2717 FEDERAL AVE 2024-12-02 - Laserfiche WebLink

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:2717-2731 Federal Avenue, Everett, WA SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY RCOMMERCIAL ❑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#: 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) 100 LF Proposed Roof Area: SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: SF ADDITIONAL DESCRIPTION (AS NEEDED): Total New+Replaced: SF Advance two geotechnical borings to 50-feet below ground surface within the City of Everett grass right-of-way.The Umings will be backfilled with benturilte arid finised to match the Surrounding Condition at giade lininedlatelly aftel CONTACT INFORMATION OWNER/APPLICANT NAME:Bobby Thompson OWNER/APP. MAILING ADDRESS: ST1EET720 Third Avenue Suite 1500 cITY Seattle STATE WA ZIP 98104 OWNER/APP. PHONE:(206) 510-5855 1OWNER/APP. EMAIL:robert.thompSOr1@Stantec.com `Required for Work in Public Right-of-Way CONTRACTOR NAME: Bobby Thompson CONTRACTOR ADDRESS: ST1EET720 Third Avenue Suite 1500 CITY Seattle STATE WA zlP 98104 CONTRACTOR PHONE:(206) 510-5855 1CONTRACTOR EMAIL:robert.thompSOn@Stantec.com CONTRACTOR LICENSE#(REQUIRED):602 529 295 EVERETT BUSINESS LICENSE#(REQUIRED):ATTACHED PRIMARY CONTACT: @ OWNER /APPLICANT ❑ CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: Bobby Thompson CONTACT PHONE:(206)510-5855 [� I CONTACT EMAIL:robert.thompson@stantec.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. 1 am the owner,or l 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 �r 03/06/23 PERMIT# Owner/Authorized Agent Signature Date (Revised 412112022)