5700 23RD DR W 2018-06-28 - Laserfiche WebLink

ILIO WORKS PERMIT 1PPLICATION 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: 5700 23RD DRIVE W, EVERETT, WA 98203 IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.)SEPA#10-040 SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY gICOMMERCIAL ❑INDUSTRIAL CHANGE OF USE? Vi NO 0 YES, FROM TO NEW WATER/SEWER SERVICE NEEDED? Q NO 0 YES,TYPE SIZE SITE WORK;/ RIGHT OF"-WAY APPLICATI':ON INFORMATION DESCRIPTION OF WORK: CONSTRUCTION OF A NEW 2-STORY EDUCATIONAL BUILDING.THE LOWER FLOOR IS UNDERGROUND LEVEL. EXCAVATION AND FILL PER CIVIL AND GEOTECHNICAL REPORT. NEW SIDEWALK TO BE CONSTRUCTED AROUND THE NEW BUILDING. ❑ FENCE IN ROW FT IN HEIGHT )\-Th ❑ DRIVEWAY APRON/CURB CUT FT WIDE VI ASPHALT/CONCRETE PAVING 5,429 SF ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF4'c6 (DR;R; , RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT 12'-6" FT TOTAL HEIG .T pJ CLEARING/GRADING/FILL/EXCAVATE CY ❑CUT/BORE IN PAVEMENT(PARALLEL) LF ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACTINFORMATION OWNER NAME: NORTHSHORE CHRISTIAN CHURCH OWNER MAILING ADDRESS: STREET 5700 23RD DRIVE W ciTY EVERETT STATE WA Zip 98203 OWNER PHONE: (425) 322-2301 OWNER EMAIL: APPLICANT NAME: MANAL SHAWISH APPLICANT MAILING ADDRESS: STREET 2812 COLBY AVE. cIT' EVERETT STATE WA ZIP 98201 APPLICANT PHONE: (425)252-2153 APPLICANT EMAIL: manal@2812architecture.com PRIMARY CONTACT: 0 OWNER 4Z1 APPLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: SAME AS APPLICANT SAME AS APPLICANT CONTACT EMAIL: SAME AS APPLICANT 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# 12-2-- 2oL� PW l 17 \u Owner/Authorized Agent Signature Date (Revised 9/23/2016)