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PI LIC WORKS PERMIT AfrLICATION <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 /> i <br /> N ttr;v:ZZ <br /> .o.s 3 _......... " .._.�.:.'.w __.......: .µns;':,:... .,.'�\.,.N., v _� .8rae•:Fsa ..ti.. s `�.n\` ,u'z`«(�61/'/ - <br /> PROJECT ADDRESS:5412 LOWELL RD <br /> IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.) <br /> SITE WORK FOR PROJECT TYPE: OSFR-DETACHED =SFR-ATTACHED O DUPLEX ED MULTI-FAMILY =COMMERCIAL <br /> CHANGE OF USE? El NO O YES, FROM TO <br /> NEW WATER/SEWER SERVICE NEEDED? 0 NO O YES,TYPE SIZE <br /> AO, ismytitte <br /> DESCRIPTION OF WORK: NEW SFR <br /> E FENCE IN ROW FT IN HEIGHT <br /> L DRIVEWAY APRON/CURB CUT FT WIDE <br /> =ASPHALT/CONCRETE PAVING SF <br /> 0 RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF <br /> CI RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT <br /> O CLEARING/GRADING/FILL/EXCAVATE CY <br /> 0 CUT/BORE IN PAVEMENT(PARALLEL) LF <br /> El CUT/BORE IN PAVEMENT(NON-PARALLEL) LF <br /> 9 <br /> OWNER NAME: BALTIC HOMES LLC <br /> OWNER MAILING ADDRESS: STREET 6041 CHAMPIONSHIP CI <br /> cnv MUKILTEO STATE WA ZIP 98275-5031 <br /> OWNER PHONE:2062407329 'OWNER EMAIL: RICHARDVAISVILA@COMCAST.NET <br /> :M: .max_\.,Y�S �,a,. ,�•.jV.,,.s J- '..�+:,s'%.NVw „ z,�\:' w'<v.$as:maa�U�',vv. ;Ni,�i�rc' A. ..awaa•:-: <br /> APPLICANT NAME: BALTIC HOMES LLC <br /> APPLICANT MAILING ADDRESS: STREET 6041 CHAMPIONSHIP CI <br /> crry MUKILTEO STATE WA ZIP 98275-5031 <br /> APPLICANT PHONE: APPLICANT EMAIL: <br /> PRIMARY CONTACT: 0 OWNER El APPLICANT O OTHER(Architect, Engineer, Etc.) <br /> CONTACT NAME:SHADYRYA YADOV CONTACT PHONE:2062407329 <br /> CONTACT EMAIL: <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 for which application is made,and/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> PW1703-034 <br /> Authorized Agent/Owner Date (Revised 10/12/2015) <br />