4626 DOVER ST 2024-12-02 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EV E R E T T SUBMITTAL INSTRUCTIONS:Email application 8 submittal documents to PermilServices@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:4626 Dover Street, Everett,WA 98203 SITE WORK FOR PROJECT TYPE: INSFR-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: B FENCE IN ROW 3.5'-4' 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 I ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: ❑CLEARING/GRADING I FILL I EXCAVATE CY ❑MR2 Only ❑MRt-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 I AERIAL/OVERLASH LF Proposed Hardscape: SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: SF Install 3.5'- 4'wooden picket fence around perimeter of front yard see attached diagram). Because the ROW adjoins the property line, a portion of the fence is proposed to be constructed on ROW. The affected ROW area is lained by the. Owner (e.g. niowed, landscaped, e1c.) and Will conlinue to be rnalfitaftied after fence install. CONTACT INFORMATION OWNER I APPLICANT NAME: Zachary Conley OWNER/APP. MAILING ADDRESS: STREET 4626 Dover Street CITY Everett STATE WA ZIP 98203 OWNER/APP.PHONE: 502-492-8160 OWNER/APP.EMAIL: zacharyaconley@gmail.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: ®OWNER /APPLICANT ❑CONTRACTOR ❑OTHER(Architect,Engineer,Etc.) CONTACT NAME: Zachary Conley CONTACT PHONE: 502-492-8160 CONTACT EMAIL: zacharyaconley@gmail.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 1 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 10/06/2022 PER IT PW ID O11 Own7!!YcI Agent Sf lure Date (Revised 4/21/2022)