10209 23RD AVE W 2025-06-25 - 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:10209 23Rd Ave W Everett WA 98204 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY RCOMMERCIAL ❑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 6 ft 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: R 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 1 INSTALL NEW 6FT CHAIN LINK TYPE FENCE, FOLLOW PROPERTY CORNERS THAT WERE SET BY PC SURVEY INC ON 07.26.22 SITE PLAN ATTACHED 2) CLEAR THE SITE FROM BI:AeKt: BERRYBUSHES CONTACT INFORMATION OWNER/APPLICANT NAME:ESTFIN LLC OWNER/APP. MAILING ADDRESS: STREET 12303 CYRUS WAY SUITE#103 CITY MUKILTEO STATE WA zip 98275 OWNER/APP. PHONE:425-387-3873 OWNER I APP. EMAIL:STONEDISCOUNT@YAHOO.COM `Required for Work in Public Right-of-Way CONTRACTOR NAME: AAA NW CONSTRUCTION INC CONTRACTOR ADDRESS: STREET 6711 70TH ST W CITY LAKEWOOD STATE WA z,, 98499 CONTRACTOR PHONE:253-820-2152 CONTRACTOR EMAIL:shubin650@gmail.com CONTRACTOR LICENSE#(REQUIRED): CC AAANWNC934PR EVERETT BUSINESS LICENSE#(REQUIRED): 64958 PRIMARY CONTACT: ❑ OWNER /APPLICANT ❑ CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE:425-387-3873 Andrew S h u b i n CONTACT EMAIL:stonediscount@yahoo.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 02. 14.23 PERMIT# Owner/Authorized Agent Signature Date (Revised 412112022)