4205 RIDGEMONT DR 2019-01-28 - Laserfiche WebLink

LIC WORKS PERIlfillPLICATION 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 I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: /2/J5 2l e, Eve c,-t/> LA lj� 98 zo.s IF APPLICABLE: ❑ LAND USE PROJECte,ykur,,--f---nr;t, SEPA, PRE-APP, SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX 0 MULTI-FAMILY ❑COMMERCIAL 0 INDUSTRIAL CHANGE OF USE? f21 NO ❑YES, FROM TO NEW WATER I SEWER SERVICE NEEDED? X.I NO 0 YES,TYPE - SIZE SITE WORK RIGHT OF-WAYAPPLICATION INFORMATION, DESCRIPTION OF WORK: ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑ASPHALT/CONCRETE PAVING SF Ni RETAINING WALL/ROCKERY IN RIGHT-OF-WAY RCS LF (3</"k. jk) 0 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: Linn ti r.,c /0 r N. 1-42-/"74-4-- OWNER — W?4 4OWNER MAILING ADDRESS: STREET4Ye2Oi5 7/Cl �vvLrr�* 'Dy v e_ /� CITY L-.. vex� V V6..)/.7/ STATE ZIP /CJ 00,3 OWNER PHONE: 'x/22=2S8-300 S1 OWNER EMAIL: C.CJl2rf�- q®t C.iU cccl. co w� ....,.,.w..,_.�... ...,,_,../ ..M. ,.,..,,..Wk ..�,..,. �. APPLICANT NAME: L<ln.� �0 yk`3 ///c2A'ie-t APPLICANT MAILING ADDRESS: STREET "1/20,..5". 7_4: Pim a ►1,`t- Y 1 ye...- ^� CITY 5�e Y e....-ti- / STATE /,,()A- ZIP P�j eaJ APPLICANT PHONE:-1✓%�S` 2S8— Yeo V APPLICANT EMAIL: AlGv ay. 1--Pir o /CiG t4. C-0 - PRIMARY CONTACT: LId OWNER 0 APPLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: YZs--_ — 5i00 CV -3i 1 L cvy-7'Le-Y CONTACT EMAIL: r�/0).1-e ./CIO/4J,C •- 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 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# (11 )L>Z)?.-2,____„)1,kje....kft6 ba Pw 1806—o2s, Owner/Authorized Agent Signature Date (Revised 10/12/2015)