417 TAMARACK AVE 2025-08-19 - Laserfiche WebLink

PUB _ WORKS PERMIT APF NATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON ( )425-257-8810 ! FAX 425-257-8857� I (E)epveretteppsw@eve■r�eptttwa.gov I https://everettwa.gov/permits _, "%r.'_.: g.: ti::Y`1�:3�:1ket 3; . . .,. ' P.MR EC}7y, � .LLIIii � Q90.40 3i6dp?I• s .�.�. -.t. j.. _„.?. ....,�.__ .�... ._. PROJECT ADDRESS: 4-( 1 '7 -1-6.:Lm c rca.ck t r• E V c -e l Wc,_, 9 S LO 3 §TE WORK FOR PROJECT TYPE: SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY ❑COMMERCIAL DINDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: ❑ FENCE IN ROW FT IN HEIGHT STORMWATER DISCHARGES TO: .;1 DRIVEWAY APRON/CURB CUT FT WIDE ®Combined Sewer ❑ASPHALT/CONCRETE PAVING ., Z? 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: 0 CLEARING/GRADING/FILL/EXCAVATE 5 f 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: 2 S y? SF ❑POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape: 5 Z 9 SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced: 3, 0-7 I SF re m-o e r »euv S: r >>?.��n-;f.,.;a,:. a �o E +ea• -..:n,,.�r-+. •:{.a� - - .,a�L s'k. 'a7't�;'y=�"�•`r' .r: .a caSF>•, 4'?5. 'i� t4 s�,+d;h i v r: - �._._. .. �'- My.�,'iPic.,•a 'i.�r ^.:A-s _. : OWNEF APPLICANT NAME: (3 ( ( c- L n IJ a-cc,Yt2 c,„I 1 OWNER/APP. MAILING ADDRESS: STREET -II 7 -re-Lv-zm> - C, CITY 1Te'_� STATE Via_ ZIP {E 3 i_L OWNER/APP. PHONE: /Z.S- Z `�D " 1I2 32 OWNER/APP.EMAIL. b r 11 i-� too nrvm +nLIX .Co *Required for Work in Public Right-of-Way CONTRACTOR NAME: ,5 j-}er Pe rr 5 6r1,�►6A e.,vrire... e,) r CONTRACTOR ADDRESS: sTREer / Z S Y 7 crrY C V e'it r t STATE V.1 G( zip 7 e c4 CONTRACTOR PHONE: (• Lo c��S� 7 L(� ,�p �-f's-(� CONTRACTOR EMAIL: S '��r yy2 c�n,r� ,�p�r r� ��r2c4-.� L. CONTRACTOR LICENSE#(REQUIRED): �NL IZ M ?CI 7 I H EVERETT BUSINESS LICENSE#(REQUIRED): 2171- ?l PRIMARY CONTACT: ❑OWNER /APPLICANT CONTRACTOR ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: / CONTACT PHONE: 1-(2 - Z L{L(- - /I'f `? 1'-1''�� CONTACT EMAIL: .5/2 !/�L-2ZS CLi� / � c'_t'D�f tQ!"� -��c i�Y fin C2. I� e..4e) 1°n ACKNOWLEDGEMENT:I have revs ed this application and confirm the information contained herein is true and correct. Work dine$rsuant 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 r , PER�MI/T# 2L02.Mer-0 �-�� lz 1 � Z©zz , - 1 — 0 Z' ner/ I�ll�l Authorized Agent Signature Date (Revised 4/15/2019).