1131 RAINIER AVE 2018-02-22 - Laserfiche WebLink

/SP PLIC WORKS PERMIT 41PLICATION CITY OF EVERETT PERMIT SERVICES viiii 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits ` PRikittl SITE INFORMATION - PROJECT ADDRESS: 1/31 �}�) (�iZ At/E 1 1(/gQp 6, (,9 96'2c/ IF APPLICABLE: 0 LAND USE PROJECT#(SEPA,PRE-APP,SS, ETC.) SITE WORK FOR PROJECT TYPE:/ ❑SFR-DETACHED CISFR-ATTACHED ❑DUPLEX DMULTI-FAMILY ❑COMMERCIAL DINDUSTRIAL CHANGE OF USE? 1:131(10-- �NU 0 YES, FROM , !–I TO NEW WATER/SEWER SERVICE NEEDED? i iii YES,TYPE SIZE SITEW ORK/ RIGHT OF WAYAPPLICATION INFORMATION DESCRIPTION OF WORK: CO/OCR 6-7:e. P/3"7/0 - ❑ FENCE IN ROW FT IN HEIGHT DR( WAY APRON I CURB CUT FT WIDE -�,, ASPHALT/CONCRETE PAVING /g 3 4/ SF I F IF wr.( Yi�7,;f7` w ,"''\ ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY . LF - 1 i ❑ RETAINING WALL I ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT lit S ❑ CLEARING/GRADING/FILL!EXCAVATE CY LJ ❑CUT/BORE IN PAVEMENT(PARALLEL) ir'rn°CV)iFt 2SE2Vei2-EtRii6cEeTsT1) ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT:INFORMATION OWNER NAME: LC(lF(s[i77 /7/0 /$/AJG X41-6,7 70/7/ OWNER MAILING ADDRESS: STREET 3/0/ l CC9.--i 0 A�� CITY (�Gket7/ STATE e.4.--A,9 ZIP /BO`�.�/ OWNER PHONE: y o.0 P-7. S sf 9/ 6 OWNER EMAIL: / /1/4-)V e E( ,v • d G ...._ _____ APPLICANT NAME: EK.i (/M 0 AJ(A),C 4. - APPLICANT MAILING ADDRESS: STREET SJ41- /9-5 l¢23C9(_ - CITY STATE ZIP APPLICANT PHONE: ' APPLICANT EMAIL: vK PRIMARY CONTACT: 0 OWNERIL 'PLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: L/.2_,1— . 3 6 1/(97. /?E0 VA-ii-iir _ CONTACT EMAIL: ,(J ve E644,44 _61,.? ACKNOWLEDGEMENT:/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!am authorized by the owner of this property to perform the work for which application is made,and!comply with the State Contra .rs Law 18.27 RCW and 296.200A WAC. / City of Everett Official Use Only PERMIT# PW/6/2-009 Owner/A horized Agent Signature Date (Revised 10/12/2015)