2113 HOYT AVE 2023-04-28 - Laserfiche WebLink

BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION: (P)425.257.8810 1(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2113 Hoyt Avenue PARCEL#:00439143400602 CITY Everett STATE WA zip 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: BLACK RICHARD A OWNER MAILING ADDRESS: STREET 2113 Hoyt Avenue CITY Everett STATE WA zi, 98201 OWNER PHONE: (425) 343-5290 OWNER EMAIL:richard.a.black2@boeing.com CONTRACTOR COMPANY NAME:Lurnio WA STATE CONTRACTOR LICENSE#(REQUIRED):LUM10H1789KR ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED):64332 CONTRACTOR ADDRESS: STREET 2500 Mottman Rd SW Suite 100 CITY OI m la STATE WA zip 98512 CONTRACTOR PHONE:360-777-6681 CONTRACTOR EMAIL:pnW.permltting@lumlo.Com PRIMARY CONTACT: ❑OWNER �A CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:Jesus Familia CONTACT PHONE:360-777-6681 CONTACT EMAIL:pnW.permitting@lumlo.com BUILDING INFORMATION VALUATION OF WORK:$ 15,360 1ASSOCIATED LAND USE PROJECT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) EXISTING USE OF BUILDING:Residential PROPOSED USE OF BUILDING:NO Change HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: VSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) VOther:Rooftop Solar Installation DESCRIPTION OF WORK: 12.80kWDC Rooftop Photovoltaic Solar Installation 32 Q CELLS Q.PEAK DUO BLK ML-G10+ (400W) MODULES 32 ENPHASE IQ8PLUS -72-2-US (240V) MICROINVERTERS 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 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 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 11/14/2022 ner/Authorized Agent Signature Date (Revised 2/8/2021)