1920 GRAND AVE 2019-06-03 - Laserfiche WebLink

PLIC WORKS PERMIT A - LICATION grr 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 1 https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1920 Grand Ave, Everett, WA 98201 SITE WORK FOR PROJECT TYPE: ❑SFR-DETACHED GZSFR-ATTACHED ❑DUPLEX ❑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 ❑ASPHALT/CONCRETE PAVING SF ❑RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT 26'Long Wall/12'Ret.Ht 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 LF ADDITIONAL DESCRIPTION(AS NEEDED): EXIST 5.IL is Si•k&N"4 EIIISr OVA li rE REfA1001A16- WATT sWPggrEv DEEP C•NCQErt PI6IL `+uWORtI"N!• RETrIINW6 v'$t- SWPftWts ^A) Florti Jb- C°AJCREtE DRivEwigy. A NEW 59tDltrt PILE WAIL u/ItHF TIE$*CKS Wait 96 /NSt*uEp tY St101L!ZE tHE 51•PE CONTACT INFORMATION OWNER/APPLICANT NAME: Stephen Tabert (Applicant) OWNER/APP. MAILING ADDRESS: STREET 250 4th Ave South,Suite 200 CITY Edmonds STATE WA ZIP 98020 OWNER/APP.PHONE: 425.778.8500 OWNER/APP.EMAIL: stephent@cgengineering.com CONTRACTOR NAME: Not hired yet CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER /APPLICANT 0 CONTRACTOR gl OTHER(Architect, Engineer, Etc.) Engineer CONTACT NAME: CONTACT PHONE: 425.778.8500 Stephen Tabert, PE CONTACT EMAIL: stephent@cgengineering.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.lam 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# C/ - ; V/30 a PW l sog-o7a Owner/Authorized Agent Signature Date (Revised 1/52017)