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El <br />• PERMIT APPLICATIOV <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 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I wvvw.everettwa.gov/permits <br />(Blue or Black Ink Only Please) ' PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: 2602 HARRISON AVE, EVERETT, WA 98201 <br />PROPERTY TAX #::005-168-594-020-00 <br />LEGAL for new construction: Short Plat subdivision Lot No. (attach copy of long legal description) <br />CONTACT INFORMATION <br />OWNER NAME: MICHAEL W CULL TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: sTREETSAME AS ABOVE <br />CITY STATE ZIP <br />OWNER PHONE:425.308.1241 <br />OWNER EMAIL: mikeCUII.I71C@gmaIJ.COm <br />CONTRACTOR NAME:SMART ENERGY TODAY <br />CONTRACTOR ADDRESS: ITlEET2500 MOTTMAN ROAD SW <br />CITY TUMWATER STATE WA ZIP 98512 <br />CONTRACTOR PHONE:360.637.4343 <br />1CONTRACTOR EMAIL: LEX.K@SMARTENERGYTODAY.NET <br />CONTRACTOR LICENSE #(REQUIRED): SMARTET869RJ <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 052463 <br />PRIMARY CONTACT: ❑ OWNER N CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />LEX KING <br />CONTACT PHONE: 360.637.4343 <br />CONTACT EMAIL: LEX.K@SMARTEN ERGYTODAY. NET <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: <br />Contract Price of Work: $ <br />Proposed Use of Building: <br />Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi -Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: 3.72 KW ROOFTOP SOLAR <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _ Addn Alteration <br />_Repair <br />Type of Project: _New _Addn _Alteration _Repair <br />Fixtures <br />List of Fixtures <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br /># of <br />Fixtures <br />List of Fixtures <br />A/C —Air Handling Units <br />Heat Pump <br />Toilet <br />Backflow Preventer (Inside Bldg) <br />Forced Air Systems <br />Unit Heater <br />Bathtub <br />Urinal <br />Gas Piping <br />Boiler <br />Lavatory (Wash Basin) <br />Drinking Fountain <br />Water Heater <br />Refrigeration <br />Shower <br />Floor Drain <br />Gas Fireplace <br />Wood Stove <br />lKitchen Sink & Disposal <br />lGrease Trap <br />Gas Range <br />Ducting <br />IDishwasher <br />lRoof Drains <br />Clothes Dryer Hookups <br />Other. <br />Clothes Washer <br />Medical Gas <br />Range Hood <br />Water Heater <br />Other: <br />Exhaust Fan <br />Sink (Service/Bar/Mop/etc.) <br />Other: <br />SPRINKLER /'SUPPRESSION <br />SYSTEM <br />Chemical or Water <br />I <br />lNo. 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 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. 1 am the owner, or 1 am authorized by the owner of this property to perform the work for which application is made, <br />and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />2/26/2020 <br />Owner/Authorized Agent Signature Date <br />City of Everett Official Use Only <br />P 1T � — 0 <br />(Revised 912312016) <br />/L <br />