746 CROWN DR 2016-10-20 - Laserfiche WebLink

a PALIC WORKS PERMIT A PPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 7q(,, 6 ro w ti IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? ❑ NO ❑YES, FROM TO NEW WATER/SEWER SERVICE NEEDED? ❑ NO ❑ YES,TYPE SIZE SITE WORK / RIGHT-OF-WAY APPLICATION INFORMATION // DESCRIPTION OF WORK: /l� ��{ CJ cl �TirL /` t Cop /11-e14 ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑ASPHALT/CONCRETE PAVING SF ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT ❑ CLEARING/GRADING/FILL/EXCAVATE CY ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT INFORMATION OWNER NAME: vli_sai-t OWNER MAILING ADDRESS: STREET 7`t(P Ooo� CITY -�j�{�� STATE ZIP 9 9ZO OWNER PHONE: OWNER EMAIL: APPLICANT NAME: APPLICANT MAILING ADDRESS: STREET CITY STATE ZIP APPLICANT PHONE: / - APPLICANT EMAIL: PRIMARY CONTACT: rx1OWNER ❑APPLICANT ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: vim"", C)-� CONTACT EMAIL: ACKN WLED EMENT: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, d 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# z� PW 0 r/Autho ' e gent Signature Dat (Revised 10/12/2015)