4504 BROADWAY 2025-03-24 - 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:Multiple locations in the vicinity of Broadway (Bundle 3A), City of Everett 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#: 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 STORMWA TER 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/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): ITotal New+Replaced: SF Geotechnical subsurface exploration program to support design and planning of Phase 2 Sound Transit Everett Link X en Ion & UIVIF- North project e0 eC nlca soil borings only, at Bundle 3A boring locations, planned O be 20 to 100 feet deep. CONTACT INFORMATION OWNER/APPLICANT NAME:Sound Transit/Reeve Geary OWNER/APP. MAILING ADDRESS: STREET401 S Jackson Street CITY Seattle STATE WA ZIP 98115 OWNER/APP. PHONE:206-717-9175 OWNER I APP. EMAIL:reeve.geary@soundtransit.org `Required for Work in Public Right-of-Way CONTRACTOR NAME: Shannon &Wilson, Inc. CONTRACTOR ADDRESS: STREET400 N 34th St, Suite 100 CITY Seattle STATE WA z,p 98103 CONTRACTOR PHONE:(206) 632-8020 CONTRACTOR EMAIL:Info-Seattle@Shanwll.Com CONTRACTOR LICENSE#(REQUIRED):SHANNW*378N0 EVERETT BUSINESS LICENSE#(REQUIRED): 19537 PRIMARY CONTACT: ❑ OWNER /APPLICANT @ CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE:(206)695-6915 Tyler Stephens CONTACT EMAIL:Tyler.Stephens@shanwil.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 Digitally signed by Reeve Geary PERMIT# Reeve Geary Date:202401A1 6434508'0' Reeve Geary Ipw Owner/Authorized Agent Signature Date (Revised 412112022)