1313 75TH ST SW BLDG A 2025-11-07

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:1313 75th St SW (;,L�:) G- -}- 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: ❑ FENCE IN ROW FT IN HEIGHT STORMWA TER DISCHARGES TO: ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑ Combined Sewer @ ASPHALT/CONCRETE PAVING 960 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:960 SF ADDITIONAL DESCRIPTION(AS NEEDED): Total New+Replaced:960 SF Minimal sized concrete pad needed to structurally support critical equipment outside of the main building structure. Equipment drawings, specificaitons, and engineering calculations will be submitted in a future mechanical permit. CONTACT INFORMATION OWNER/APPLICANT NAME:Helion Energy OWNER/APP. MAILING ADDRESS: ST11IT1415 75th St SW CITY Everett STATE W'Q\ z,P 98203 OWNER/APP. PHONE:425-332-7463 OWNER I APP.EMAIL:tlandry@helionenergy.com Re uired 4 for Work in Public Right-of-WayJ',, f- c CONTRACTOR NAME: ! tu, (0 yi( J e w I Ce L—L L CONTRACTOR ADDRESS: STREET 2 8 2025 CITY STATE ZIP CONTRACTOR PHONE: p [CONTRACTOR EMAIL: - CONTRACTOR LICENSE#(REQUIRED): M A(rS k I"( I� EVERETT BUSINESS LICENSE#(REQUIRED):;-?C�( I ' G j PRIMARY CONTACT: 8 OWNER /APPLICANT ❑ CONTRACTOR ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME:Tyler Landry CONTACT PHONE:425-332-7463 CONTACT EMAIL:tlandry@helionenergy.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.I 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 � buy 2/26/2025 PERMIT# � �� 1' Owner/Authorized Agent Signature Date (Revised 412112022)