3331 WETMORE AVE 2017-09-25 - Laserfiche WebLink

PIOLIC WORKS PERMIT 4PLICATION CITY OF EVERETT PERMIT SERVICES 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: v'/'_-'_ lit/ D 20 IF APPLICABLE: ❑ LAND USE PROJECT#(S EPA, 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: 1 -' ry i rs c� L FENCE IN RO 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 l�sJ CLEARING/GRADING/FILL/EXCAVATE CY (IY6mu-r «O C r) ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT INFORMATION OWNER NAME: 0 C OWNER MAILING ADDRESS: STREET L J� CITY STATE 71P OWNER PHONE: - - OWNER EMAIL: �G �� C d cC' 1 APPLICANT NAME: t� I \ APPLICANT MAILING ADDRESS: STREET CITY STATE ZIP CI APPLICANT PHONE: APPLICANT EMAIL: PRIMARY CONTACT: V OWNER ❑APPLICANT ❑ OTHER(Architect, Engineer, Etc.) CON ACT NAME: L / CONTACT PHONE: S �Q��T Aae-.`l CONTACT EMAIL: ACKNOWLEDGEMENT.,I have reviewed this applicion 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. Th 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.If am the owner,or i am authorized by the owner of this property to perform the work for which application is made,and t comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Oficial Use Only PERMIT# PW 160$ - 03Q Owner/Authorized Agent Signature D (Revised 10/12/2015)