3617 UPLAND AVE 2025-03-28 - 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:3617 Upland Ave. Everett, WA 98204 SITE WORK FOR PROJECT TYPE: BSFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: 8 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.)REV1 21-063 IF APPLICABLE: ❑FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB#: JOB#: DESCRIPTION OF SITE WORK / RIGHT-OF-WAY WORK FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: ❑ FENCE IN ROW 0 FT IN HEIGHT STORMWA TER DISCHARGES TO: 8 DRIVEWAY APRON/CURB CUT 27 FT WIDE ❑ Combined Sewer 8 ASPHALT/CONCRETE PAVING 3205 SF 8 Separated Storm Sewer 8 RETAINING WALL/ROCKERY IN RIGHT-OF-WAY 25.5 LF ❑ Direct Discharge to Snohomish River or Puget Sound ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT 0 FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: 8 CLEARING/GRADING/FILL/EXCAVATE 75 CY ❑ MR2 Only 17 MR1-5 ❑ MR1-9 8 CUT/BORE IN PAVEMENT(PARALLEL) 390 LF QUANTITY OF PROPOSED HARD SURFACES: 8 CUT/BORE IN PAVEMENT(NON-PARALLEL) 20 LF Proposed Roof Area:0 SF ❑ POLE WORK/AERIAL/OVERLASH 0 LF Proposed Hardscape:3205 SF ADDITIONAL DESCRIPTION (AS NEEDED): ITotal New+Replaced:3205 SF Cut: 5 CY, Fill: 70 CY CONTACT INFORMATION OWNER/APPLICANT NAME:Justin & Rhealene Tucker OWNER/APP. MAILING ADDRESS: STREET 3617 Upland Ave. CITY Everett STATE WA ZIP 98203 OWNER/APP. PHONE:425-239-6003 OWNER I APP. EMAIL:ltuck9@yahoo.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: III OWNER /APPLICANT ❑ CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE:425-239-6003 Justin & Rhealene Tucker CONTACT EMAIL:jtuck9@yahoo.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. 1 am the owner,or l 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# 7/24/2023 Ipw Owner/Authorized Agent Signature Date (Revised 412112022)