1123 RAINIER AVE 2018-02-22 - Laserfiche WebLink

PI LIC WORKS PERMIT 41PLICATION ell%01,,UP'-'4440,,,----4 --_ CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwagov/permits PROJECT SITE INFORMATION _._ S. - PROJECT ADDRESS: 'Jaz RA l NItIZ 4 v / c/aSi- ET/; 4ti4 / 6a0 IF APPLICABLE: 0 LAND USE PROJECT#(SEPA,PRE APP,SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX LTI-FAMILY ❑COMMERCIAL DINDUSTRIAL CHANGE OF USE? 121r) YES, FROM TO NEW WATER/SEWER SERVICE NEEDED? --03-4/6-0 YES,TYPE SIZE SITE WORK`I RIGHT OF WAY APPLICATION;INFORMATION DESCRIPTION OF WORK: Ce OC R,G 7---E ?m--77 0 ❑ FENCE IN ROW FT IN HEIGHT �0 DRIVEWAY APRON/CURB CUT FT WIDE LIa ASPHALT/CONCRETE PAVING 8&-)) SF ^ [E s j v,,/7 , , ; " ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY . LF t"2'Li i`s i °'' ; "y S j 1 i ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIG I 1 ❑ CLEARING/GRADING/FILL/EXCAVATE CY 6........, CII OFEVERET T ❑CUT/BORE IN PAVEMENT(PARALLEL) LF yyq Permitp$ Services ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF GONTACT.INFORMATION . . OWNER NAME: t vI t77 (16W5l IC- AGl/-nle,R/r, (1 OWNER MAILING ADDRESS: STREET 31C9 e) Cc91,3 A!/E-- 94:9A0CITY C vfT/! I STATE 14,...1/41zIP OWNER PHONE:1/2 .2-be — '7'0/6 OWNER EMAIL: 15EJJVICU - e)�61— _ ... . .. -, m.-.�� //.�,,,,..M... .._t.__.,.... ....M.n..r.._.. .., m...M ... ,._Nr _. ... m�.� .. ...2. . ...e APPLICANT NAME: � 144 AJ (A)/ ,?A J APPLICANT MAILING ADDRESS: STREET Q�-1E 5 / "- C9 (/ _i CITY STATE ZIP APPLICANT PHONE: ' APPLICANT EMAIL: ` ��IC'AI't'LICANT 0}OTHER(Architect,�Engineer, Etc.) „w} ` RrM '� X4 �`Y PRIMARYCONTACT: 0 OWNER CO TACT NAME: 2._-.0 CONTACT PHONE: .47/25— ,2.3 8 Q`(� E'- �/�+J/=�1Alj�. CONTACT EMAIL: EAJ ti �'v/l.'9 - Qk G ACKNOWLEDGEMENT.I have reviewed this application 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. 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!comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 2" (...-- f / PERMIT# 00101111F PWI61R- 010 Owner/Authorized Agent Signature Date (Revised 10/12/2015)