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PUBLIC WORKS PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETTSUBMITTAL INSTRUCTIONS:Email application&submittal documents to PermitServices@everettwa.gov or drop off at 3200 Cedar Street 2nd Floor Drop Box <br /> WASHINGTON CONTACT INFORMATION:(P)425-257-8810 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:100th St SW&18th Ave W <br /> SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED @TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL <br /> IF APPLICABLE: O LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.)REV1122-025,REV1122-028,REV1122029 <br /> IF APPLICABLE: ❑FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# <br /> UTILITY COMPANY'S NAME&JOB#: JOB#: <br /> DESCRIPTION OF SITE WORK / RIGHT-OF-WAY WORK <br /> FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: <br /> ❑ FENCE IN ROW FT IN HEIGHT STORMWA TER DISCHARGES TO: <br /> @ DRIVEWAY APRON/CURB CUT 235 FT WIDE ❑ Combined Sewer <br /> @ ASPHALT/CONCRETE PAVING 20,543 SF @ Separated Storm Sewer <br /> ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ Direct Discharge to Snohomish River or Puget Sound <br /> @ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT 3,364 SF FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: <br /> @ CLEARING/GRADING/FILL/EXCAVATE 5,860 CY ❑ MR2 Only ❑ MR1-5 W MR1-9 <br /> @ CUT/BORE IN PAVEMENT(PARALLEL) 424 LF QUANTITY OF PROPOSED HARD SURFACES: <br /> @ CUT/BORE IN PAVEMENT(NON-PARALLEL) 205 LF Proposed Roof Area: 19,605 SF <br /> ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape:20,543 SF <br /> ADDITIONAL DESCRIPTION (AS NEEDED): Total New+Replaced:40,148 SF <br /> This project proposes clearing and grading of 1.32 acres in support of a 23 single-family, attached town home <br /> project along with the associated utilities and road In ras ruc ure. n-site rockeries and a propose <br /> detemtlamiwetpaal vatilt will be tised to stabilize the proposed grading. Please note that the retaiming wall and <br /> numbers are dup1mcated from the Farly Clear and Grade application and should not be counted <br /> CONTACT INFORMATION <br /> OWNER/APPLICANT NAME:Pacific Ridge Homes/Jeff Wegener <br /> OWNER/APP. MAILING ADDRESS: STREET 17921 Bothell-Everett Hwy,Suite 100 <br /> CITY Bothell STATE WA ZIP 98012 <br /> OWNER/APP. PHONE:(425)219-2087 OWNER I APP. EMAIL:jlwegener@pacificridgehomes.com <br /> `Required for Work in Public Right-of-Way <br /> CONTRACTOR NAME: Pacific Ridge-DRH, LLC/Tom Allen <br /> CONTRACTOR ADDRESS: STREET 17921 Bothell-Everett Hwy,Suite 100 <br /> CITY Bothell STATE WA zIP 98012 <br /> CONTRACTOR PHONE:(425)939-1169 CONTRACTOR EMAIL:tallenl @pacificridgehomes.com <br /> CONTRACTOR LICENSE#(REQUIRED):603487821 EVERETT BUSINESS LICENSE#(REQUIRED): 056403 <br /> PRIMARY CONTACT: ❑ OWNER /APPLICANT ❑ CONTRACTOR @ OTHER(Architect, Engineer, Etc.) Civil Engineer/CPH Consultants <br /> CONTACT NAME: CONTACT PHONE:(425)285-2391 <br /> Matthew Hough CONTACT EMAIL:matt@cphconsultants.com <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must <br /> 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 <br /> authorized in writing from the Building Official before being authorized under any circumstance. 1 am the owner,or 1 am authorized by the owner of this property to <br /> perform the work for which application is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> 11 . 18.22 PERMIT# <br /> ;4_/� �� IPW <br /> Ow r/Authoriz Agent Signature Date (Revised 412112022) <br />