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NEN <br /> Pl LIC WORKS PERMIT AgapLICATION <br /> CITY OF EVERETT PERMIT SERWES <br /> EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 <br /> WASH INGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov https://everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:6522 Wetmore Ave, Everett, WA 98203 <br /> SITE WORK FOR PROJECT TYPE: ❑✓SFR-DETACHED ❑TOWNHOUSE ❑DUPLEX ❑ADU EMULTI-FAMILY ECOMMERCIAL ❑INDUSTRIAL <br /> IF APPLICABLE: ✓0 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.)SS20-005 <br /> IF APPLICABLE: ❑ FRANCHISE/UTILITY COMPANY, ANNUAL BLANKET PERMIT# <br /> UTILITY COMPANY'S NAME&JOB#: JOB# <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 15 FT WIDE ✓❑ Combined Sewer <br /> ❑ASPHALT/CONCRETE PAVING SF El 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 FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: <br /> ❑✓ CLEARING/GRADING/FILL/EXCAVATE 350 CY El MR2 Only El MR1-5 ✓❑ 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:2,173 SF <br /> ❑ POLE WORK/AERIAL/OVERLASH LF Proposed Hardscape:2871 SF <br /> ADDITIONAL DESCRIPTION (AS NEEDED): Total New+Replaced:5,044 SF <br /> CONTACT INFORMATION <br /> OWNER I APPLICANT NAME: Brent Sanders <br /> OWNER/APP. MAILING ADDRESS: STREET PO Box 1 154 <br /> CITY Everett STATE WA ZIP 98206 <br /> OWNER I APP. PHONE:425-275-6937 OWNER I APP. EMAIL:info©maverickhldgs.com <br /> *Required for Work in Public Right-of-Way <br /> CONTRACTOR NAME: 9 Al c k o fL- <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED):. IVkL-s A L B EVERETT BUSINESS LICENSE#(REQUIRED): �6 55 <br /> PRIMARY CONTACT: ❑ OWNER /APPLICANT El CONTRACTOR ✓❑OTHER(Architect, Engineer, Etc.) Engineer <br /> CONTACT NAME: CONTACT PHONE:(425) 303-9363 <br /> Brian Kalab CONTACT EMAIL:brian@insightengineering.net <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 for which application is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> ��ii /� PERMIT#/1G 08/26/2021 PW L n S "0/4 <br /> Owner/Authorized Agent Signature Date (Revised 1/72019) <br />