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3402 WAVE DR 2023-01-18
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3402 WAVE DR 2023-01-18
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Last modified
1/18/2023 5:46:40 PM
Creation date
1/19/2023 9:13:42 AM
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Address Document
Street Name
WAVE DR
Street Number
3402
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BUILDING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <br /> SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION: (P)425.257.8810 1 (E)everetteps@everettwa.gov I (W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 3402 Wave Drive PARCEL#: 00571700600500 <br /> cITY Everett STATE WA zlp 98203 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Timothy Walsh <br /> OWNER MAILING ADDRESS: STREET 3402 Wave Drive <br /> CITY Everett STATE WA ZIP 98203 <br /> OWNER PHONE:425-301-1410 OWNER EMAIL: tjwal7@gmail.com <br /> CONTRACTOR COMPANY NAME:Blossom Solar <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):BLOSSSL823M7 ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57621 <br /> CONTRACTOR ADDRESS: ITIEET1706 Lombard Ave <br /> CITY Everett STATE WA ZIP 98201 <br /> CONTRACTOR PHONE:425-610-7067 CONTRACTOR EMAIL:office@blossomsolar.com <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> BUILDING INFORMATION <br /> VALUATION OF WORK: $31,150.00 ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING: <br /> PROPOSED USE OF BUILDING: <br /> HEAT SOURCE: ❑Gas DElectric ❑Other <br /> BUILDING TYPE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition [-]Remodel [-]Repair ❑T.I. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration [-]Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub [-]Tank(above ground) Z10ther:Photo Voltaic Solar <br /> DESCRIPTION OF WORK: <br /> 10.73 kW grid tied roof mounted solar system. <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 1 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 /> PERMIT# <br /> 8/9/2022 <br /> Owner/Authorized Agent Signature Date (Revised 2/8/2021) <br />
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