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PLIC WORKS PERMIT i&PLICATION <br /> 1277- CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 303 Skyline Dr. Everett, WA <br /> IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) <br /> SITE WORK FOR PROJECT TYPE:IRSFR-DETACHED ❑SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL <br /> CHANGE OF USE? 0 NO ❑YES, FROM TO <br /> NEW WATER/SEWER SERVICE NEEDED? ®NO 0 YES,TYPE SIZE <br /> SITE WORK`I RIGHT-OF-WAY APPLICATION INFORMATION <br /> DESCRIPTION OF WORK: Expand and replace existing driveway (36" x 20') and install <br /> sod or landscape rock (36' x 8'). <br /> o FENCE IN ROW FT IN HEIGHT <br /> 0 DRIVEWAY APRON/CURB CUT FT WIDE <br /> p ASPHALT/CONCRETE PAVING 720 SF <br /> ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF <br /> ❑ RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT FT TOTAL HEIGHT <br /> 0 CLEARING/GRADING/FILL/EXCAVATE 12.44 CY <br /> 0 CUT/BORE IN PAVEMENT(PARALLEL) LF <br /> ❑CUT/BORE IN PAVEMENT(NON-PARALLEL) LF <br /> CONTACT,INFORMATION <br /> OWNER NAME: Jane & Steve McKenzie <br /> OWNER MAILING ADDRESS: STREET 303 Skyline Dr. <br /> CITY EVerett STATE v v`/�, <br /> A Zip 98201 <br /> OWNER PHONE: 360-794-5060 (OWNER EMAIL:stevemac805@gmail.com <br /> APPLICANT NAME: Same as above <br /> APPLICANT MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> APPLICANT PHONE: (APPLICANT EMAIL: <br /> PRIMARY CONTACT: p OWNER 0 APPLICANT 0 OTHER(Architect,Engineer, Etc.) <br /> CONTACT NAME: CONTACT PHONE: 360-794-5060 <br /> Steve McKenzie CONTACT EMAIL:stevemac8O5@gmail.com <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. I am the owner,or I am authorized by the owner of this property to <br /> perform the work for which applica ion 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 /> _ 5 / PW 1.309 --01--1 <br /> • uthorized Ag> t ignature Date (Revised 9/23/2016) <br />