4110 CLIFF DR 2022-01-26 - Laserfiche WebLink

PUBLIC WORKS 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 SITE: WORK /RIGHT OF WAY APPLICATION INFORMATION _............. _............. . DESCRIPTION OF WORK: 2 LOT SHORT PLAT WITH EX. SFR TO REMAIN ON LOT 2 NEW DRIVEWAY AND UTILITY SERVICES TO SERVE NEW SFR ❑ FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON / CURB CUT FT WIDE ❑ ASPHALT / CONCRETE PAVING 400 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) 22. LF APPLICANT NAME: WAYNE SMITH APPLICANT MAILING ADDRESS: STREET P.O. BOX 5015 ciTv EVERETT STATE WA zip 98203 APPLICANT PHONE: 425.252.1884 JAPPLICANT EMAIL: PRIMARY CONTACT: ❑ OWNER ❑ APPLICANT OTHER (Architect, Engineer, Etc.) OMEGA ENGINEERING, INC CONTACT NAME: CONTACT PHONE: 425,903.4852 JOSEPH .SMEBY CONTACT EMAIL: joe@omega-eng.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 Adoe wner/Authorize Agen Ignature Date (Revised 912312016)