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nom PERMIT APPLICATION <br /> BUILDING / MECHANICAL I PLUMBING I SIGN IITRINKLER/ 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 I(E)everetteps@everettwa.gov i www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 420 94th St SW PROPERTY TAX#: 00726800000300 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAMEAlfonso Aguirre TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 420 94th St SW <br /> CITY Everett STATE WA ZIP 98204 <br /> OWNER PHONE: 760-455-9211 OWNER EMAIL: aaguirrec04@yahoo.com <br /> CONTRACTOR NAME: Solgen Power, LLC <br /> CONTRACTOR ADDRESS: STREET 1992 Saint St. <br /> cirr Richland STATE WA ZIP 99354 <br /> CONTRACTOR PHONE: 509-530-2369 CONTRACTOR EMAIL: permitting a,solgenpower.com <br /> CONTRACTOR LICENSE#(REQUIRED): SOLGEPL830RJ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 62231 <br /> PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR El OTHER(Please Specify) Permitting Specialist <br /> CONTACT PHONE: 509-530-2369 <br /> CONTACT NAME:Lorena Pulido <br /> CONTACT EMAIL: permitting@solgenpower.com <br /> .B UiI DiNG.INFORMATION •.. •: <br /> Existing Use of Building: Contract Price of Work:$ 6708 <br /> Proposed Use of Building: Heat Source: OGas ❑Electric ❑Other <br /> BUILDING USE: EISFR ❑Townhouse El Duplex ❑ADU ❑MultI-Famity-#Units: OCommercial ❑Accessory Structure <br /> Type of Project: ❑New LAddition ❑Remodel El Repair ❑T.t. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> PV Solar roof mount install <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 /> NC—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boller 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 Ventilation 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/OII Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER 1 SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System 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,lam the owner,or!am authorized by the owner of this property to perform the work for which application is made, <br /> and i comply with the Slate Contractors Law 18,27 RCW and 286.200A WAG. <br /> PET <br /> City of Everett teOfffiicial Use Only <br /> 0R/1 P/2f12() _ "`�'�`V✓� <br /> Owner/Authorize Agent Ignature Date (Revised 4/15/2019) �/� <br />