1108 RUCKER 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: 1108 Rucker Avenue Everett WA 98201 SITE WORK FOR PROJECT TYPE: ASFR-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 M 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 STORMWATER 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): Total New+Replaced: SF Replace 2 trees in landscape section, next to sidewalk with same species, exact same location. Tree: Prunus cerasifera 'KI-duter'S VeSuviUS' Cuornun Ilarne. Krauter's Vesuvius Flowering Pluin One came down in , They will do the locate for sure and traffic plan if needed. I will purchase trees and an arborist will plant. CONTACT INFORMATION OWNER/APPLICANT NAME: Katherine Benusa OWNER/APP. MAILING ADDRESS: sTREET1108 Rucker Avenue ,,,,, Everett STATE WA ziP 9$201 OWNER/APP.PHONE:425-330-2620 OWNER 1 APP. EMAIL:randyreena@aol.com `Required for Work in Public Right-of-Way CONTRACTOR NAME: Self- Katherine Benusa CONTRACTOR ADDRESS: STREETI 108 Rucker Ave Everett STATE WA Z,P 98201 CONTRACTOR PHONE:425-330-2620 CONTRACTOR EMAIL:Randyreena@aol.COm CONTRACTOR LICENSE#(REQUIRED):NA EVERETT BUSINESS LICENSE#(REQUIRED): NA PRIMARY CONTACT: ®OWNER /APPLICANT ❑ CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME:Katherine Benusa CONTACT PHONE:425-330-2620 CONTACT EMAIL:randyreena@aol.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 application is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 02/06/2023 PERMIT# Ow erlAuthorized Agent Signature Date (Revised 412112022)