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PUBLIC WORKS PERMIT APPLICATION <br /> 47.7. <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 3802 Broadway, Everett, WA 98201 <br /> IF APPLICABLE: 0 LAND USE PROJECT#(SEPA,PRE-APP,SS,ETC.) <br /> SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY OCOMMERCIAL DINDUSTRIAL <br /> CHANGE OF USE? 0 NO 0 YES, FROM TO <br /> NEW WATER/SEWER SERVICE NEEDED? 0 NO 0 YES,TYPE SIZE <br /> SITE WORK/ RIGHT-OF-WAY APPLICATION INFORMATION <br /> DESCRIPTION OF WORK: Convert existing under-drained grass athletic field to synthetic turf <br /> o FENCE IN ROW FT IN HEIGHT <br /> ❑DRIVEWAY APRON/CURB CUT FT WIDE <br /> ❑ASPHALT/CONCRETE PAVING SF t <br /> ❑RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF w..� tt""r <br /> ' <br /> ❑RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIG 3 AUGg 2017 I) <br /> CLEARING/GRADING/FILL/EXCAVATE 6,500 CY CITY OF <br /> o CUT/BORE IN PAVEMENT(PARALLEL) LF PermitServicesr <br /> o CUT/BORE IN PAVEMENT(NON-PARALLEL) LF <br /> CONTACT INFORMATION <br /> OWNER NAME: Everett School District, Steven Krause <br /> OWNER MAILING ADDRESS: STREET 3900 Broadway <br /> ciT' Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 425-3854196 OWNER EMAIL: skrause@everettsd.org <br /> APPLICANT NAME: DA Hogan &Associates, Inc., Eric Gold <br /> APPLICANT MAILING ADDRESS: STREET 119 First Ave. S., Suite 110 <br /> CITY Seattle STATE WA ZIP 98104 <br /> APPLICANT PHONE: APPLICANT EMAIL: <br /> PRIMARY CONTACT: 0 OWNER , I APPLICANT 0 OTHER(Architect,Engineer, Etc.) <br /> CONTACT NAME: CONTACT PHONE: 206-285-0400 <br /> Eric Gold CONTACT EMAIL: ericg@dahogan.com <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 1 am authorized by the owner of this property to <br /> perform the work for which application is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> PW 19-0g-OLIO <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />