2131 BAKER AVE 2018-01-11 - Laserfiche WebLink

��s� �� 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 PFtOJEC'r SITE IIdFORI1ilAT10N PROJECT ADDRESS: Z�3 J — a�t I��Y' IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, 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: � x l T � T Q�1 'C'F' �4 L�' T�►'1 C �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 � OWNERNAME: R'��'�''� WDE�� OWNER MAILING ADDRESS: sTReer 2 i 3 ) �A'K ,�-U � r � CITY C�� STATE ZIP � v �� I OWNER PHONE. y2S "Z��—7S Z 2- OWNER EMAIL _._... _._.. ._ ..._.. . ,.__ ._ _._ ...,. : __.., ___.._.. . _.._. . - APPLICANT NAME: Sq V�'1'e APPLICANT MAILING ADDRESS: sTREeT CIiY STATE Z�P APPLICANT PHONE: APPLICANT EMAIL: _.... .......... . ... __,_..:., : . .. PRIMARY CONTACT: ❑ OWNER ❑APPLICANT ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: CORITACT EMAIL: ACKNOWLEDGEMENT:1 have reviewed fhis application and confirm the informatron contained herein is true and correct. Work done pursuant to this permit musf comply with current federal,state, and local law. The granting of a permit only aufhorizes approved work and no deviations therefrom.Deviations must firsf be authorized in writing from the Burlding 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 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# �� � � �.� .-__ y/g�z-� ,� PV�I ��5 - o n� OwnerlAuthorized Agent Signature Date (Revised 10/12/2015)