2721 HOYT AVE 2024-12-09 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL INSTRUCTIONS:Email application&submittal documents to PerrnilServices@everetlwa.guv or drop off at 3200 Cedar Street 2nd Fluor Drop Box WASHINGTON CONTACT INFORMATION:(P)425-257-88101(E)PermilServices@everettwa.gov I(W)everettwa.govfpermits PROJECT SITE INFORMATION PROJECT ADDRESS:2721 Hoyt Ave., Everett, WA 98201 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY BCOMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.)NIA IF APPLICABLE: ❑FRANCHISE/UTILITY COMPANY, ANNUAL BLANKET PERMIT#N/A UTILITY COMPANY'S NAME&JOB#: JOB#: DESCRIPTION OF SITE 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 I CONCRETE PAVING SF ❑Separated Storm Sewer ❑ RETAINING WALL I 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/FILL/EXCAVATE CY 13 MR2 Only 0 MR1-5 13 MR11-9 ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: 8 CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area: SF ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: SF ADDITIONAL DESCRIPTION AS NEEDED): ITotal New+Replaced: SF Removing three 2000-gallon out of service underground gasoline storage tanks. Tanks are located under concrete pad. Site is now location of a parking lot. No buildings in vicinity of tanks. CONTACT INFORMATION OWNER/APPLICANT NAME:JB Everett, LLC OWNER I APP. MAILING ADDRESS: sT1eeT15203 SE 80th St. Cnv New Castle STATE WA ;IP 98059 OWNER I APP. PHONE:206-654-7045 X105 1OWNER I APP. EMAJL:johnbhend@adaptengr.com 'Required for Work in Public Right-of-Way CONTRACTOR NAME: Northern Environmental LLC CONTRACTOR ADDRESS: SIEET2661 N. Pearl St., #145 (:,TY Tacoma STATE WA r,,98407 CONTRACTOR PHONE:253-536-6961 1CONTRACTOR EMAIL:ashley@northernenv.com CONTRACTOR LICENSE#(REQUIRED):NORTHEL855B9 IEVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: ❑OWNER /APPLICANT N CONTRACTOR ❑OTHER (Architect, Engineer, Etc.) ONT CONTACT NAME:Ashley Ruhl I I CACT PHONE:253-314-3360 CONTACT EMAIL:ashley@northernenv.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 authonzes approved work and no deviations therefrom.Deviations must first be authorize 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 t e work for which application is made,and I comply wrlh the Stale Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 8-9-22 PR,MIT# OwnerlAuthorized Agent Signature Date (Revised 412112022)