1001 14TH ST 2024-03-01 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION 0 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 WA S H I N G T O N CONTACT INFORMATION: (P) 425-257-8810 l (E) PermitServices@everettwa.gov I (W) everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:1001 14th St, Everett WA SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI -FAMILY @COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: @ LAND USE PROJECT # (SEPA, PRE-APP, SS, ETC.) SMA #16-011 IF APPLICABLE: ❑ FRANCHISE/UTILITY COMPANY, ANNUAL BLANKET PERMIT # UTILITY COMPANY'S NAME & JOB #: JOB #: 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 / CURB CUT FT WIDE @ ASPHALT / CONCRETE PAVING 13465 SF @ RETAINING WALL / ROCKERY IN RIGHT-OF-WAY 140 LF @ RETAINING WALL / ROCKERY OVER 4FT IN HEIGHT 8 FT TOTAL HEIGHT @ CLEARING / GRADING / FILL / EXCAVATE 44240 CY ❑ CUT/BORE IN PAVEMENT (PARALLEL) LF ❑ CUT/BORE IN PAVEMENT (NON -PARALLEL) LF @ POLE WORK / AERIAL / OVERLASH 671 LF ADDITIONAL DESCRIPTION (AS NEEDED): DRAINAGE MITIGATION QUESTIONS: STORMWA TER DISCHARGES TO: ❑ Combined Sewer ❑ Separated Storm Sewer @ Direct Discharge to Snohomish River or Puget Sound TRIGGERED REQUIREMENTS: ❑ MR2 Only ❑ MR1-5 0 MR1-9 QUANTITY OF PROPOSED HARD SURFACES: Proposed Roof Area: 0 SF Proposed Hardscape: 13465 SF Total New + Replaced: 13465 SF Work will be conducted within roads and parking lots owned by the Port no City ROW work see drawings. See Storm submittal for information on the stormwater treatment design and construction stormwater treatment (construction stormwater will be discharged to sewer after treatment, NPDES permit application pending). CONTACT INFORMATION OWNER / APPLICANT NAME: Port of Everett / Elise Gronewald OWNER / APP. MAILING ADDRESS: STREET PO Box 538 CITY Everett STATE WA zip 98206 OWNER / APP. PHONE: 425.388.0630 OWNER / APP. EMAIL: eliseg@portofeverett.com *Required for Work in Public Right -of -Way CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE #(REQUIRED): EVERETT BUSINESS LICENSE #(REQUIRED): PRIMARY CONTACT: @ OWNER / APPLICANT ❑ CONTRACTOR ❑ OTHER (Architect, Engineer, Etc.) CONTACT NAME: Elise Gronewald CONTACT PHONE: 425.388.0630 CONTACT EMAIL.. eliseg@portofeverett.com ACKNOWLEDGEMENT., l 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. l am the owner, or I am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. Elise Gronewald 8/11/2022 Owner/Authorized Agent Signature Date City of Everett Official Use Only PERMIT # PW (Revised 412112022)