1517 132ND ST SE 2024-12-09 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EV E R E T T SUBMITTAL INSTRUCTIONS:Email application 8 submfttal documents to PermitServices@everettwa.gov or drop off at 3200 Cedar Street 2nd Floor Drop Box WASHINGTON CONTACT INFORMATION:(P)425-257-8810 l(E)PermiIservices@everettwa.gov I(W)everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:1517 132nd St 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 8r 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 STORMWATER DISCHARGES TO: ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑ Combined Sewer ®ASPHALT/CONCRETE PAVING 6,740 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: R CLEARING/GRADING/FILL/EXCAVATE 97 CY ❑ MR2 Only 0 MR1-5 ❑ M_R1-9 ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area:2,734 SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape:2,086 SF ADDITIONAL DESCRIPTION (AS NEEDED): Total New+Replaced:4,820 SF *Quantities include the future Chase Bank building and sidewalk next to premises, which will be constructed under a separate permit. CONTACT INFORMATION OWNER/APPLICANT NAME:TA 132nd ST, LLC OWNER/APP. MAILING ADDRESS: S1EET2600 Dallas Parkway, Suite 370 CITY Frisco STATE TX ZIP 75034 OWNER I APP. PHONE:(469) 458-0485 x4 OWNER I APP.EMAIL:abaker@tekindevelopment.com "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: 8 OWNER /APPLICANT ❑ CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE:(469)458-0485 x4 Alicia Baker CONTACT EMAIL:abaker@tekindevelopment.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. I am the owner,or I am authorized by the owner of this property to perform the work for which applica ' n is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only IPERMIT# PW Ow Authorized Agent ignature D to (Revised 412112022)