812 35TH ST 2019-08-08 - Laserfiche WebLink

PUULIC WORKS PERMIT LICATION r#74rriCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: &'L 357 5 J k l/brie G./h IF APPLICABLE: 0 LAND USE PROJECT#(SEPA, PRE APP,SS, ETC.) SITE WORK FOR PROJECT TYPE:❑SFR-DETACHED SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY El COMMERCIAL 0 INDUSTRIAL CHANGE OF USE? 0 NO 0 YES, FROM TO - • NEW WATER I SEWER SERVICE NEEDED? XNO 0 YES,TYPE SIZE SITE WORK I RIGHT-OF-WAY APPLICATION INFORMATION n DESCRIPTION OF WORK: 4 61-/7 �L G'�'7Z/Ab OF' yi1 , oma/ //NV T etc K Ls oolL /1/4' 6Aevit/D D/sTv,Cgir/vGet- Zreo Pr7site-"/ ev7 G€#t 9hr W No 57-'A1i0 %/f7S 77,v14- 0 FENCE IN ROW FT IN HEIGHT ❑ DRIVEWAY APRON/CURB CUT FT WIDE 0 ASPHALT/CONCRETE PAVING SF ❑ RETAINING WALL I 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 CONTACTINFORMATION OWNER NAME: .706 67,2/GA<G4v0 OWNER MAILING ADDRESS: STREET /do 3O/J6 )( // CITY ��/�-d‘ STATE tile) ZIP 7 9Z 7 Z. OWNER PHONE: yZ S- 33O ' 0 2-70 OWNER EMAIL: 1—SrR C,a24-/✓1�8y 0 6Aii /L APPLICANT NAME: 5x711 APPLICANT MAILING ADDRESS: STREET CITY STATE ZIP APPLICANT PHONE: APPLICANT EMAIL: PRIMARY CONTACT: SWNER 0 APPLICANT 0 OTHER(Architect, Engineer, Etc.) CONTACT NAME: CONTACT PHONE: CFO/ 57,e/G/G/tAiD CONTACT EMAIL: 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 -+e,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# PW 19)3(0-6 I Owner/Authorize•Igent Signature Date (Revised 10/12/2015)