331 ALVERSON BLVD 2019-05-28 - Laserfiche WebLink

041677016ØJBLIC WORKS PERMITPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 3 3 1 A 1 U e/Y-ScArt I v SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX El MULTI-FAMILY ❑COMMERCIAL ❑INDUSTRIAL IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP,SS, ETC.) IF APPLICABLE: 0 FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB#: JOB# ' ' DESCRIPTION OF SITE WORK/ RIGHT-OF-WAY WORK FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: ❑FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON/CURB CUT FT WIDE .y ASPHALT/CONCRETE PAVING 197y 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 ❑POLE WORK/AERIAL/OVERLASH i LF q �,r ADDITIONAL DESCRIPTION(AS NEEDED): �� K�'QM5js` f u )C`..C,:�3'�° y ��r1 \\\•• ",. J V U ( CONTACT INFORMATION OWNER/APPLICANT NAME: 9 \f i‘lc--) Is Q--Q.sk 1, 1i017.46(MJ 062_ C70tv2,15-Lc; 7_ OWNER/APP. MAILING ADDRESS: STREET 33( A \ J L �sQ YV \7 I CITY v --.. i- STATE w a ZIPi OWNER/APP.PHONE: 3++��6 0-c/Z l -?-q9 71OWNER/APP.EMAIL: v/i�\ �er,A0A• c)e2 e 1,moo,C `-ZIJ ' CONTRACTOR NAME: V--- "L- CONTRACTOR ADDRESS: STREET t. CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#('REQUIRED): PRIMARY CONTACT: OWNER /APPLICANT 0 CONTRACTOR 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: 5 Q - 9 Z` ^ ti '3. po.tl\ ‘A-e ryNovj 'est__ CONTACT EMAIL: (� U\3 I t e_(V C.)ez pAi ,1,e_ca',-, ACKNOWLEDGEMENT:1 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 t -Building Official before being authorized under any circumstance.I am the owner,or 1 am 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# 4I --- 1 --- [ 1 PW goo l - 0Co2 Owner/Authorized Agent ignature Date (Revised 1/52017)