404 14TH ST BASE FILE 2024-12-09

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: Approximately 400 feet east of 404 14th Street SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) Early Public Works permit application;related to PW2206-007 IF APPLICABLE: ❑FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB M 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 STORMWATER DISCHARGES TO: ❑DRIVEWAY APRON I 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 I FILL/EXCAVATE 0/0/3350/1150 Cy ❑MR2 Only ❑MR1-5 ❑✓ MR1-9 OO CUT/BORE IN PAVEMENT(PARALLEL) 175 LF QUANTITY OF PROPOSED HARD SURFACES: ❑✓ CUT/BORE IN PAVEMENT(NON-PARALLEL) 20 LF Proposed Roof Area:0 SF ❑POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape:11,185 SF ADDITIONAL DESCRIPTION AS NEEDED): Total New+Replaced:11,185 SF The work includes site preparation, demolition, excavation, PVD install and placement of fill material for preload purposes. These elements of work and the quantities reflected above are in preparation for the remainder of work that is covered under PW2206-007. CONTACT INFORMATION OWNER/APPLICANT NAME: Port of Everet OWNER I APP. MAILING ADDRESS: STREET 1205 Craftsman Way, Suite 200 ciTv Everett STATE WA Z,P 98201 OWNER/APP.PHONE: 425-259-31 64 1OWNER I APP. EMAIL: *Required for Work in Public Right-of-Way CONTRACTOR NAME: Glacier Environmental Services CONTRACTOR ADDRESS: STREET 3415 121 st St. SW CITY Lynnwood STATE WA 71P 98087 CONTRACTOR PHONE: 425-355-2826 CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): GLACIESI 08C7 EVERETT BUSINESS LICENSE#(REQUIRED): 26280 PRIMARY CONTACT: Q OWNER /APPLICANT ❑CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: 425-508-6627 Brandon Whitaker CONTACT EMAIL: bwhitaker@portofeverett.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/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 PERMIT# t �7tLZL>lU ,y �rg of 9/12/22 PW Owner/Authorized Agent Signature Date (Revised 1172019)