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PUBLIC WORKS PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E) everefteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:2313 CEDAR ST <br /> IF APPLICABLE: = LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.) <br /> SITE WORK FOR PROJECT TYPE: =SFR-DETACHED =SFR-ATTACHED =DUPLEX =MULTI-FAMILY =COMMERCIAL <br /> CHANGE OF USE? ONO = YES, FROM TO <br /> NEW WATER/SEWER SERVICE NEEDED? = NO = YES,TYPE SIZE <br /> SITE WORK RIGHT-OF-WAY APPLICATION INFORMATION <br /> DESCRIPTION OF WORK: PSE-106350626 <br /> to install gas service at approx. 240' N c/I of 24th St& 16'W to 9' E c/I of Cedar st (1) 3x5 soft surface & (1) 3x5 paving cut <br /> anticipated. <br /> APPROVED <br /> See TCP sheets for notes. <br /> By JWISDQ at 6:57:59 AM,31512019 <br /> = CUT/BORE IN PAVEMENT(PARALLEL) LF <br /> = CUT/BORE IN PAVEMENT(NON-PARALLEL) LF <br /> CONTACT INFORMATION <br /> OWNER NAME: EATON JOHN &BOCALAN BASILIO <br /> OWNER MAILING ADDRESS: STREET 2313 CEDAR ST <br /> CITY EVERETT STATE WA zip 98201-3144 <br /> OWNER PHONE: OWNER EMAIL: <br /> APPLICANT NAME: Susan Sidick <br /> APPLICANT MAILING ADDRESS: STREET 1660 Park Lane <br /> CITY Burlington STATE WA ZIP 98233 <br /> APPLICANT PHONE: 4254576353 APPLICANT EMAIL: susan.sidick@pse.com <br /> PRIMARY CONTACT: = OWNER =APPLICANT = OTHER(Architect, Engineer, Etc.) <br /> CONTACT NAME: [ContactName] CONTACT PHONE: [ContactPhone] <br /> CONTACT EMAIL: [ContactEmail] <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 /> PERMIT# <br /> PW1903-005 <br /> ETRAKiT APPLICATION RECEIVED 31112019 (Revised 313012018) <br />