2317 MAPLE ST 2019-02-11 - Laserfiche WebLink

PLIMIC WORKS PERMIT LI I N CITY OF EVERETT PERMIT SERVICES Noal 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 0Y1� _ PROJECT ADDRESS: � �� IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED CI DUPLEX El MULTI-FAMILY ❑COMMERCIAL DINDUSTRIAL CHANGE OF USE? ❑ NO 0 YES, FROM TO NEW WATER/SEWER SERVICE NEEDED? 0 NO 0 YES,TYPE SIZE SITE WORK/ RIGHT-OF-WAY APPLICATION INFORMATION DESCRIPTION OF WORK: ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON/CURB CUT FT WIDE %ASPHALT/CONCRETE PAVING rN/ 100C) 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 . ess- diysa CONTACT t INFORMATION OWNER NAME:) A \ T 67_� c J�v'J �f�a 1-1- -f 3&Vl►'r C.9 I po( 4116te OWNER MAILING ADDRESS: STREET XOf 69 Cn VI h ),dite 5 t I)c:4 )) CITY MG{ rI U ll� STATE I/0 714 ZIP 9gd.7 E OWNER PHONE:�)S ' 7 5 OWNER EMAIL: V APPLICANT NAME: Oryl Afe_ /'KO 71. 74Y�C/, �° APPLICANT MAILING ADDRESS: STREET 9,'j / 7 ,- ,1p 6 c�� CITY ��/,,4p, STATE ha ZIP ?p�yy��,e/ /J APPLICANT PHONE: 2O ! 3,5'0 APPLICANT EMAIL. PRIMARY CONTACT: ❑ OWNER 0 APPLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: 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 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# 7:24' -707S) Owner/Authorized Agent Sig l+'" Date (Revised 10/12/2015)