2706 TAYLOR DR 2024-10-14 - Laserfiche WebLink

® PUBLIC WORKS PERMIT APPLICATION `n CITY OF EVERETT PERMIT SERVICES EV E R E T T SUBMITTAL INSTRUCTIONS:Email application&submittal documents to PermitSeivices@everethva.gov or drop off at 3200 Cedar Street 2nd Floor Drop Box WASHINGTON CONTACT INFORMATION:(P)425-257-8890 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits PROJECT SITE 1NFORMATION PROJECT ADDRESS: 'Z' C7 E, A fVP_ 7j y.l_ E_VFIZE11, 4 JF7. - C7b2d_�; SITE WORK FOR PROJECT TYPE: SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU []MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) IF APPLICABLE: ❑FRANC HISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME S JOB M JOB M tlESCRIPTION OF SITE WURK 1 1G' HT-OFMAY WORK FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: ❑ FENCE IN ROW FT IN HEIGHT STORMWATER DISCHARGES TO: DRIVEWAY APRON/CURB CUT �C(� x (`_FT WI [3 Combined Sewer e M ASPHALT/CONCRETE PAVING '`I SF �� E3 Separated Storm Sewer ❑RETAINING WALL I ROCKERY IN RIGHT-OF-WAY LF E3 Direct Discharge to Snohomish River or Puget Sound ❑ RETAINING WALL I ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: ❑ CLEARING I GRADING I FILL I EXCAVATE CY [3MR2 Only [3MR1.5 [3MR1-9 ❑CUTIBORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: SF ❑ POLE WORK I AERIAL I OVERLASH LF Proposed Hardscape: SF ADDITIONAL DESCRIPTION AS NEEDED): Total New+Replaced: SF 2,4Pto,VC' qd v�i.11a C' feflS'/an[ � 17r�R�i•(! fl4c� ��cLkcr� CONTACT INFORMAiNON OWNER I APPLICANT NAME: ? c�Z lz1-4 OWNER I APP. MAILING ADDRESS: STREET CITY 1✓ t! Id1l, STATE G� '< BP OWNER]APP. PHONE:644� ,�0 - 7�_7'IB5c7 OWNER/APP. EMAIL: 'Requlred for Work in Public Right-of-Way CONTRACTOR NAME: H CONTRACTOR ADDRESS: STREET /-yref' P S. �(J 9W49 cay V 1-tQC' L I STATE t')to zip 99 47 b CONTRACTOR PHONE: 1CONTRACTOR EMAIL: K' t>'7 % `'14 CONTRACTOR LICENSE#(REQUIRED): -Ou"'/VT 17 C 09- L_.3 £VERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑ OWNER /APPLICANT ❑CONTRACTOR IS OTHER(Architect, Engineer, Etc.) r/ d CONTACT NAME: CONTACT PHONE: !� J �j.- �, 7'7 P/4" 7 - /4" Orve.a CONTACT EMAIL: ✓� � �?,4��, �E2 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 f comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Mfl_ 001 OwnerlAut rued Agent Signa a Date (Revised 4/21/2022)