1427 100TH ST SW 2025-03-03 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL INSTRUCTIONS L mail apO,:alion&submittal documents to PermitServicestaeverettwa.gov or drop offal 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:1427 100th St SW., Everett, WA 98021 SITE WORK FOR PROJECT TYPE. ❑SFR-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#: 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. B DRIVEWAY APRON/CURB CUT 42.9' and 102.3' FT WIDE ❑Combined Sewer @ ASPHALT/CONCRETE PAVING 1 252 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 Renovation of driveway's entrance including widening of curb cut and driveway entrance; installation Of two new security gates, al I lu new lanciscaping island. a Is dl lu s Mum requires the wide Ing Ot the rlveway an re oca Ing CONTACT INFORMATION OWNER/APPLICANT NAME:CPI Fairway Estates Owner, LLC c/o Carlyle Group OWNER/APP. MAILING ADDRESS: STREET 1001 Pennsylvania Ave. NW clTv Washington DC sT-,�E -F 20004 OWNER/APP. PHONE: OWNER/APP. EMAIL: 'Required for Work in Public Right-of-Way CONTRACTOR NAME: Rivers Edge Environmental Services CONTRACTOR ADDRESS: SrRE11 17115 SE 270th Pl. Suite#106 'IT, Covington �1ATE WA �,F 98042 CONTRACTOR PHONE:(425)584-7089 CONTRACTOR EMAIL:projects@rivers.city CONTRACTOR LICENSE#(REQUIRED):RIVERREE855DT EVERETT BUSINESS LICENSE#(REQUIRED)- 56781 PRIMARY CONTACT: ❑OWNER /APPLICANT ❑ CONTRACTOR @ OTHER(Architect. Engineer. Etc.) Architect CONTACT NAME: CONTACT PHONE:(206)819-1279 Lawrence Houston CONTACT EMAIL:lawrencehouston@comcast.net 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 ore permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in wnting from the Building Official before being authorized under any circumstance l 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 LaA11_*5/� City of Everett Official Use Only z�i7�Zvz 3 PW Owner/Authorized Agent Signature D rr, (Revised 412 112 0 2 2)