4630 VIEW DR 2024-11-08 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:Email application&submittal documents to PermltServlees@everettwa.gov or drop off at 3200 Cedar Street 2nd Floor Drop Box WASHINGTON CONTACT INFORMATION;(P)425-257-8810((E)PermitServices@everettwa.gov I(W)everettwa.gov/permits ,'h Y y j x 'RROJECT>.$ TE INFORNlAfi1QN*y r �� ° , �v PROJECT ADDRESS: © �s r(J f I V �►' ( / ( 1 �.� SITE WORK FOR PROJECT TYPE: MSFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU []MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA,PRE-APP, SS, ETC.) IF APPLICABLE: ❑FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB#; JOB M. N� � J- :` Q�� iR�l /E1111Q1�'' �I;i'EfVR RIGHT�Vf! �?I :�■� ��1 z x s S,t FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: ❑.FENCE IN ROW r FT IN HEIGHT STORMWA TER DISCHARGES TO: ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑Combined Sewer ❑ASPHALT/CONCRETE PAVING SF ❑Separated Storm Sewer ❑ RETAINING WALL I ROCKERY IN RIGHT-OF-WAY LF ❑Direct Discharge to Snohomish River or Puget Sound ❑RETAINING WALL/ROCKERY OVER 4FT W HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: ❑ CLEARING/GRADING I 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: Sr ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: SF ADDITIONAL DESCRIPTION(AS NEEDED): ITotal New+Replaced: SF OWNER/APPLICANT NAME: l e-111t1deu i l e r qlw Yt OWNER/APP. MAILING ADDRESS: STREET 44,.3o �to Dr CITY r'z?r4 ft STATE �`' ZIP OWNER 1 APP.PHONE: OWNER 1 APP. EMAIL: "Required for Work In Public Right-of-Way CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE; CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED) PRIMARY CONTACT: DOWNER /APPLICANT ❑CONTRACTOR ❑ OTHER(Architect,Engineer, Etc.) CONTACT NAME: CONTACT PHONE: / a-!;o_ — 3 4 2— ?/ �--? fVAtvA Ae_helrrn ail CONTACT EMAIL: /Gtr,'10e,4 2c. O ,h4Aao • co"- 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 PERM T PVV 1 n I Owner/Authorized Agent Signature Date (Revised 412112022)