1732 COLBY AVE 2019-06-24 - Laserfiche WebLink

PLT WORKS PFRNLII Ai, .. _ 1 [0 IN CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov https://everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: SITE WORK FOR PROJECT TYPE: DSFR-DETACHED DTOWNHOUSE ❑DUPLEX DADU DMULTI-FAMILY DCOMMERCIAL ❑INDUSTRIAL • IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE-APP, SS, ETC.) IF APPLICABLE: ❑ FRANCHISE/UTILITY COMPANY,ANNUAL BLANKET PERMIT# UTILITY COMPANY'S NAME&JOB#: JOB# • DESCRIPTION OF SIT WORK! NT-OF- AY WORK FILL IN ALL QUANTITIES OF WORK BELOW,AS APPLICABLE: DRAINAGE MITIGATION QUESTIONS: ❑ FENCE IN ROW FT IN HEIGHT STORMWATER DISCHARGES TO: ❑ DRIVEWAY APRON/CURB CUT FT WIDE 0 Combined Sewer ❑ASPHALT/CONCRETE PAVING SF 0 Separated Storm Sewer ❑ RETAINING WALL/ROCKERY IN RIGHT-OF-WAY LF 0 Direct Discharge to Snohomish River or Puget Sound 0 RETAINING WALL/ROCKERY OVER 4FT IN HEIGHT . '-FT TOTAL HEIGHT TRIGGERED REQUIREMENTS: 0 CLEARING/GRADING/FILL/EXCAVATE / {P•y 0 MR2 Only ❑MR1-5 0 MR1-9 0 CUT/BORE IN PAVEMENT(PARALLEL) LF l� i QUANTITY OF PROPOSED HARD SURFACES: ❑ CUT/BORE IN PAVEMENT(NON-PARALLEL) LIAR ? Prvposecil Roof Area: SF 9 d ❑ POLE WORK/AERIAL/OVERLASH C/�` }L" 2019 Ffropp Hardscape: SF ADDITIONAL DESCRIPTION(AS NEEDED): P�3� f• �+^ Total New+Replaced: SF c—e3 CONTACT INFORMATION OWNER/APPLICANT NAME: nay OWNER/APP. MAILING ADDRESS: STREET I CIN /—Vrf" I- STATE j ZIP OWNER/APP. PHONE: 144 9 OWNER/APP. EMAIL: *Required for Work in Public Right-of-Way CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): EVERETT BUSINESS LICENSE#(REQUIRED): PRIMARY CONTACT: 0 OWNER /APPLICANT 0 CONTRACTOR 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: V�4tt-h.t„/ /' '1G/i CONTACT EMAIL: 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 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# 3/ 2 G �l PW 1905-063 Owner/Authorized Agent Signature Date (Revised 1/72019)