1325 MADRONA AVE 2018-05-22 - Laserfiche WebLink

� �5 a° ��s� uv�� s�� 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 SIT'E IPo1FORMATION PROJECT ADDRESS: ( �j Z S I V`��L O j�(7� �F ��o��!�"^' '"_ ❑ LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) SITE WORK FOR PROJECT TYPE: SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? �NO ❑YES, FROM TO NEW WATER/SEWER SERVICE NEE�ED? �NO ❑YES,TYPE SIZE SITE WORK/ RIGHT-OF'-WAY APPLICATION 1NFORMATION � ' / _ � DESCRIPTION OF WORK: � `'X!ST �7 C I"� ��v�'<.t� ❑ FENCE IN ROW FT IN HEIGHT ;,..__,, , ,;v .. , � ��,�g� �'' � j }`,t , `..1;� ,�DRIVEWAY APRON/CURB CUT FT WIDE c ; ' �,, ":_ � �, �.,! � ;. ; ❑ASPHALT/CONCRETE PAVING SF ' � � y F LF � �C� � 9 2t��7 � E__.i 1 ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY ��}, ��,:-�� ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGFifi i�`�,f �� /� ��-T""i� ❑ CLEARING/GRADING/F1LL/EXCAVATE CY `�'�rm it� :�:�->`` ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT INFORMATION � OWNER NAME: �l I �,�;� > �� • ' ;C j �C V OWNER MAILING ADDRESS: sTReET I�ZS I�q� f A� � � CITY .J�. � STATE �ry ZIP � �p Z l� OWNER PHONE: �'I 2-S `� 1' 1'�3'-7 OWNER EMAIL: . __ ..... ...... , . . . . _ -� � � � r � APPLICANT NAME: �/l S Co r l`e APPLICANT MAILING ADDRESS: srReer �� ./ Nl� �� r, CITY �'�lY- STATE � ZIP )��' APPLICANT PHONE: `�Z--S �So 1-�Ss� APPLICANT EMAIL: v ' �,.. � ;o.�, a��o c • ew. ,...:., _.... .. .. . ..:._ ._ ....: ...._ . . PRIMARY CONTACT: ❑ OWNER C+�APPLICANT ❑ OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: L ZS " S� 1� S � �e��lV�v'l COMTACT EMAIL: dc� ' C�•, �1 �_,� "Y��4 0�,�. ACKNOWLEDGEMENT.�I have�eviewed fhis application and confirm fhe information contained herein is true and correct. Work done pursuant to this permit must comply with currenf federal,sfate,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in wrifing from the Building Otficial 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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use On/y � PERMIT# �----= � � -� � - � P1�V I � /(� C� j� Owner/ ut or' ed Agent Signature Date (Revised 10/92/2015)