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P �LIC WORKS PERMIT �PLICATION <br /> CITY OF EVERETT PERM{T SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECTADDRESS: 1923- 78TH PL. SE EVERETT 98204 LOT 10 <br /> IF APPLICABLE: ❑ LAND USE PRaJECT#(SEPA, PRE-APP, SS, ETC.)_____ <br /> SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED �ISFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL <br /> CHANGE OF USE? I� NO ❑YES, FROM TO <br /> NEW WATER/SEWER SERVICE NEEDED � N� �7 YES TYPE 6 INCH SIDE SEWER SIZE 1 INCH METER <br /> SITE WORK / RIGHT-OF-WAY APPLICATION INFORMATION <br /> DESCRIPTION OF WORK: <br /> ❑ FENCE IN ROW FT IN HEIGHT <br /> ❑ DRNEWAY APRON /CURB CUT FT WIDE <br /> ❑ASPHALT/CONCRETE PAVWG g� <br /> ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF <br /> ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT <br /> ❑ CLEARING/GRADING 1 FILL/EXCAVATE LY <br /> ❑ CUT/BORE IN PAVEMENT(PARALLEL) Lf= <br /> ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF <br /> CONTACT INFORMATION <br /> OWNER NAME: �PINE HEIGHTS LLC <br /> OWNER MAILING ADDRESS: s7REEr120 SW EVERETT MALL WAY SUITE 100 <br /> aTv EVERETT sT.�,�e WA ra 98204 <br /> OWNER PHONE: 360-953-2800 OWNER EMAIL: WWW.SEAPACHOMES.COM <br /> APPLICANT NAME:SEA PAC HOMES <br /> APPLICANT MAILING ADDRESS: sT��_E- 120 SW EVERETT MALL WAY SUITE 100 <br /> c�-v EVERETT gT,y�� WA z�P 98204 <br /> APPLICANT PHONE:360-953-2800 APPLICANT EMAIL: WWW.SEAPACHOMES.COM <br /> PRIMARY CONTACT: ❑ OVVNER �7 APPLICANT ❑OTHER(Architect, Engineer, Etc.) <br /> CONTACTNAME: STEVE SNYDER CONTACTPHONE: 425-319-0122 <br /> CONTACT EMAIL: STEVE.S@SEAPACHOMES.COM <br /> ACKNOWLEDGC-MENT.�!have reviewed this app/ication and confrrm the information contained herern is true and r.nrrect. Work done pursuant fo this permit must <br /> comply with current federal,state,and local!aw_ The graniing of a permrt 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 cirr.umstance. l am the owner,or I am authorized by the owner of tliis p�operiy to <br /> perform the work for whicl�application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 3-4-16 � Y V <br /> OwnerlAuthorized Age Si nature Da:e <br /> (Revised 90/12i20i5J <br /> 1 <br />