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Pu A: LIC WORKS PERMIT AZ— LICATION <br /> osinP_ <br /> lip CITY OF EVERETT PERMIT SERIFS <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 I(E)everetteps@everettwa.gov I https://everettwa,gov/permits <br /> PROJECT SITE INFORMATION <br /> . - <br /> PROJECT ADDRESS:3217 Hewitt Avenue, Everett,WA <br /> SITE WORK FOR PROJECT TYPE: OSFROETACHED CITOWNIIOUSE ODUPLEX DADU OMULTI-FAMILY OCOMMERCIAL 1,70,711KIDUST <br /> IF APPLICABLE: 0 LAND USE PROJECT#(SERA,PRE-APP,SS,ETC.)SEPA 418-013,Ecology SEPA*2°18°6828 <br /> IF APPLICABLE: 0 FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# <br /> UTILITY COMPANY'S NAME&JOB#: JOB# <br /> DESCRIPTION OF SITE WORK I RIGHT0F01111AY WORK <br /> FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: <br /> E..:FENCE IN ROW 0 FT IN HEIGHT <br /> Li DRIVEWAY APRON/CURB CUT 0 FT WIDE <br /> 0 ASPHALT/CONCRETE PAViNG 1950 SF <br /> 1E6711'i37f1VEF' <br /> 0 RETAINING WALL/ROCKERY IN RIGHT-OFANAY 0 LF LP <br /> 1:3 RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT 0 FT TOTAL H <br /> JAN 18 2 <br /> 0 CLEARING/GRADING/FILL/EXCAVATE 500 backfill excavation CY 019 <br /> 0 CUT/BORE IN PAVEMENT(PARALLEL) 0 LF CITY OF EVERETT <br /> Permit Servi,-; ,-2; <br /> o CUT/BORE IN PAVEMENT(NON-PARALLEL) 0 IF <br /> 10 POLE WORK/AERIAL I OVERLASH 0 LF <br /> ADDITIONAL DESCRIPTION(AS NEEDED): <br /> Remove Three 30,000-gallon USTs and backfill to existing grade.Repave with asphalt to match existing pavement, <br /> CONTACT INFORMATION <br /> OWNER/APPLICANT NAME:SC Fuels • <br /> OWNER/APP. MAILING ADDRESS: sneer 1800 W. Katella Avenue, Suite 400 ‘. <br /> CITY Orange STATE WA 2._p 92867 <br /> OWNER I APP.PHONE:714.516.7273 OWNER/APP.EMAIL:hdbrooltD@SCILIeIS.COM <br /> , - <br /> CONTRACTOR NAME:Wyser Construction Co, <br /> CONTRACTOR ADDRESS: STREET 19015 109th Avenue SE <br /> cay Snohomish STATE WA zp 98298 <br /> CONTRACTOR PHONE:425.742.0898 CONTRACTOR EMAIL:darren©vvyserdirI.Corn <br /> CONTRACTOR LICENSE#(REQUIRED):VVYSERCI035N9 EVERETT BUSINESS LICENSE#(REQUIRED): 34328 <br /> - - <br /> PRIMARY CONTACT: 0 OWNER /APPLICANT 0 CONTRACTOR VI OTHER(Architect.Engineer.Etc.) site Assessor <br /> CONTACT NAME: CONTACT PRONE:208.407.8926 <br /> Howard Small <br /> CONTACT EMAIL:hwSmallagstrienviro.corn <br /> ACKNOWLEDGEMENT.-I have reviewed this application and confirm the information contained herein is true and correct Work done pursuant to MIS permit must <br /> comety with current federal,state,and local law The granting of a permit only authorizes approved work andi70 deviations therefrom.Deviations must first be <br /> autrionzed in writing from the Building Official before being authonzed under any circumstance tam The owner or I am authorized by the owner of this property to <br /> ivrinfm theitork lot vittch application is made.and I comply with the State Contractors Law 1627 RCW and 29t3 200A WAC <br /> City of Everett Official Use Only <br /> PERMIT <br /> 1/11/2018 PW ozz <br /> Owner/Authorized Agent Signature Date (Revised 115/2017) 6-1 <br />