1019 PACIFIC AVE 2025-03-31 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I https:Heverettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:1019 Pacific Ave, Everett, WA, 98201 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY ✓❑COMMERCIAL []INDUSTRIAL IF APPLICABLE: Ll LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) EPPLI CABLE: ElFRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB M 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 STORMWATER DISCHARGES TO: 7-1 DRIVEWAY APRON/CURB CUT 4 FT WIDE ❑ Combined Sewer s❑ASPHALT/CONCRETE PAVING 120 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 Trench across Alley to install conduits. (2) buildings to be backed up by (1) Generator. Plans attached to this document CONTACT INFORMATION OWNER/APPLICANT NAME:Puget Sound Kidney Centers (Contact-Marvin Schlepp) OWNER/APP. MAILING ADDRESS: sTREET1019 Pacific Ave CITY Everett STATE VV`/�, A 1,98201 OWNER/APP. PHONE:425-259-1913 OWNER/APP. EMAIL:MarvS@pskc.net `Required for Work in Public Right-of-Way CONTRACTOR NAME: Dahl Electric Inc CONTRACTOR ADDRESS: STIEET521 E. Victoria Ave cIn Burlington STATE WA ZIP 98233 CONTRACTOR PHONE:360-755-1145 CONTRACTOR EMAIL:BIDS@dahlelectric.com CONTRACTOR LICENSE#(REQUIRED):DAHLEE1921 P8 EVERETT BUSINESS LICENSE#(REQUIRED): 037024 PRIMARY CONTACT: ❑ OWNER /APPLICANT 71 CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE:360-661-7605(Cell) Garrett Hoffman CONTACT EMAIL:Ghoffman@dahlelectric.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 I 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 PERMIT# 5/06/2022 IPW Owner/Authorized Agent Signature Date (Revised 1172019)