS NEEDED): Total New+Replaced: SF Perform two(2)vertical Geotechnical Test Borings with soil sampling on east side of sidewalk through natural ground. Diameter of boreholes approx. 8 inches(max.). Each borehole approx. 70 ft deep.Temporary(estimated 1 year max.)standpipe piezometers to be installed within completed boreholes. Begin work 10/17/22. No vehicle/pedestrian traffic interference. CONTACT INFORMATION OWNER/APPLICANT NAME: Jacob FUIkS OWNER/APP. MAILING ADDRESS: STREET 600 Washington Avenue, Suite 950 CITY St. Louis STATE MO zip 63101 OWNER/APP. PHONE: (217)-622-8095 OWNER/APP. EMAIL: jfulks@hanson-inc.com *Required for Work in Public Right-of-Way CONTRACTOR NAME: Holt Services Inc. CONTRACTOR ADDRESS: STREET PO Box 1659 CITY Milton STATE WA Zip 98354 CONTRACTOR PHONE: 253)-604-4878 CONTRACTOR EMAIL: srasmussen@holtservicesinc.com CONTRACTOR LICENSE#(REQUIRED): HOLTSS1898JG EVERETT BUSINESS LICENSE#(REQUIRED): 052763 PRIMARY CONTACT: ❑ OWNER /APPLICANT R CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: Steve Rasmussen CONTACT PHONE: (253)-318-6748 CONTACT EMAIL: srasmussen@holtservicesinc.com 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 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 perform the work 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 Only 9/30/2022 PERMIT# IPW Owner/Authorized Agent Signature Date (Revised 4/21/2022)