11414 W IBBERSON DR 2021-08-26 - Laserfiche WebLink

NMI 4110 PERMIT APPLICATIO01 n BUILDING / MECHANICAL/ PLUMBING / SIGN /SPRINKLER / DEMOLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS:11414 W Ibberson Dr PROPERTY TAX#:00479600000100 LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: Beverly Sobelman TENANT BUSINESS NAME(Commercial): OWNER MAILING ADDRESS: STREET 11414 W Ibberson Dr crry Everett STATE WA ZIP 98208 OWNER PHONE: (206)399-7173 OWNER EMAIL: bsobelman@gmail.com CONTRACTOR NAME: A AND R SOLAR SPC CONTRACTOR ADDRESS: STREET 3211 MLK Jr Way S, Suite B ciTv Seattle STATE WA zip 98208 CONTRACTOR PHONE:206-707-9937 office CONTRACTOR EMAIL:permits@a-rsolar.com CONTRACTOR LICENSE#(REQUIRED):RSOLAS*903JM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 053961 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:Wendy(360)621-8238 , Will (206) 307-1741 Wendy Wenrick-Admin, Will MacArthur-Project Manager CONTACT EMAIL: permits@a-rsolar.com BUILDING INFORMATION Existing Use of Building:SFR Contract Price of Work: $ 1274.00 Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other BUILDING USE: ❑SFR Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure Type of Project: ❑New ❑Addition ✓❑Remodel ❑Repair ❑T.l. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use DESCRIPTION OF WORK: Installing PV system on rooftop of SFR. ASSOCIATED BUILDING PERMIT#(if applicable): MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION Fixture Fixture Fixture List of Fixtures Fixture Count Count List of Fixtures Count List of Fixtures Count List of Fixtures A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility, laundry, mop Exhaust Fans(Residential) Commercial Ventilatior Floor Drain Toilet Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) Forced Air Systems Other: Medical Gas Water Valves or Fixtures Gas Fireplace/Insert/Log Roof Drains Water Heater SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: Water Suppression System No.of Heads Chemical Suppression System No.of Heads 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 made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only /y "�/ey/,y�(, 02/05/2021 PT ..... 02_ a2___ Owner/Autho ed Agent Signature Date (Revised 10/10/2018)