4502 HOYT AVE 2024-03-29 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE INFORMATION (PROJECT ADDRESS:4502 HOYT AVE SITE WORK FOR PROJECT TYPE: ❑✓ SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI -FAMILY ❑COMMERCIAL ❑INDUSTRIAL IIF APPLICABLE: ❑ LAND USE PROJECT # (SEPA, PRE-APP, SS, ETC.) 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: 0 FENCE IN ROW 6 FT IN HEIGHT ❑ DRIVEWAY APRON / CURB CUT FT WIDE ❑ ASPHALT / CONCRETE PAVING SF ❑✓ RETAINING WALL / ROCKERY IN RIGHT-OF-WAY 68 LF ❑ RETAINING WALL / ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT ❑ CLEARING / GRADING / FILL / EXCAVATE CY ❑ CUT/BORE IN PAVEMENT (PARALLEL) LF ❑ CUT/BORE IN PAVEMENT (NON -PARALLEL) LF ❑ POLE WORK / AERIAL / OVERLASH LF ADDITIONAL DESCRIPTION (AS NEEDED): DRAINAGE MITIGATION QUESTIONS: STORMWA TER DISCHARGES TO: ❑ Combined Sewer ❑ Separated Storm Sewer 171 Direct Discharge to Snohomish River or Puget Sound TRIGGERED REQUIREMENTS: ❑ MR2 Only ❑ MR1-5 ❑ MR1-9 QUANTITY OF PROPOSED HARD SURFACES: Proposed Roof Area SF Proposed Hardscape: SF I Total New + Replaced: SF SEE DRAWING CONTACT INFORMATION OWNER/APPLICANT NAME:TYLER ROURKE OWNER / APP. MAILING ADDRESS: 1111IT4502 HOYT AVE CITY EVERETT STATE WA Z,p 98203 OWNER / APP. PHONE: 425-971 -3572 IOWNER / APP. EMAIL:tylerrOUrket@hOtmalI.com `Required for Work in Public Right -of -Way CONTRACTOR NAME: Same as above 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: Tyler Rourke CONTACT PHONE: 425-971 -3572 CONTACT EMAIL:tylerrourke@hotmail.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 wr irr§7rothe Building Official before being authorized under any circumstance. I am the owner, or I am authorized by the owner of this property to perform thew orwtl h application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT # 7) -�O -202 t Ipw Owner/ uth rized Agent Signature Date (Revised 1172019)