Laserfiche WebLink
PlaVIC WORKS PERMIT iffigLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 ' FAX 425-257-8857 I (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> 'Y� sxx3;w •.,a --a _ - -- , n�sYrs= .,:._. - ----- - ' ` S <br /> . .- '---4- - -‘2-1-- 04-;,---..'z'' �.ti _ • n �v�.�, a{@zm . _ . " \-ss��- � - - � tie _ 9 <br /> PROJECT ADDRESS:6406 HIGHLAND DR <br /> IF APPLICABLE: = LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) <br /> SITE WORK FOR PROJECT TYPE: =SFR-DETACHED =SFR-ATTACHED =DUPLEX =MULTI-FAMILY =COMMERCIAL <br /> CHANGE OF USE? = NO = YES, FROM TO <br /> NEW WATER/SEWER SERVICE NEEDED? = NO = YES,TYPE , SIZE <br /> a <br /> PPN <br /> DESCRIPTION OF WORK: SITE DEVELOPMENT FOR NEW SFR DETACHED <br /> O FENCE IN ROW FT IN HEIGHT <br /> = DRIVEWAY APRON/CURB CUT FT WIDE <br /> =ASPHALT/CONCRETE PAVING SF <br /> = RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF <br /> = RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT <br /> = CLEARING/GRADING/FILL/EXCAVATE CY <br /> = CUT/BORE IN PAVEMENT(PARALLEL) LF <br /> = CUT/BORE IN PAVEMENT(NON-PARALLEL) LF <br /> OWNER NAME: TSYMBALYUK VOLODYMYR/LINA <br /> OWNER MAILING ADDRESS: STREET 505 103RD PL SE <br /> ciry EVERETT STATE WA ZIP 98208 <br /> OWNER PHONE:4252931892 'OWNER EMAIL: <br /> APPLICANT NAME: TSYMBALYUK VOLODYMYR/LINA <br /> APPLICANT MAILING ADDRESS: STREET 505 103RD PL SE <br /> CITY EVERETT STATE WA ZIP 98208 <br /> APPLICANT PHONE: 4252931892 APPLICANT EMAIL: <br /> PRIMARY CONTACT: = OWNER =APPLICANT = OTHER(Architect, Engineer, Etc.) <br /> CONTACT NAME:TSYMBALYUK VOLODYMYR/LINA CONTACT PHONE:4252931892 <br /> CONTACT EMAIL: <br /> ACKNOWLEDGEMENT.I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must <br /> 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 <br /> authorized in writing from the Building Official before being authorized under any circumstance.lam the owner,or I am authorized by the owner of this property to <br /> perform the work for which application is made,and I comply with the State Contractors Law 8.2r <br /> CW and 296.200A WAC. <br /> i r . 8 t,, T /9t,( g /204 City of Everett Official Use Only <br /> /! PERMIT# <br /> PW1608-044 <br /> Authorized Agent/Owner Date (Revised 10/12/2015) <br />