1329 MADRONA AVE 2019-02-11 - Laserfiche WebLink

P ON SLI 3200CEDAR I A 98201 LIQ I CITY OF EVERETT PERMIT SERVICES STREET, EVERETT (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 139_9 I \ta-1>R 0 j h ,ewe. IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED El DUPLEX ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? 0 NO 0 YES, FROM TO - NEW WATER/SEWER SERVICE NEEDED? ,'NO 0 YES,TYPE SIZE SITE WORK'/ RIGHT-OF-WAY APPLICATION INFORMATION DESCRIPTION OF WORK: PROV 1 df e-0'14 S"+.J)U,CI! D—i^ jak4 ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON/CURB CUT FT WIDE /fg00 sf ❑ASPHALT/CONCRETE PAVING SF ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF Cot'n'CA. , 'J p.A ❑ 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: `4 /P1--/J o ii l C2 T) OWNER MAILING ADDRESS: STREET Z tiZ � S'f- && ) ' CITY Eve gte t STATE j4. zi 9no3 OWNER PHONE: 4 q-o 7 OWNER EMAIL APPLICANT NAME: APPLICANT MAILING ADDRESS: STREET CITY STATE ZIP APPLICANT PHONE: APPLICANT EMAIL: PRIMARY CONTACT: gOWNER 0 APPLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: Ctb^) _ 00 JA-A.Jocu r C ' 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.I am the owner,or I am authorized by the owner of this property to perform the work for which applicati7 is made,and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 173 Owner/Authorized Agent ignature Date (Revised 10/12/2015)