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IX rcruvii I ArrLltim 1 iim <br /> BUILDII— MECHANICAL/PLUMBING /SIC_PRINKLER/DEMOLITION <br /> .ERETT- CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX425.257-8857 I(E)everetteps©everettwa.gov I www.everettwa,gov/permits <br /> (Blue or Mack Ink n'Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:8022 Beverly Ln, Everett, WA 98203 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Khue Nguyen TENANT_BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET$022 Beverly Ln <br /> ........:.. <br /> cry Everett _ . <br /> TM WA ZIP 98203 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME.Northwest Electric and Solar <br /> 'CONTRACTOR ADDRESS: STREET18001 73rd Ave NE <br /> crry Kenmore sTnT WA_ P 98028 <br /> CONTRACTOR PHONE:2063560601 CONTRACTOR EMAIL:nwesdhubler@gmail.COM <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE:#(REQUIRED);- <br /> PRIMARY CONTACT: ❑OWNER CI CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:4802862079 <br /> Drew Hubler ,CONTACT EMAIL:nweSdhubiera gmail.com <br /> BUILDING INFORMATION <br /> ExistingUse of Buildin :Residence Contract?Prlee of Work:$10 000 <br /> Proposed Use of::Building:Residence :Heat Source:,,, OGas . DElectric OOther <br /> BUILDING USE: OSFR ❑Townhouse _DDuplex ❑ADU ❑Multi-Family-#Units: OCommercial C�Accessory Structure <br /> Type of Project ENew . ❑✓Addition ❑Remodel ❑Repair OT.I. DStgn. OSprinkler IDDemolition DChange of Use <br /> DESCRIPTION OF WORK: <br /> 12.24 kW DC solar install and(2) 13.5 kWh Tesla Pawerwail Batteries <br /> ASSOCIATED Bt8LDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION,;. <br /> Fixture <br /> Fixture <br /> List of FixturesFixture Fixture"` <br /> Count Count List of Fixtures Count ! List of Fixtures Count List of Fixtures <br /> NC—Air Handling Units Gas Piping. Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas RangeSink-Commercial Clothes:Washer rci <br /> al(3-comp,prep,floor) <br /> Clothes Dryer ry , Heat Pump&Ductless _Dishwasher Sink-Residential(kitchen,bath,bar).,,, <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatior- Floor Drain Toilet <br /> Exhaust Hood(Type I) Not Heat/AC system V Hose Bibb Urinal. <br /> Exhaust Hood(T <br /> ype ype!1) Water Heater Interceptor Grease Vltaste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove T Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other Medical Gas Water Valves or Fixtures <br /> P g Roof Drains Water Heater <br /> Gas Fir <br /> e IaceilnsertiLo <br /> Water SSPRIIsNKL 9 <br /> ER I SUPPRESSION SYSTEM Sewage or Sump Pump Other upStem <br /> I No:of Heads <br /> pP y <br /> Chemical Suppression System' No,of Heads , <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must compty 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,lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 ROW and 296.200A WAC; <br /> City of Everett Official Use Only <br /> FERMI <br /> q77/2_a IcW.jc)601 e 622 <br /> Owner/Authorized:Mont.Signature Date (te isett fWfORO8} <br />