5510 OCEAN AVE 2017-09-08 - Laserfiche WebLink

Pt f LIC WORKS PERMIT PLICATI®N CITY OF EVERETT PERMITS ICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: �j� (� c,n / v-(f— Eve-*-e_ s A q6 2c) J IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED RSFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? Ind NO ❑YES, FROM —/ TO NEW WATER f SEWER SERVICE NEEDED? & NO ❑YES,TYPE SIZE SITE WORK/ RIGHT-OF-WAY APPLICATION INFORMATION DESCRIPTION OF WORK: (A-t6ck.d a d i �- t4 K-,-A-9 { r ❑ 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: I avj 1',Q JC S6,-) B✓U1 Ce- OWNER eOWNER MAILING ADDRESS: STREET '5C-,ib OCA u i7 CITY -V"C' L ' STATE '* ZIP �6 OWNER PHONE: �P ' Z�(.e - -7Gl 2� OWNER EMAIL: 1'l h I'u C c. (`�' CC r - C�✓� APPLICANT NAME::...:....... ...r�'... .... _ .:__r.._ .._.,_,. .,,,.._ .. ....... ..._.. .... . . APPLICANT MAILING ADDRESS: STREET CIN STATE b-V ZIP (6 APPLICANT PHONE: 2,0(.P - 2-77 Le -- 7 'l Z APPLICANT EMAIL: 1,1 PRIMARY CONTACT: OWNER ❑APPLICANT ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: �� - 2_1 Ce VLZ Gam. CONTACT EMAIL: V a_L c- G'� {y(d ACKNOWLEDGEMENT.•I have reviewed this application and confirm the information contained herein is rue 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 98.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 14A CQ_ P W Owner/Authorized Agent Signature Date (Revised 10/92/2095)