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SEE <br />BUILDING PERMIT APPLICATION <br />EVERETTSUBMITTAL <br />CITY OF EVERETT PERMIT SERVICES <br />INSTRUCTIONS: See applicable submllal checklist for sudnMal repuiremans and number ofcopes required for review. <br />WASxmG70N <br />Men drop OH completed application plus all nal lttl submiXaltlmments to 3200 Cedar Street 2nd Poor Intake Drop Bon. <br />CONTACT INFORIMTION: (P)42S29-8810I (E) Penn'llServices®eveleMvaSov I (W) evereHwe godthan tlb <br />(Blue or Back Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS STREET 1914 lCRth St 5W PARCELC 03552300503301 <br />c rry Evered mwna WA or 982M <br />SUITEIUNITM FLOOR#: AODmONAL LOCATION INFORMATION (if applicable): <br />TENANTIBUSINESS NAME (if non-residential): NA <br />LEGALDESCRIPTONfornexwnaWclion: Shun Platumbdivision: Lon No.: (anacb copy of long legal deeviptbn) <br />CONTACT INFORMATION <br />OWNER NAME: Robert Trichler <br />OWNER MAILING ADDRESS: mA,A, 1914106th StSW <br />pm. EverettSTATEWA as 98201 <br />OWNER PHONE: 425-319-5169 <br />OWNER EMAIL: M'Irichler®ComWst.net <br />CONTRACTOR COMPANY NAME: SOlgen Polder LLC <br />WA STATE CONTRACTOR LICENSE IRREOUIREO): SOLGEPLO20BE <br />CITY OF EVERETT BUSINESS UCMSE a(REOUIREDS 62231 <br />CONTRACTOR ADDRESS: mrsool Bedford St <br />rry PBsm STATE WA Sol agash <br />CONTRACTOR PHONE: 855-709-1181 <br />CONTRACTOR EMAIL: permiffing@solgenWwer.com <br />PRIMARY CONTACT: DOWNER CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />Donnave Flaherty <br />CONTACT PHONE: g55-709-1181 <br />CONTACTEMAIL:pBf i1 ing�sOlgenpower.mm <br />BUILDING INFORMATION <br />VALUATION OFWORK:$8591,40 ASSOCIATED LAND USE PROJECT p(if applicable): <br />M4Nm shall hours W mass" by marreavelue N all Senor, manage ant WUlpmat real W mmises me Acm wneNer merely fad arm) <br />EDSTING USE OF BUILDING: Residence <br />PROPOSED USE OF BUIMNG: PV Solar roof mould InetallagM <br />HEATSOURCE: OGes ZEIel DONer <br />BUILOINGTYPE: FISFR ❑raanhouse ElDlpex ElADU Ellfulff-Farnfly-tilsdW ElCommertlal DAccesaory SNeture <br />TYPE OF PROJECT(check all that apply): EIN"CnsWction DAddtlion ❑Remodel ElRepair 11T.I. L]Change&Use <br />Dona lac ElPonabla ORe-mof DEtledor ABemBan OTank(abow ground) ❑Aco ssMSWcWre <br />OFence over 7B high OReckBtorega OPpdelot Tub OTank(aloveground) 00lher: PvaGNrocamuntinstallaeon <br />DESCRIPTION OF WORK: <br />Poll solar roof mount installation, 3 circuits, System Size: 9.99kW, MPU <br />ACNNOWLEOGEMENT:IY.eremewatlfNa tppS'ulun anJcvnlirmlhe inbmra(ion mnM1inW llereMk Weantlemett WM bfepuwuMbfNaprMl mu&mrlp'y WM <br />wny4/gene. Vale mAreel kw. The granting of A mmmif MY Income, appmvM week ant an OaNadma Nemasom. Cerirtbv mart Tvaf be Swearword m warep Sea, Am <br />BGTmTe Ofioai betas oemg aufmmetlwpw any ci2marmce/ am the owner, co l am Whwn by Sees owner W See prupeM to parson the wum M whall epIDwfun a made, <br />and Icamlov M the State Contractors Law IS 27 RC W and the.2WA WAC <br />Cry M Ewfm omwl Use Only <br />11/8/2022 PERMIT# <br />OwnerlAWM1otlaed Agent Signature O Care (FeNivd 4T@G22) <br />