1917 124TH PL SE 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:12420,12510, 12419, 12407 21st AVE SE and 2026, 2006, 2002 124th ST SE, and behind 1917 124th PL SE SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU RMULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: O 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 Bordeaux HOA needs to remove 9 street trees with roots damaging sidewalks and growing into water mains. The trees aie in hont Of and behind to above addresses within our NOA. These tlees, Mice ieniuved, will be 1163placed CONTACT INFORMATION OWNER/APPLICANT NAME: Tracy Miller, Bordeaux HOA President OWNER/APP. MAILING ADDRESS: ST1EET1 91 7 124th PL SE CITY Everett STATE WA ZIP 98208 OWNER/APP. PHONE:206-604-2068 1OWNER/APP. EMAIL:tracy—boma@msn.com `Required for Work in Public Right-of-Way CONTRACTOR NAME: Washington Tree Experts CONTRACTOR ADDRESS: ST1EET9792 Edmonds Way #123 CITY Edmonds STATE WA zIP 98020 CONTRACTOR PHONE:206-362-3380 1CONTRACTOR EMAIL:wtetree@yahoo.com CONTRACTOR LICENSE#(REQUIRED):27-2358696 1EVERETT BUSINESS LICENSE#(REQUIRED): 602-997-491 PRIMARY CONTACT: 8 OWNER /APPLICANT ❑ CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT Miller CONTACT PHONE:206-604-2068 CONTACT EMAIL:tracy_boma@msn.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 Tracy Miller 9/18/2023 pW# Owner/Authorized Agent Signature Date (Revised 412112022)