905 80TH ST SW FORMOST FUJI 2024-12-03

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: 905 80th St SW, Everett, WA 98203 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI -FAMILY RCOMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT # (SEPA, PRE-APP, SS, ETC.) NIA IF APPLICABLE: ❑ FRANCHISE/UTILITY COMPANY, ANNUAL BLANKET PERMIT # N/A UTILITY COMPANY'S NAME & JOB #: N/A JOB #: N/A DESCRIPTION OF SITE WORK / RIGHT-OF-WAY WORK FILL IN ALL QUANTITIES OF WORK BELOW, AS APPLICABLE: ❑ FENCE IN ROW N/A FT IN HEIGHT ❑ DRIVEWAY APRON / CURB CUT FT WIDE @ ASPHALT / CONCRETE PAVING 6,178 SF ❑ RETAINING WALL / ROCKERY IN RIGHT-OF-WAY N/A LF ❑ RETAINING WALL / ROCKERY OVER 4FT IN HEIGHT N/A FT TOTAL HEIGHT ❑ CLEARING / GRADING / FILL / EXCAVATE 150 IMPORT Cy 8 CUT/BORE IN PAVEMENT (PARALLEL) 465 LF 8 CUT/BORE IN PAVEMENT (NON -PARALLEL) 68 LF ❑ POLE WORK / AERIAL / OVERLASH N/A LF ADDITIONAL DESCRIPTION (AS NEEDED): DRAINAGE MITIGATION QUESTIONS: STORMWA TER DISCHARGES TO: ❑ Combined Sewer 8 Separated Storm Sewer ❑ Direct Discharge to Snohomish River or Puget Sound TRIGGERED REQUIREMENTS: ❑ MR2 Only 91MR1-5 ❑ MR1-9 QUANTITY OF PROPOSED HARD SURFACES: Proposed Roof Area: 11,057 SF Proposed Hardscape: 6,330 SF Total New+ Replaced: 17,387 SF Proposed pro' nsi f construction of a 11,057 SF building expansion with associated accessible parking relocation, sidewalk improvements, and utility relocations/improvements. Storm water runoff will be collected and conveyed to existing on -site storm conveyance CONTACT INFORMATION OWNER / APPLICANT NAME: Dennis Gunnell, Formost Fuji Corp OWNER / APP. MAILING ADDRESS: STREET 19211-144th Avenue, N.E. CITY Woodinville STATE WA ZIP 98072 OWNER / APP. PHONE: (425) 483-9090 OWNER / APP. EMAIL: DennisG@FormostFuji.com `Required for Work in Public Right -of -Way CONTRACTOR NAME: No work in R/W CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE #(REQUIRED): I EVERETT BUSINESS LICENSE #(REQUIRED): PRIMARY CONTACT: @ OWNER / APPLICANT ❑ CONTRACTOR @ OTHER (Architect, Engineer, Etc.) Engineer CONTACT NAME: WIII Semple CONTACT PHONE: (425) 656-7462 CONTACT EMAIL: wesemple@barghausen.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 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. WELL sew-PLe 4/5/2023 Owner/Authorized Agent Signature Date City of Everett Official Use Only PERMIT # PW (Revised 412112022)