801 LAUREL DR 2018-05-22 - Laserfiche WebLink

� Pl _IC WORKS PERMIT � 'LICATION ` CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: rt"''��'\ 1_.�-t_' �= � i— �t= . IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) SITE WORK FOR PROJECT TYPE:LySFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? ,�NO ❑YES, FROM TO NEW WATER/SEWER SERVICE NEEDED? _�O ❑ YES,TYPE SIZE SITE WORK / RIGHT-OF-WAY APPLICATION INFORMATION DESCRIPTION OF WORK: �� F�� 'Z�i,�tC✓f�t f,V ;y�l—� `3�'j(.�(.c ��!t'LL. 'Z;� '' ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑ASPHALT/CONCRETE PAVING SF .�'"RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT ❑ CLEARING/GRADING/FILL/EXCAVATE CY ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT INFORMATION OWNER NAME: ��-Jvr'<'�1� C��;�✓ OWNER MAILING ADDRESS: sTREET �'n � ui�v�c� �� / C,�C.,� C�-t? CITY � �i�� >� STATE ,�/� � ZIP � OWNER PHONE: zt7� `��3�-F ��S 7 OWNER EMAIL: !�,r�t,,� , <- c��.;./ ��;2��1; � , C�-�i�— APPLICANT NAME: ;J�?�','��t�' ✓ APPLICANT MAILWG ADDRESS: sTReer ��O/ �/�,��.L � CITY ��/��-��'�T_ STATE C'✓��T ZIP ��/ APPLICANT PHONE: '��U�, L7�c�`�� L/G�S' 3 APpLICANT EMAIL: Uf'r 5�.� c ',�+-,/ � r' �,`�, ��-.. PRIMARY CONTACT: �OWNER ❑APPLICANT ❑OTHER(Architect, Engineer, Etc.) CONTA�CT NAME: , CONTACT PHONE: 2v(� y�j-y - y� � �� J 7��'Za�7V' �O��✓ CONTACT EMAIL: nJ/'c(c:�.✓i , � u�,/ ` <..:'t� <y, � , (� �-� ACKNOWLEDGEMENT:I have reviewed this application and confirm the information confa d 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.1 am the owner, or I am authorized by the owner of this property to perform the work for which application is made, and l comply wifh the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# -_ � _ z � - � � PW160�� `�� OwnerlAuthoriz d Agent Signature Date (Revised 10/12/2015)