2810 FOREST VIEW DR 2019-02-06 - Laserfiche WebLink

P -LIC WORKS PERMIT = PLICATION '00 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.everettwagov/permits PROJECT SITE INFORMATION' PROJECT ADDRESS: L. $j p Fore_rt✓%e-vv .Pr/ re__ E ue4c1' ; L44.9-"-- 9 Z 03 IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED ['DUPLEX 0 MULTI-FAMILY ❑COMMERCIAL ['INDUSTRIAL CHANGE OF USE? ❑ NO ❑YES, FROM TO - NEW WATER 1 SEWER SERVICE NEEDED? 0 NO 0 YES,TYPE SIZE SITE WORK/ RIGHT-OF-WAY APPLICATION INFORMATION DESCRIPTION OF WORK: (A ets 6ileel7L a/) dO[Nh-t"/)c-t 7"dreincz9yo 7` crRIA//.r',oc c.e d v GC rl a glz_ '^'//9 w Mr ti Oi i'11 74-0 ex i s('',9 c%7(j. �G fiC 1-7 4 arm r7 , i/- ❑ FENCE IN ROW FT IN HEIGHT IS3 DRIVEWAY APRON/CURB CUT FT WIDE ❑ASPHALT/CONCRETE PAVING SF i 7s 1 '''i.\ 0 RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ,e1 i 1 1 El RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGH is ❑CLEARING/GRADING/FILL/EXCAVATE CYCifY ill, y O F FVFRFTT ❑ CUT/BORE IN PAVEMENT(PARALLEL) LFF-7ierrnit ar. o CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT INFORMATION OWNER NAME: Erika /2.0 i'v)iP9 e4- OWNERMAILINGADDRESS: STREET 2 at 0 /�0r,eJ'¢ Y7'-fAA/ dv+/v2- '^� Q cIN Cr v'e- .Q —/ STATE V tC `— ZIP / 82--03 OWNER PHONE: 64/16 - 3 9/ -56 ZZ f OWNER EMAIL: e- tw ta IA OPli. n 9e..y.-- e y g (.1 .c n fyi M4Q (vtN APPLICANT NAME: /9"// _epri'ov1J` t/✓R'tP�prva('�'ni, ani tJ' rat''hek ), inC. CC /O 4/vgv• 2> APPLICANT MAILING ADDRESS: STREET /76/6 'H/ /5 'e. J J i-,' /0 6 �3 Q p CITY 6 0 e-' STATE ZIP % C!o/Z APPLICANT PHONE: `/25 " 2 0 8 - 7 9 9/ APPLICANT EMAIL: 471c0 Qa//1'e A-f'ov7J' 10-/erPr,o oP7'htom-,, , CoGo -, PRIMARY CONTACT: ❑ OWNER XAPPLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: '1 2.---6" - 7?7 _ / ©,'F A 4-e./v i h /9-1 v c r-e. '' CONTACT EMAIL: ,>m o e Q(/JeRrroi't.f'W 4 f-e-4.--,Yo 0f'✓'!'1 J , Go[.y-1 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.I am the owner,or I am authorized by the owner of this property to perform the work for which application is made,and!comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# P1! tet2-3-- - oz(-/ Owner/Authorized Agent Signature Date (Revised 10/12/2015)