905 WETMORE AVE BASE FILE 2019-11-27

s � Use 4,77, Aatostseeirowets PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 905 WETMORE AVE IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY I-GICOMMERCIAL El INDUSTRIAL CHANGE OF USE? 0 NO 0 YES, FROM TO NEW WATER/SEWER SERVICE NEEDED? 0 NO 0 YES,TYPE SIZE SITE WORK-/ RIGHT OF-WAtAPPLICATION INFORMATION DESCRIPTION OF WORK: APS TO POTHOLE EXISTING UNDERGROUND UTILITIES TO DETERMINE DEPTH AND LOCATION FOR DESIGN PURPOSES o FENCE IN ROW FT IN HEIGHT ❑DRIVEWAY APRON/CURB CUT FT WIDE ❑ASPHALT I CONCRETE PAVING 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 CONTACT INFORMATION OWNER NAME: CITY OF EVERETT OWNER MAILING ADDRESS: STREET 3200 CEDAR ST ary EVERETT STATE WA ZIP 98201 OWNER PHONE: 425-257-8810 OWNER EMAIL: EVERETTPS@EVERETTWA.GOV APPLICANT NAME: APPLIED PROFESSIONAL SERVICES APPLICANT MAILING ADDRESS: STREET 43530 SE NORTH BEND WAY CITY' NORTH BEND STATE WA ZIP 98045 APPLICANT PHONE:425-888-2554 APPLICANT EMAIL: JOHNG@APSLOCATES.COM PRIMARY CONTACT: 0 OWNER pi APPLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: 425-864-5547 JOHN GARDIN CONTACT EMAIL: JOHNG@APSLOCATES.COM 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 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# PW 130- O53 '7/Z 61/. IPW Owner/Authorized Agent Signature Date (Revised 9/23/2016)