3020 GRAND AVE 2019-02-06 - Laserfiche WebLink

,�---� CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps©everettwagov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: _0 Z 0 — 6,--a ri7 d live IF APPLICABLE: 0 LAND USE PROJECT#(SEPA,PRE APP,SS, ETC.) SiTE WORK FOR PROJECT TYPE:, SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY El COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? ,IE(NO ❑YES, FROM TO - NEW WATER/SEWER SERVICE NEEDED? NO 0 YES,TYPE SiZE SITE WORK/ RIGHT-OF-WAY APPLICATION iNFORMATIOie1 - DESCRIPTION OF WORK: C©siS/`'c,(C/ 7Ze h G-c //7 �c./C`a, /P/4-74'0 kr/e y to p/-e774e c74- .::://-0 - 6774") 4j eA. Je h/xic/ 7 7c-e> ,FENCE IN ROW 42 /7 FT IN HEIGHT ❑ DRIVEWAY APRON/CURB CUT FT WIDE 0 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 L. ' CONTACT INFORINATION OWNER NAME: Te'( 77 / OWNER MAILING ADDRESS: STREET �/%d 26 225 Z f�C, s g/� CITY /✓o u41-10' 'l"Q Q 7 frc lsC/STATE K ZIP 9804-3 -3 OWNER PHONE: OWNER EMAiL: APPLICANT NAME:µT"XA i96? /!/� APPLICANT MAILING ADDRESS: STREET CITY STATE ZIP APPLICANT PHONE: 12 S- ?7J9__Z 4'/ U APPLICANT EMAIL: PRIMARY CONTACT: 0(OWNER" �❑APPLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: ...P/eve#7 l'ipcPja CONTACT EMAIL: ACKNOWLEDGEMENT:!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 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# 41/011116 , PW 17/(--04a v0,I Owner/Authorized Agent Signature Date (Revised 10/12/2015)