Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 <br />WASHINGTON (P) 425-257-8810 1 (E) PermitServices@everettwa.gov I www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT ADDRESS: 1525 Florida Drive Everett, Washington 98203 <br />BUILDING AREA: sq ft <br />PROJECT TYPE: ❑ NEW CONSTRUCTION Z ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL <br />BUILDING USE: ❑✓ SFR []TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: ❑ COMMERCIAL <br />ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK <br />CONTRACT PRICE OF WORK: $ 7680 <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIBE SCOPE OF WORK: 6.40kWDC Rooftop Photovoltaic Solar Installation // 4.80kWAC <br />6.40kWDC Rooftop Photovoltaic Solar Installation // 4.80kWAC <br />16 Q CELLS Q.PEAK DUO BLK ML-G10+ (400W) MODULES <br />16 ENPHASE IQ8PLUS-72-2-US (240V) MICROINVERTERS <br />THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br />LINE VOLTAGE WORK? ❑ NO 0 YES - Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: I ❑ Complete Re -wire <br />LOW VOLTAGE WORK? 0 NO ❑ YES- # of Devices: <br />SELECT SCOPE (REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat ❑ Audio ❑ Secure Access ❑ Security System <br />❑ Fire Alarm - Installations under this permit only include electrical wiring rough -in of the system. An <br />additional Fire Alarm Permit is required for review of device location and installation approval. <br />❑ Other (List All): <br />CODE COMPLIANCE <br />IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓ NO LJ YES -- See Below & Pg. 2 <br />❑ By checking this box, I am stating that I have read and understand all of WAC 296-46B-900, selected the specific reason on page <br />2 of this application (see next page), AND Plan Review is NOT required because I meet all of the following sub sections that do not <br />See Page 2 require Plan Review. <br />ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: 0NO []YES -See Below & Pg. <br />® Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent, sale, or lease <br />without the proper electrical licensing and certification, or exemption. By checking this box, I am stating that I have completed and <br />See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. <br />CONTACT INFORMATION <br />OWNER NAME:GEHLKE ZECHARIAH & JESSI6 TENANT BUSINESS NAME (If Commercial): <br />OWNER MAILING ADDRESS: STREET 1525 Florida Drive <br />CITY Everett STATE WA ZIP 98203 <br />OWNER PHONE: (425) 314-6895 <br />OWNER EMAIL: zechgehlke@gmail.com <br />CONTRACTOR NAME: Lumlo <br />CONTRACTOR ADDRESS: STREIT2500 Mottman Rd SW Suite 100 <br />CITY Tumwater STATE WA ZIP 98512 <br />CONTRACTOR PHONE:360-777-6681 <br />ICONTRACTOR EMAIL: pnW.permittina(allumio.com <br />CONTRACTOR LIC. #(REQUIRED): LUIVI IUM I / 04Y\4 <br />CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 104%5%5L <br />PRIMARY CONTACT: DOWNER ❑✓ CONTRACTOR E] OTHER (Please Specify) <br />CONTACT NAME: <br />Jesus FamiliaCONTACT <br />CONTACT PHONE: 360-777-6681 <br />EMAIL:Dnw. Derm itti naC@1 umio.com <br />AGREEMENT. 1 hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <br />type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state <br />or local law regulating construction or the performance of construction. That/ am authorized by the owner of this property to perform the work for which application is made and/ <br />comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only <br />PERMIT #: <br />12/07/2022 I E <br />Ow/Authorized Agent Signature Date (Revised 41512022) Page 1-Application <br />