2002 ROCKEFELLER AVE 2018-01-19 - Laserfiche WebLink

�� ,0�� 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 PROJEC'T SITE IWFOFtMAT10W PROJECT ADDRESS: �J(�t— /CCJC�C� F' C�r' �V� IF APPLICABLE: ❑ IAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) SITE WORK FOR PROJECT TYPE: SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? �I NO ❑YES, FROM TO NEW WATER/SEWER SERVICE NEE3ED? �NO ❑YES,TYPE SIZE SITE WORK/ RIGHT-AF-WAY APPLICATION INFORMATION DESCRIPTION OF WORK: ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑ASPHALT/CONCRETE PAVING SF RETAINING WALL/ROCKERY IN RIGHT-OF-WAY ��pp�� O LF ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT ❑ CLEARWG/GRADING/FILL/EXCAVATE CY ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT INFORMATION OWNER NAME: {'1 ' �,� �x �1ti� OWNER MAILING ADDRESS: sTReer 2 QZ�Z �� e I CITY ^ '� STATE �� ZIP �CJ�Q OWNERPHONE: �ZS� �Z� -' S� OWNEREMAIL: APPLICANT NAME: �C �Y1-� APPLICANT MAILING ADDRESS: srReeT CITY STATE Z�P APPLICANT PHONE: APPLICANT EMAIL: _ __,.... , �:......._ .. . PRIMARY CONTACT: ❑ OWNER ❑APPLICANT ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: ACKNOWLEDGEMENT.�I have reviewed this applicafion and confirm the information contained herein is true and correcf. 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 deviafions the�efrom.Deviations musf firsf be authorized in writing from the Building Official before being authorized under any circumstance. I am the owner,or 1 am aufhorized by the owner of this property to perform the work for which applicafion is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# ' P�/ �"lOS -6�'�, � �c��1,z ��,�.-�' � 1 i 8'1 � 7 Owner/Authorized Agent Signature Date (Revised 90/12/2015)