1001 14TH ST 2018-02-26 - Laserfiche WebLink

4rerr PUBLIC WORKS PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES -t f1= b�l n0. 3200 CEDAR STREET, EVERETT, WA 98201 Fa-nJ (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: South of 1205 Craftman Way IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.)SMA#16-011 Waterfront Place Central shoreline permit SITE WORK FOR PROJECT TYPE:GSFR-DETACHED ❑SFR-ATTACHED El DUPLEX ❑MULTI-FAMILY (COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? El NO 0 YES, FROM TO NEW WATER/SEWER SERVICE NEEDED? El NO 0 YES,TYPE SIZE SITE WORK / RIGHT-OF-WAY APPLICATION INFORMATION DESCRIPTION OF WORK: Pre-load future commercial site with approximately 700 CY of clean fill; pile will be covered with plastic sheeting; will be in place for 6-12 months; see attached plan for haul route and alternative haul route. 0 FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON!CURB CUT FT WIDE -Pl 1°afre n �Or ❑ASPHALT/CONCRETE PAVING SF ev'eAcs O HJT. ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF 0 RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT p CLEARING/GRADING/FILL/EXCAVATE 700 CY Fill CY 0 CUT/BORE IN PAVEMENT(PARALLEL) LF 0 CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT INFORMATION OWNER NAME: Port of Everett OWNER MAILING ADDRESS: STREET 1205 Craftsmad Way,Suite 200 c,TY Everett STATE WA ZIP 98201 OWNER PHONE: 425-388-0720 OWNER EMAIL: LauraG@portofeverett.com APPLICANT NAME: Laura Gurley for Port of Everett APPLICANT MAILING ADDRESS: STREET same as above CITY STATE ZIP APPLICANT PHONE: same APPLICANT EMAIL: same PRIMARY CONTACT: 2 OWNER 0 APPLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: 425-388-0720 Laura Gurley CONTACT EMAIL: LauraG@portofeverett.com 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# petkiltok--)///. 61,7- PW 1-405 -03 1 Owner/Authorized Agent Signature Date (Revised 9/23/2016)