2030 MELVIN AVE 2024-03-29 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P) 425-257-8810 l FAX 425-257-8857 l (E) everetteps@everettwa.gov l https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2030 Melvin Ave, Everett, WA 98203 SITE WORK FOR PROJECT TYPE: ❑✓ SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX []ADU ❑MULTI -FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT # (SERA, 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: L7 FENCE IN ROW 6 FT IN HEIGHT ❑ DRIVEWAY APRON / CURB CUT FT WIDE ❑ ASPHALT / CONCRETE PAVING SF ❑ RETAINING WALL / ROCKERY IN RIGHT-OF-WAY LF ❑ RETAINING WALL I 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: STORMWATER DISCHARGES TO: [I Combined Sewer ❑ Separated Storm Sewer ❑ Direct Discharge to Snohomish River or Puget Sound TRIGGERED REQUIREMENTS: D MR2 Only ] MR1-5 ❑ MR1-9 QUANTITY OF PROPOSED HARD SURFACES: Proposed Roof Area: SF Proposed Hardscape:___ SF Total New + Replaced: SF Privacv fence located at the back of property, partially located in undeveloped alleyway. Roughiv 4 feef;into ROW. CONTACT INFORMATION OWNER / APPLICANT NAME: Melissa LaPier OWNER / APP. MAILING ADDRESS: STREET 2030 Melvin Ave CITY Everett STATE WA ZIP 98203 OWNER / APP. PHONE: 425-232.-8974 OWNER I APP. EMAIL: melissaekelly@live.com 'Required for Work in Public Right -of -Way CONTRACTOR NAME: N/A CONTRACTOR ADDRESS: STREET GnY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE #(REQUIRED): EVERETT BUSINESS LICENSE #(REQUIRED): PRIMARY CONTACT: O OWNER I APPLICANT ❑ CONTRACTOR ❑ OTHER (Architect, Engineer, Etc.) CONTACT NAME: (� Melissa Laf ier CONTACT PHONE:425-232-8974 CONTACT EMAIL: melissaekelly@live.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 PERMIT # (LIC-4_ ii ��p 10/21/2021 PLW Owner/Authorized Agent Signature Date (Revised 1172019)