4823 EVERGREEN WAY BASE FILE 2024-11-08

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: Northside Former Dry Cleaner-Claremont Village Shopping Center 4821 Evergreen Way Everett,Washington 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: ❑FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB#: JOB M 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: SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: SF ADDITIONAL DESCRIPTION (AS NEEDED): ITotal New+Replaced: SF Installation of three(3)temporary environmental soil borings within the landscaping between the north end of Claremont Village Shopping Center and Wilmington Ave.Soil borings will be backfilled after completion. Estimated project time is one day.See figure attached for boring locations. Private and public utility locates will be completed prior to work.No road/sidewalk closures or detours are anticipated. Off CONTACT INFORMATION OWNER/APPLICANT NAME: Apex Companies LLC Attn.Anders Utter OWNER/APP. MAILING ADDRESS: STREET 801 NW 42nd St suite 204 CITY Seattle STATE WA Zip 98107 OWNER/APP. PHONE: 425-757-1452 OWNER/APP. EMAIL:anders.utter@apexcos.com *Required for Work in Public Right-of-Way CONTRACTOR NAME: Cascade Drilling,LP CONTRACTOR ADDRESS: STREET 19404 Woodinville-Snohomish Rd CITY Woodinville STATE WA zip 98072-8454 CONTRACTOR PHONE: 425-466-8588 CONTRACTOR EMAIL: kgoble@cascade-env.com CONTRACTOR LICENSE#(REQUIRED): 6029485560010001 EVERETT BUSINESS LICENSE#(REQUIRED): 47889 PRIMARY CONTACT: [N OWNER /APPLICANT ❑ CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: Anders Utter CONTACT PHONE: 425-757-1452 CONTACT EMAIL: anders.utter@apexcos.com ACKNOWLEDGEMENT:1 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 PERMIT# 12/1/2022 Ipw Owner/Authorized Agent Signature Date (Revised 412112022)