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-. P1. IC WORKS PERMIT AlipLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT ADDRESS:3217 HEWITT AVE <br /> IF APPLICABLE: c LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) <br /> SITE WORK FOR PROJECT TYPE: OSFR-DETACHED O SFR-ATTACHED O DUPLEX O MULTI-FAMILY O COMMERCIAL <br /> CHANGE OF USE? O NO El YES, FROM TO <br /> NEW WATER/SEWER SERVICE NEEDED? o NO o YES,TYPE SIZE <br /> ., o <br /> DESCRIPTION OF WORK: Monitoring Wells in Sidewalk- Drill and install 4 groundwater monitoring wells in sidewalk <br /> O FENCE IN ROW FT IN HEIGHT <br /> o DRIVEWAY APRON/CURB CUT FT WIDE <br /> (ASPHALT/CONCRETE PAVING SF <br /> 0 RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF <br /> I= RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT <br /> 0 CLEARING/GRADING/FILL/EXCAVATE CY <br /> I= CUT/BORE IN PAVEMENT(PARALLEL) LF <br /> El CUT/BORE IN PAVEMENT(NON-PARALLEL) LF <br /> OWNER NAME: SC Fuels <br /> OWNER MAILING ADDRESS: STREET 1800 W. Katella Avenue,Ste.400 <br /> crry Orange STATE CA ZIP 92867 <br /> OWNER PHONE:7148737570 !OWNER EMAIL: holbrookd@scfuels.com <br /> APPLICANT NAME: Howard Small <br /> APPLICANT MAILING ADDRESS: STREET 2407 Solar Loop Road <br /> cfTY Chewelah STATE WA ZIP 99109 <br /> APPLICANT PHONE: 2084078926 JAPPLICANT EMAIL: hwsmall@gsmenviro.com <br /> PRIMARY CONTACT: El OWNER El APPLICANT O OTHER(Architect, Engineer, Etc.) <br /> CONTACT NAME: [ContactName] CONTACT PHONE: [ContactPhone] <br /> CONTACT EMAIL: [ContactEmail] <br /> ACKNOWLEDGEMENT.I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must <br /> 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 <br /> authorized in writing from the Building Official before being authorized under any circumstance. 1 am the owner,or I am authorized by the owner of this property to <br /> perform the work for which application is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> PW1802-010 <br /> Authorized Agent/Owner Date (Revised 10/12/2015) <br />