1820 PACIFIC AVE 2017-06-28 - Laserfiche WebLink

- PUBLIC WORKS PERMIT �4PPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PRo�ecr a��ReSs: PACIFIC AVE BETWEEN COLBY AND BROADWAY ;��% -'f�=c��;� �(k�1 IF APPLICABLE: ❑LAND USE PROJECT#(SEPA,PRE-APP,SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATfACHED ❑DUPLEX ❑MULTI-FAMILY I�COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? �NO ❑YES. FROM TO NEW WATER/SEWER SERVICE NEEDED? C.�NO ❑YES,TYPE SIZE SITE WORK / RIGHT-OF-WAY APPLICATION INFORMATION DESCRIPTION OF WORK: INSTALL CITY OF EVERETT FIBER OPTIC CABLE FROM THE WALL STREET ADMIN BUILDING TO THE NORTH- EAST CORNER OF BROADWAY AVE ALONG PACIFIC AVE.INSTALL 1 -4"PVC CONDUIT 80'ON THE SOUTHWEST CORNER OF OAKES AND PACIFIC AVE.BETWEEN EXISTING CITY OF EVERETT AND SNOHOMISH COUNTY HANDHOLES.ALL WORK WILL BE PERFORMED IN THE ROW. ❑ FENCE IN ROW 0 FT IN HEIGHT ❑DRIVEWAY APRON/CURB CUT 0 FT WIDE ❑ASPHALT/CONCRETE PAVING 0 SF ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY � LF ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT 0 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: CITY OF EVERETT/INFORMATION TECHNOLOGY OWNER MAILING ADDRESS: sTReeT 2930 WETMORE AVE SUITE 6A cirY EVERETT � V�/7 �-�,� srare WA zi� 98201 OWNER PHONE: (425)257-8663 OWNER EMAIL: KWALSER CI.EVERETT.WA.US APPLICANT NAME: MILNE ELECTRIC APPLICANT MAILING ADDRESS: srrtEer 14582 172ND DRIVE SE cirr MONROE STATE wA ziP 98272 APPLICANT PHONE: (360 863-9617 EXT 229 APPLICANT EMAIL: GEORGE.HATLAND@MILNEELECTRIC.COM PRIMARY CONTACT: ❑OWNER �APPLICANT ❑OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: (360)863-9617 EXT 229 GEORGE HATLAND CONTACT EMAIL: GEORGE.HATLAN D@MILNEELECTRIC.COM ACKNOWLEDGEMENT:I have reviewed this application and confirm the inforrnation contained herein is true and correct. Work done pursuant to this permit must comply with cunent federal,state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authonzed in writing from the Buifding Officia/before being authorized under any circumstance. I am the owner,or 1 am authorized by the owner of this property to perform fhe work for which application is made,and 1 comply with the State Contractors Law 15.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# �h ' ;, � ( Z'I `2�1�� PW :�'ll�� - ��Z O ner/Au rized Agent Signature Date (Revised 10/12/2015) /