9730 27TH AVE SE 2023-04-04 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P) 425-257-8810 1 (E) PermitServices@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 9730 27th Ave SE Everett, WA 98208 BUILDING AREA: 1927 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑✓ ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑✓ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 2000.00 ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIBE SCOPE OF WORK: Installing 7.665kw solar pv system on roof of home. 21 REC 365NP2 modules, 10 Chilicon CP720 microinverters, and 1 CP250 micro. Installing 7.665kw solar pv system on roof of home. 21 REC 365NP2 modules, 10 Chilicon CP720 microinverters, and 1 CP250 micro. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO DYES - Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re -wire LOW VOLTAGE WORK? ❑✓ NO ❑ YES- # of Devices: SELECT SCOPE (REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat ❑ Audio ❑ Secure Access In Security System ❑ Fire Alarm - Installations under this permit only include electrical wiring rough -in of the system. An additional Fire Alarm Permit is required for review of device location and installation approval. ❑✓ Other (List All): solar CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 21 NO LJ YES -- See Below & Pg. 2 ❑ By checking this box, I am stating that I have read and understand all of WAC 296-46113-900, selected the specific reason on page 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 See Page 2 require Plan Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ❑✓ NO ❑YES -See Below & Pg. ❑ Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent, sale, or lease without the proper electrical licensing and certification, or exemption. By checking this box, I am stating that I have completed and See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME:MeIISSa Martinez TENANT BUSINESS NAME (If Commercial): OWNER MAILING ADDRESS: STREET 9730 27th Ave ,IT, Everett STATE WA zIP 98208 OWNER PHONE: 425-530-0159 OWNER EMAIL: missyr_25@yahoo.com CONTRACTOR NAME: Brimma Solar CONTRACTOR ADDRESS: STREET320 SW Century Dr. #405-388 CITY Bend STATE 0R ZIP 97702 CONTRACTOR PHONE: 800-808-1955 CONTRACTOR EMAIL: grant@brimmasolar.com CONTRACTOR LIC. #(REQUIRED): ECBRIMMSL824KJ CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 6030466710010002 PRIMARY CONTACT: [—]OWNER ❑✓ CONTRACTOR []OTHER (Please Specify) CONTACT NAME: Lynnette Harley CONTACT PHONE: 253-359-1444 CONTACT EMAIL:Lynnette@brimmasolar.com AGREEMENT: I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this 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 or local law regulating construction or the performance of construction. That 1 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 296.200 WAC. City of Everett Official Use Only PERMIT #: 9� 9/30/2022 E Owner/Authbifized Agent Signature 61 Date (Revised 41512022) Page 1-Application