2611 HOYT AVE 2019-03-27 - Laserfiche WebLink

PIJLLIC WORKS PERMIT LI ATS N 1.11111P/%110,--A— CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION-' PROJECT ADDRESS: 261) Chi IF APPLICABLE: 0 LAND USE PRO ECT#(SEPA,PRE-APP, SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED igSFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY ID COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? NO 0 YES, FROM TO NEW WATER/SEWER SERVICE NEEDED? kr NO 0 YES,TYPE SIZE SITE WORK l RIGHT OF-WAY APPLICATION INFORMATION , DESCRIPTION OF WORK: ce .• U114i'i Cr GL.e-ictL+ek4.1 V et 0-4" • ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON/CURB CUT FT WIDE ❑ASPHALT/CONCRETE PAVING SF ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF ❑RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT ❑CLEARING I GRADING/FILL/EXCAVATE CY ❑CUT/BORE IN PAVEMENT(PARALLEL) LF ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF CONTACT INFORMATION OWNER NAME: c 4. 1L(n► )--IL.--- OWNER MAILING ADDR SS: STREET 1 p o. oo, 2 3941 CITY ioLoi:4,. STATE IAA- ZIP 9 '2o( 6 OWNER PHONE �Zj 32Q OWNER EMAIL. ('jlyeu,15 rs ip `ai CU ► Gc APPLICANT NAME: 0 j 1- 4,- '1C7 APPLICANT MAILING ADDRESS: STREET $a 4't-t.. as aLci ' CITY STATE ZIP APPLICANT PHONE: 014421 APPLICANT EMAIL: Saw 4- ° V„µ PRIMARY CONTACT: KOWNER 0 APPLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: -414,,,Q-- 011f‘LA LeAw./ C CONTACT EMAIL: 50,-A--- 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 lam authorized by the owner of this property to perform the work for whic -pplication is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. / City of Everett Official Use Only PERMIT# PW t$03-03g Owner/Auth• ized Agent Signature Date (Revised 10/12/2015)