Laserfiche WebLink
PUBLIC WORKS PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS:Email application&submittal documents to PermitServices@everethia.gov or drop off at 3200 Cedar Street 2nd Floor Drop Box <br /> WASHINGTON CONTACT INFORMATION:(P)425-257-8810 1(E)PermitServices@evereltwa.gov I(W)evereltwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:100th St SW&18th Ave W <br /> SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED @TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL <br /> IF APPLICABLE: @ LAND USE PROJECT#(SEPA,PRE-APP,SS, ETC.)REVII22-025,REVII22-028,REV1122029 <br /> r <br /> LICABLE: ❑FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# <br /> UTILITY COMPANY'S NAME&JOB M JOB M <br /> DESCRIPTION OF SITE WORK / RIGHT-OF-WAY WORK <br /> FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: <br /> ❑ FENCE IN ROW FT IN HEIGHT STORMWATER DISCHARGES TO: <br /> ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑Combined Sewer <br /> ❑ASPHALT/CONCRETE PAVING SF N Separated Storm Sewer <br /> ❑RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ Direct Discharge to Snohomish River or Puget Sound <br /> @ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT 3364 SF FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: <br /> @ CLEARING/GRADING/FILL/EXCAVATE 5,830 CY ❑ MR2 Only ❑ MR1-5 EI MR1-9 <br /> ❑CUT/BORE IN PAVEMENT(PARALLEL) LF QUANTITY OF PROPOSED HARD SURFACES: <br /> ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Proposed Roof Area:19,605 SF <br /> ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape:20,543 SF <br /> ADDITIONAL DESCRIPTION(AS NEEDED): 1 Total New+Replaced:40,148 SF <br /> Clearing and Grading of 1.32 acres in support of a 23 single-family, attached town home project. On-site retaining <br /> was and a proposed detention/wetpoolvault will a used to stabilize the proposed grading. <br /> CONTACT INFORMATION <br /> OWNER/APPLICANT NAME:Pacific Ridge Homes/Jeff Wegener <br /> OWNER/APP. MAILING ADDRESS: STREET 17921 Bothell-Everett Hwy,Suite 100 <br /> CITY Bothell STATE WA ZIP 98012 <br /> OWNER I APP.PHONE:(425)219-2087 OWNER/APP. EMAIL:jlwegener@pacificridgehomes.com <br /> 'Required for Work in Public Right-of-Way <br /> CONTRACTOR NAME: Pacific Ridge-DRH,LLC/Tom Allen <br /> CONTRACTOR ADDRESS: STREET 17921 Bothell-Everett Hwy,Suite 100 <br /> CRy Bothell STATE WA z,P 98012 <br /> CONTRACTOR PHONE:(425)939-1169 CONTRACTOR EMAIL:talleni @pacificridgehomes.com <br /> CONTRACTOR LICENSE#(REQUIRED): OT49791Z? ?ACJffkb&?51;rjS I EVERETT BUSINESS LICENSE#(REQUIRED): 6403 <br /> PRIMARY CONTACT: ❑OWNER /APPLICANT ❑CONTRACTOR @ OTHER(Architect, Engineer, Etc.) Civil Engineer/CPH Consultants <br /> CONTACT NAME:Matthew Hough CONTACT PHONE:(425)285-2391 <br /> CONTACT EMAIL:matt@cphconsultants.com <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must <br /> 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 <br /> authorized in writing from the Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this property to <br /> perform the work fo4whiche ion is made,andI comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMITNovember 11, 2022Own r/Auth rire Date (Revised 4/21/2022) l <br />