2515 RAINIER AVE 2024-03-29 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF E.VERETT PERMIT SERVICES E V E R E T T 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov https://everettwa.gov/permits PROJECT 317E INFORMATION PROJECT ADDRESS: , SITE WORK FOR PROJECT TYPE: FR-DETACHE OWNHOUS UPLE DU ULTI-FAMIL OMMERCIA DUSTRIAL IF APPLICABLE: AND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) IF APPLICABLE: DRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB#: JOB# DESCRIPTION`IF SITE'FORK/ RIGI'IT-OF-WAIL'it OK FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: ENCE IN ROW FT IN HEIGHT STORMWA TER DISCHARGES TO: )RIVEWAY APRON/CURB CUT FT WIDE :onibined Sewer SPHALT I CONCRETE PAVING SF 3eparated Storm Sewer RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF Nrect Discharge to Snohomish River or Puget Bound STAINING WALL I ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: LEARiNG/GRADING/ ILI EXCAVATE s CY R2 Only R1-5 ARI-9 UTIBORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: UT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: SF OLE WORK/AERIAL I OVERLASH LF Proposed Hardscape: , SF ADDITIONAL DESCRIPTION AS NEEDED): Total New+Replaced: SF CONTACT TACT IPi1=®RMATION77 OWNER/APPLICANT NAME: OWNER/APP. MAILING ADDRESS: STREET CITY 5.., STATE ttJ... ZIP OWNER/APP.PHONE. ', .. , .:.SCJ aC.'rfc7 OWNER/APP. EMAIL: ti) ... 9../ (� Cf 6A 'Required for Work In Public Right-of-Way CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CMSTATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: WNER /APPLICANT ONTRACTOR THER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: ACKNQWLEDGEMENT: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 permlt only authorizes approved work and no deviations therefrom. Deviations must first he authorized In writing from the Building Official before being authorized under any circumstance.l am the owner,or t am authorized by the otyner 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. r City of Everett Official Use Only 1 1 i PERMIT# f PW 2I 0 Owner/Authorized Agent Signature Date (Revised 1/72019)