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S PERMIT APPLICATIONS <br /> BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / DEMOLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 l(E)everetteps@everettwa.gov l www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:4807 Wilmington Ave PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivision Central Park ADD Lot No.1 1 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Christopher Casey TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET4807 Wilmington Ave <br /> ciTy Everett STATE WA ZIP 98203 <br /> OWNER PHONE:425-303-0472 OWNER EMAIL:CCbj@msn.com <br /> CONTRACTOR NAME:SOlgen Power, LLC <br /> CONTRACTOR ADDRESS: STREET1992 Saint St <br /> crry Richland STATE WA ZIP 99352 <br /> CONTRACTOR PHONE:(509) 408-1165 CONTRACTOR EMAIL:permitting@solgenpoWer.Com <br /> CONTRACTOR LICENSE#(REQUIRED):SOLGEPL83ORJ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 62231 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:(509) 408-1165 <br /> Mariela CONTACT EMAIL:permitting@solgenpower.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:Residential Contract Price of Work: $5,160 <br /> Proposed Use of Building:Solar Install Heat Source: ❑Gas DElectric ❑Other <br /> BUILDING USE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> Type of Project: ❑New ❑✓Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> PV Solar Roof Mount <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer 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) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/InserULog Roof Drains Water Heater <br /> SPRINKLER I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <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 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 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 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PE T# u of <br /> kZ <br /> Owner/Authorized-Age n ignaattu e Date (Revised 10/10/2018) <br /> I <br /> I7 <br /> fr— <br />