3402 PAINE AVE 2017-09-08 - Laserfiche WebLink

WLIC WORKS PERMIT` LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT; WA 98201 (P) 425-2578810 1 FAX 425257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 3/ oZ MAINE A\)EJJ uI— EVa2r--IT IF APPLICABLE: IN LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) tG SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? Z NO ❑YES, FROM TO NEW WATER/SEWER SERVICE NEEDED? ® NO ❑YES,TYPE SIZE SITE WORK / RIGHT-OF-WAY APPLICATION INFORMATION DESCRIPTION OF WORK: AZO-F SF-DSN Q�zL<:1WC_L-UD65 5►TE- G2FAD1�J G,••STo&iIA DI261MA�E. PA27rlAI-- _ E�JQ1T -�F (-E- REPLAC-r--M E.NT SEEM EJ JTAL IATA I�I 1 N C�WALL-: LAST-I N-ELi�CF- .�A 9 'Fo u N D61() 5 T DTCIZTkAS S IL-L CONTAIAJME_NT &A!9M fol BAYER CNGxZ� sTol2AGF- 2.Ec,T 7CALEZuuv?HF�.1T_ ❑ FENCE. IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON/CURB CUT FT WIDE 19 ASPHALT/CONCRETE PAVING (0,9 SF M [= DD ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF pp p c ❑RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL_ HEIGHT ED o 8 2U16 *CLEARING/GRADING/FILL/EXCAVATE -� 1, aoo CY CITY OF EVERETT ❑CU-T/BORE IN PAVEMENT(PARALLEL) LF Permit Services ❑CUT/BORE- IN PAVEMENT(NON PARALLEL.) LF CONTACT INFORMATION OWNER NAME: Pic) (.1o, I p.(=._S g2misA t"oU�'Y OWNER MAILING ADDRESS: STREEr EVC 1V—a-'j - - STATE �(� ZIP OWNER PHONE: � �OWNER EMAIL: APPLICANT NAME: JHGog APPLICANT MAILING ADDIRESS: STREET S�M� JAS CjWNFA__ �•�_ ��m ____._�._� CITY STAFE Zip APPLICANT PHONE: APPLICANT EMAIL: ; L v�.0 PRIMARY CONTACT: ❑OWNER W APPLICANT ❑OTHER(Architect, Engineer, CONTACT NAME: SP11E AS A1FJCA)J'( CONTACT PHONE: s� CONTACT EMAIL: ��u ACKNOWLEDGEMENT l have reviewed this application and confirm the information contained herein is true and correct Work done pursuant to this permit nwst 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/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 18.27 RCW and 296.200A WAC City of Everett Official Use Only PERMIT Owner/Authorized:gent Signature Date (Revised 10/12/2015;