2401 CEDAR ST 2019-01-25 - Laserfiche WebLink

PLILILIC WORKS PERMIT I PLICATION Or— 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 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: C9140 ( C-edav e\}e'eM' , W , �� a o IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE APP,SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX MULTI-FAMILY ❑COMMERCIAL ID INDUSTRIAL CHANGE OF USE? 0 NO 0 YES, FROM TO NEW WATER/SEWER SERVICE NEEDED? 0 NO 0 YES,TYPE SIZE SITE WORK/ RIGHT-OF-WAY APPLICATIONINFORMATION DESCRIPTION OF WORK: FENCE IN ROW (.Q FT IN HEIGHT ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑ASPHALT/CONCRETE PAVING SF ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT ❑ CLEARING/GRADING/FILL/EXCAVATE CY ❑ CUT/BORE IN PAVEMENT(PARALLEL) LF ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT INFORMATION OWNER NAME: \\C tikv't cs of 61; OWNER MAILING ADDRESS: STREET p9 401 Cedes►v , I( CITY ��V�N - STATE C_P `' ZIP V�G OWNER PHONI3:LraS-T-I$S'" '6,;79'*6OWNER EMAIL V\ i CN l �,p�Oc Uh YYlo1I I cot-y) • Mw APPLICANT NAME: NN(Y�Q• APPLICANT MAILING ADDRESS: STREET CITY STATE ZIP APPLICANT PHONE: APPLICANT EMAIL: PRIMARY CONTACT: yKOWNER 0 APPLICANT 0 OTHER(Architect,srEngineer, Etc.) ��/ CONTACT NAME: r 'U` t'('�'Cl�L''E`(UCn CONTACT PHONEl'A ,) '1S- $e>cig /f Wa-5) 3cS -DUO v'( ' -t CONTACT EMAIL: 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.lam the owner,or l 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# ig Pw/ g • ner/Aut :^zZ Agent Signature Date (Revised 10/12/2015)