4201 RUCKER AVE COMMUNITY HEALTH CENTER 2019-04-10

4zErr PLIC WORKS PERMIT A-=LICATION 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: 4205Rucker Avenue, Everett WA 98203 IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX El MULTI-FAMILY OCOMMERCIAL DINDUSTRIAL CHANGE OF USE? 0 NO 0 YES, FROM TO NEW WATER/SEWER SERVICE NEEDED? ❑ NO ❑ YES,TYPE SIZE SITE WORK/ RIGHT-OF-WAY!APPLICATION INFORMATION DESCRIPTION OF WORK: Site work to include demolition of one driveway, partial sidewalk, and some landscaping. New site work to include partial new sidewalk, some parking re-striping, and relocation of existing generator to new pad. ❑ FENCE IN ROW FT IN HEIGHT ,0 Mita-Arm b DRIVEWAY APRON/CURB CUT 28'-0" FT WIDE RuA� 0 ASPHALT/CONCRETE PAVING 3,776 32-Trenching for Transformer Relocate-387 S SF 33-New Concrete Sidewalk-1,121 SF ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF 34-ADA Signage-4 EA 35-CIP Curbs-826 LF o RETAINING WALL!ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT '36-New Asphalt-295SY ❑ CLEARING/GRADING/FILL/EXCAVATE CY 37-New Landscape Areas 3,083 SF 38-New Pole Lights-8 EA ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF 39-CMU Trash Enclosures-6'-62LF 50-Trench for Genertor Relocate-494 SF ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF 2a5 ►skst `Port,--Com\*mTI.ScA, ,r A vAN_ CONTACT INFORMATION OWNER NAME: Community Health Care of Snohomish County OWNER MAILING ADDRESS: STREET 8609 Evergreen Way cITY Everett STATE WA ZIP 98208 OWNER PHONE: 425.789.3700 OWNER EMAIL: dkapetanov@chcsno.org APPLICANT NAME: J.R.Abbott Construction, Inc. APPLICANT MAILING ADDRESS: STREET 3408 1st Avenue South,Suite 101 cin Seattle STATE WA ZIP 98134 APPLICANT PHONE: 206.467.8500 APPLICANT EMAIL: jeffvp@abbottconstruction.com PRIMARY CONTACT: 0 OWNER 4/7 APPLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: 206.467.8500 Jeff Vander Pol CONTACT EMAIL: jeffvp@abbottconstruction.com ACKNOWLEDGEMENT:l 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 mad- and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 6/', 3/2.® /-7 PW I3-o6 -oiR Owner/Authorized Agent ignatur Date (Revised 9/23/2016) I