2900 TERMINAL AVE 2024-08-05 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION 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 WASHINGTON CONTACT INFORMATION:(P)425-257-8810 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2720 W Marine View Drive (approximate)-to be located on existing traffic signal/light poles in the ROW SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU []MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: O 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: DRAINAGE MITIGATION QUESTIONS: ❑ FENCE IN ROW FT IN HEIGHT STORMWA TER DISCHARGES TO: ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑ Combined Sewer ❑ASPHALT/CONCRETE PAVING SF ❑ Separated Storm Sewer ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ Direct Discharge to Snohomish River or Puget Sound ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: ❑ CLEARING/GRADING/FILL/EXCAVATE CY ❑ MR2 Only ❑ MR1-5 ❑ MR1-9 ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area:n/a SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: n/a SF ADDITIONAL DESCRIPTION (AS NEEDED): ITotal New+Replaced:n/a SF Install two 2 double face ole mounted Marine Terminal ID signs. Sign to be located in ROW on the corner of Terminal Ave and W Marine View Drive. CONTACT INFORMATION OWNER/APPLICANT NAME:Port of Everett OWNER/APP. MAILING ADDRESS: STREET 1205 Craftsman Way, Suite 200 CITY Everett STATE WA Z,P 98201 OWNER/APP. PHONE: (425) 388-0616 OWNER I APP. EMAIL: garrettj@portofeverett.com `Required for Work in Public Right-of-Way CONTRACTOR NAME: TBD CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: R OWNER /APPLICANT ❑ CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: (425)388-0616 Garrett Jensen CONTACT EMAIL: garrettj@portofeverett.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. 1 am the owner,or l 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. Q City of Everett Official Use Only �� 12/8/2022 PERMIT# PW Owner/Authorized Agent gignature Date (Revised 4/21/2022)