2808 10TH ST 2025-03-28 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL INSTRUCTIONS:Email application&submittal documents to PermilServices@everettwa.gov or drop off at 3200 Cedar Street 2nd Floor Drop Box CONTACT INFORMATION: (P)425-257-88101(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits WASHINGTON PROJECT SITE INFORMATION PROJECT ADDRESS:2808 10th ST Everett, Washington 98201 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: R LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.)playground equipment replacement IF APPLICABLE: ❑FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB#: JOB#: DESCRIPTION OF SITE WORK I 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 8 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: R CLEARING/GRADING/FILL/EXCAVATE 350 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): lTotal New+Replaced: SF disposal of En removal and Engineered wood fiber chips. Supply and installation of compacted crushed rock base for g p pP CONTACT INFORMATION OWNER/APPLICANT NAME:Lolly Huggins OWNER I APP. MAILING ADDRESS: STREET802 E Mukilteo Blvd Everett STATE WA ziP 98203 OWNER/APP.PHONE:425-512-2057 1OWNER/APP. EMAIL:lhugglns@everettwa.gov *Required for Work in Public Right-of-Way CONTRACTOR NAME: LSI PlayCreatlon CONTRACTOR ADDRESS: STREET2104 SW 152nd ST Suite1 c,Ty Burien STATE WA z.P 98166 CONTRACTOR PHONE.206-932-6366 1CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED):LAN DSSI973NQ 1EVERETT BUSINESS LICENSE#(REQUIRED): 44560 PRIMARY CONTACT: ❑OWNER /APPLICANT ❑CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME:Lolly Huggins CONTACT PHONE:425-512-2057 CONTACT EMAIL:lhuggins@everettwa.gov ACKNOWLEDGEMENT:1 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 1 am authorized by the owner of this property to perform the work for which applicatio is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 112 2 PW Owner/Authorized Agent Signa ur bate I (Revised 412112022)