932 MAPLE ST 2018-07-18 - Laserfiche WebLink

44.77, PUtLIC WORKS PERMIT AFLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT,SITE INFORMATION y: v PROJECT ADDRESS: ION ' �/ �( � 144/1 932 Ø4L,r ar7z4 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: ❑ LAND USE PROJECT#(SEPA,PRE-APP,SS, ETC.) IF APPLICABLE: 0 FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB#: JOB# DESCRIPTION OF SITE WORK/ RIGHT-OF-WAY,WORK FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: 0 FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON/CURB CUT FT WIDE /ASPHALT/CONCRETE PAVING 7DI✓h SF //❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ` s, 'r } a V$ ❑RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIG g ❑CLEARING/GRADING/FILL/EXCAVATE CY \„,1 PR 2 7 2018 ❑CUT/BORE IN PAVEMENT(PARALLEL) LF CITY r F EVER ETT ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF Permit a.. r l'"tll;rQ ,.,, o POLE WORK/AERIAL/OVERLASH LF ADDITIONAL DESCRIPTION(AS NEEDED): 17-q74/2 '1 0411 F tkf) 41,6 + Ko 52101--- erio (� ( s) cu i3O -- MA ( HU) 1 b1 Deikerk- CONTACT INFORMATION OWNER/APPLICANT NAME: (& 'f1 Cl,r-(S J'i✓( h� C4 I"�-� OWNER/APP. MAILING ADDRESS: STREET 11O1 l 09 ' ¶ CITY ��jj,, '�''�r✓��(/ STATE (Al ter— CONTRACTOR ZIP 1 g 1 OWNER/APP. PHONE: L12/C. (Z V g OWNER/APP. EMAIL: 1DA�� Ci -( �j , NAME: t �( �-�e ` 4 , 0 CONTRACTOR ADDRESS: STREET l� 5- I v CITY I 6-}+P i f /►STATEHet- ZIP ✓� (41 CONTRACTOR PHONE: vl L �, IF 'I ,fig CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): U Yk CA is'N C) EVERETT BUSINESS LICENSE#(REQUIRED): 34 32.ip PRIMARY CONTACT: 0 OWNER /APPLICANT %CONTRACTOR 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: �r CONTACT PHONE: p42 . I51 1 T t�I J �`��'�� CONTACT EMAIL: itJT[7Z i q Ct S ✓� �r 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# Q=2) PW i©0 -- Owner/Authorized Agent Signature Date (Revised 1/52017)