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PERMIT APPLICATION <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br /> !� CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 10307 1ST DR SE, EVERETT, WA 98208 PROPERTY TAX#:00396900001500 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: ANDREA M BERUTTI TENANT NAME (If Commercial): <br /> OWNER MAILING ADDRESS: STREET 10307 1ST DR SE <br /> crn EVERETT STATE WA ZIP 98208 <br /> OWNER PHONE:847.852.6786 OWNER EMAIL:drea_13@hotmail.com <br /> CONTRACTOR NAME:SMART ENERGY TODAY <br /> CONTRACTOR ADDRESS: STREET2500 MOTTMAN ROAD SW <br /> CITY TUMWATER STATE WA zip 98512 <br /> CONTRACTOR PHONE:360.637.4343 CONTRACTOR EMAIL:LEX.K@SMARTENERGYTODAY.NET <br /> CONTRACTOR LICENSE#(REQUIRED):SMARTET869RJ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 052463 <br /> PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:360.637.4343 <br /> LEX KING CONTACT EMAIL:LEX.K@SMARTENERGYTODAY.NET <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building:SFR Contract Price of Work: $15668 <br /> Proposed Use of Building:SFR Heat Source: ❑Gas EElectric DOther <br /> Building Type: ®SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: DCommercial ❑Industrial <br /> Type of Project: ❑New DAddition ❑Remodel DRepair ❑T.I. ❑Sign DSprinkler EDemolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> ROOFTOP PV. 12 AXITEC AC-310MH/120S MODULES. 1 SOLAREDGE SE3800H-US INVERTER. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /> Fixtures List of Fixtures Fixtures List of Fixtures #of List of Fixtures #of List of Fixtures <br /> Fixtures Fixtures <br /> A/C—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace _Wood Stove Kitchen Sink & Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups 'Other: Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink (Service/Bar/Mop/etc.) Other: <br /> SPRINKLER / SUPPRESSION SYSTEM <br /> Chemical or Water J No. of Heads <br /> ACKNOWLEDGEMENT:l have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br /> 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 <br /> 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 which application is made, <br /> and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PE T <br /> 11/21/2019 <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />