5816 25TH AVE W 2025-06-25 - Laserfiche WebLink

PUBLIC WORKS PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 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: 5814 25TH AVENUE W, EVERETT, WA 98203 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.) EPPLICABLE: 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: ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON / CURB CUT FT WIDE ❑ ASPHALT / CONCRETE PAVING SF ❑ RETAINING WALL / ROCKERY IN RIGHT-OF-WAY LF 0 RETAINING WALL / ROCKERY OVER 4FT IN HEIGHT 9 FT TOTAL HEIGHT s❑ CLEARING / GRADING / FILL / EXCAVATE 225 CY ❑ CUT/BORE IN PAVEMENT (PARALLEL) LF ❑ CUT/BORE IN PAVEMENT (NON -PARALLEL) LF ❑ POLE WORK / AERIAL / OVERLASH LF ADDITIONAL DESCRIPTION (AS NEEDED): DRAINAGE MITIGATION QUESTIONS: STORMWATER DISCHARGES TO: ❑ Combined Sewer ❑ Separated Storm Sewer ❑ Direct Discharge to Snohomish River or Puget Sound TRIGGERED REQUIREMENTS: ❑ MR2 Only ❑ MR1-5 ❑ MR1-9 QUANTITY OF PROPOSED HARD SURFACES: Proposed Roof Area: SF Proposed Hardscape: SF Total New+ Replaced: SF Replacement of existing failing tiered qravitv block walls with a new geogrid reinforced SierraScape wall at the top of a slope steep slope. CONTACT INFORMATION OWNER/APPLICANT NAME: JOCELYN KIERSTEIN OWNER/APP. MAILINGADDRESS: STREET 5814 25TH AVENUE W CITY EVERETT STATE WA Z,P 98203 OWNER / APP. PHONE: 808-352-681 1 OWNER / APP. EMAIL:JOCeklersteln@gmall.COm `Required for Work in Public Right -of -Way CONTRACTOR NAME: WALL SYSTEMS NW, INC. CONTRACTOR ADDRESS: STREET16530 WALLINGFORD AVE N cIn SHORELINE STATE WA ZIP 98133 CONTRACTOR PHONE:425-864-8846 1CONTRACTOR EMAIL:tbenedict@walIsystemsnw.com CONTRACTOR LICENSE #(REQUIRED): WALLSSN875BQ EVERETT BUSINESS LICENSE #(REQUIRED): PRIMARY CONTACT: F11 OWNER / APPLICANT ❑ CONTRACTOR ❑ OTHER (Architect, Engineer, Etc.) CONTACT NAME: Jocelyn Kierstein CONTACT PHONE: 808-352-681 1 CONTACT EMAIL: JOCEKIERSTEIN@GMAIL.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 # PW Owner/Authorized Agent Signature Date (Revised 1172019)