5309 S 2ND AVE 2018-02-26 - Laserfiche WebLink

4fir F BLIC WORKS PERMII`�PLICATION 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.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 5 309 ,g' 2 A/ID lafiVE,. IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED USER-ATTACHED El DUPLEX 0 MULTI-FAMILY ❑COMMERCIAL 0 INDUSTRIAL CHANGE OF USE? ❑ NO 0 YES, FROM TO NEW WATER/SEWER SERVICE NEEDED? ❑ NO ❑ YES,TYPE SIZE SITE WORK/ RIGHT-OF-WAY APPLICATION INFORMATION DESCRIPTION OF WORK: 6.- /4L- /,STJT///rS 3 X S '/JL-X/S T/,4/b S/'///I/7 /1/9 /7L c �' tt//rN / V 3 5 / //1 /7No //Gt /(/7 ,/ /'iiU/. /J , T? 7--/t &I✓T AUT o i 7-7/ /2_0.1.ti ae'To E (.51,70 / /tvaea//el ry 4-r 53 09 s 2'IIJ 'Aft ❑ FENCE IN ROW FT IN HEIGHT O DRIVEWAY APRON/CURB CUT FT WIDE Er ASPHALT/CONCRETE PAVING 5')C o2®l SF ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF O RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT ❑ CLEARING/GRADING/FILL/EXCAVATE CY 0 CUT/BORE IN PAVEMENT(PARALLEL) LF 0 CUT/BORE IN PAVEMENT(NON-PARALLEL) LF r CONTACT INFORMATION OWNER NAME: ,5P/2/ic r �g rn// v/liek470(4.5 — 3T&1/1/e7/ SCO7/)-(/&72 OWNER MAILING ADDRESS: STREET. -.2 oZ/C .$ 2 S-2/ / 5'1 /� p CITY 9 /f l c 4 STATE /jtl!!, ZIP 9'p 4/Q OWNER PHONE: 220(j - '0 - 9/59 OWNER EMAIL: _51-e /et? hew 4-12w.51) /7-,(dem APPLICANT NAME: "V -/ 51k Y CIr)1�(//(//(4 7/(J/../5 APPLICANT MAILING ADDRESS: STREET .2.2s7.7 kr A S, CITY / -'AJ7 1 STATE / A ZIP 9 O3/ APPLICANT PHONE: U/2 7S1/— e'/3%' APPLICANT EMAIL: ve lers /2B .11/y(#t '/9, f07Y1 PRIMARY CONTACT: 0 OWNER G(APPLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: e/2 S=75-6.—k/,3q ,04(/<' /4:12:=7Q3 CONTACT EMAIL: r,Sters. no-rIjSJy 7erpric'er11/7 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. lam the owner,or lam 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# 4/(4:4:4— /a.1/ V/6 PW I OI- Owner/Authorized Agent Signature Date (Revised 10/12/2015)