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OIL P■ LIC WORKS PERMIT 4PLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECTSITE INFORMATION <br /> PROJECT ADDRESS:3228 NORTON AVE <br /> IF APPLICABLE: O LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.) <br /> SITE WORK FOR PROJECT TYPE: CD SFR-DETACHED =SFR-ATTACHED VDUPLEX `114MULTI-FAMILY =COMMERCIAL <br /> CHANGE OF USE? C, I NO I YES, FROM TO <br /> NEW WATER/SEWER SERVICE NEEDED? = NO = YES,TYPE SIZE <br /> SITE WORK/ RIGHT OF-WAY APPLICATION INFORMATION <br /> DESCRIPTION OF WORK: SITE WORK AT 3228 A&B C&D, 3230, 3232 NORTON <br /> hc�.9�c <br /> o\t-ut.19 - r7.—S pM <br /> U <br /> = FENCE IN ROW FT IN HEIGHT <br /> O DRIVEWAY APRON/CURB CUT FT WIDE <br /> t4ASPHALT/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 /> O CUT/BORE IN PAVEMENT(PARALLEL) LF <br /> O CUT/BORE IN PAVEMENT(NON-PARALLEL) LF <br /> CONTACTINFORMATION <br /> OWNER NAME: HOUSING HOPE-NORTON AVE <br /> OWNER MAILING ADDRESS: STREET 5830 EVERGREEN WAY <br /> cm' EVERETT STATE WA ZIP 98203 <br /> OWNER PHONE: (OWNER EMAIL: <br /> APPLICANT NAME: HOUSING HOPE <br /> APPLICANT MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> APPLICANT PHONE: 'APPLICANT EMAIL: <br /> PRIMARY CONTACT: = OWNER = APPLICANT O OTHER(Architect, Engineer, Etc.) <br /> CONTACT NAME: BULLOCK TODD CONTACT PHONE:4253476556 <br /> CONTACT EMAIL: TODDBULLOCK@HOUSINGHOPE,ORG <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.I am the owner,or I am authorized by the owner of this property to <br /> perform the work f r which appliction is made,and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> i (ts�oL� City of Everett Official Use Only <br /> !! �� PERMIT# <br /> PW1607-012 <br /> Authorized Agent/Owner Date (Revised 10/12/2015) <br />