9900 12TH AVE W 2025-03-31 - 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: 9900 12th ave WeSt, Everett Wa 98204 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU RMULTI-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: 8 FENCE IN ROW 5ft FT IN HEIGHT STORMWA TER DISCHARGES TO: ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑ Combined Sewer 8 ASPHALT/CONCRETE PAVING 1969 SF ❑ Separated Storm Sewer 8 RETAINING WALL/ROCKERY IN RIGHT-OF-WAY 51f 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 Remodel of Winsley Appartments Pool Deck, see attached plans CONTACT INFORMATION OWNER/APPLICANT NAME: Abacus Capitol Group OWNER/APP. MAILING ADDRESS: STREET 2041 ROSENCRANS AVE STE 322 ,,, EL SEGUNDA STATE CA Z,P90245 OWNER/APP. PHONE: 206-200-4946 OWNER/APP. EMAIL: `Required for Work in Public Right-of-Way CONTRACTOR NAME: VIKING CONSTRUCTION GROUP CONTRACTOR ADDRESS: STREET 2609 WETMORE AVE CITY EVERETT STATE WA z,p 98201 CONTRACTOR PHONE:425-286-8131 1CONTRACTOR EMAIL:LARS@VIKINGCG.NET CONTRACTOR LICENSE#(REQUIRED):VIKINCG837LT IEVERETT BUSINESS LICENSE#(REQUIRED): 604047154-001-0001 PRIMARY CONTACT: ❑ OWNER /APPLICANT @ CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: SCOTT LARSON CONTACT PHONE:425-286-8131 CONTACT EMAIL:LARS@VIKINGCG.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 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 Scott Larson 3/14/2023Ipw PERMIT # Owner/Authorized Agent Signature Date (Revised 412112022)