4819 ALGER AVE 2024-07-22 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL INS.�RUCTIONS:Email application&submittal documents to PermftServices@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 JW Z A k kdw I TT '� O�OkM g, PROJECT ADDRESS: 4e I QI_T Ar4ev Av&- . SvCyet V,)P— Ole;20 S SITE WORK FOR PROJECT TYPE- ' SFR-DETACHED 0TOWNHOUSE DDUPLEX EIADU []MULTI-FAMILY OCOMMERCIAL [INDUSTRIAL IF APPLICABLE: OLAND USE PROJECT#(SEPA, PRE-APP,SS;ETC.) IF APPLICABLE: ❑FRANCHISE/UTI-ITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB M -JOB M g� .., ; ,t. rwbkk, ib".F ITE 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 13 Combined Sewer ASPHALT/CONCRETE PAVINGSF E3 Separated Storm Sewer ❑RETAINING WALL I ROCKERY IN TIGHT-OF-WAYLF 13 Direct Discharge. to Snohomish River or Puget Sound DRETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: 0 CLEARING I GRADING I FILL/EIVATE CY 13 MR2 Only [3 MR11-5 [3 MR1-9 ❑CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: C� 6 SF ❑POLE WORK I AERIAL I OVERLASH LF Proposed Hardscape: SF. ADDITIONAL DESCRIPTION.(AS NEEDED): Total New+Replaced: -7 SF 4t, V& 01- d ^>.' o 4" Pvc- P-00fed dv a 1,Y) SU ri WX k0bitIMAt 7.pgltv 77.g7 OWNER I APPLICANT NAME: OWNER I APP. MAILING ADDRESS: STREET' 4g(9 -f crry STATE ZIP U'03 OWNER/APP.PHONE: 'k-771,� OWNER/APP.EMAIL:, C,L, I/A r C41 S�-, A) eO rY7. ----------- *Required for Work in Public Right-of:Way CONTRACTOR NAME:- JV AL, CONTRACTOR ADDRESS: STREET CITY STATE. . ZIP CONTRACTOR PHONE: 1CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED).: EVERETT BUSINESS LICENSE#(REQUIRED):- PRIMARY CONTACT: OWNER I APPLICANT 11 CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: D_C J�j YD C(A 10,y- CONTACT EMAIL: Ct,e0ci Y&qgax_(0 WSIV.&OM ACKNOWLEDGEMENT.,I have reviewed th' 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 w. The granting of 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.,lam the owner,or I am authorized by the owner of this property to perform the work.for which application is mace,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT IPW /6w&:rr'/A&fior1fed Agent Signature Date (Revised 412112022)