1827 126TH ST SE 2023-06-27 - 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 1827 126th St SE PARCEL#: CITY Everett STATE WA ZIP 98208 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential): N/A LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Mark Brown OWNER MAILING ADDRESS: STREET 1827 126th St SE CITY Everett STATE WA ZIP 98208 OWNER PHONE: (425) 308-7377 OWNER EMAIL: mrbrown_55@yahoo.com CONTRACTOR COMPANY NAME:Nationwide Solar WA STATE CONTRACTOR LICENSE#(REQUIRED): NAITOS*786CW CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 64489 CONTRACTOR ADDRESS: STREET 6407 NE 117th Ave Suite B CITY Vancouver STATE WA ZIP 98662 CONTRACTOR PHONE:(800)908-8992 ext 222 CONTRACTOR EMAIL:Fangobung@mynationwidesolar.com PRIMARY CONTACT: ❑ OWNER ❑✓ CONTRACTOR ©OTHER(Please Specify) Permit Technician CONTACT NAME: CONTACT PHONE:(800)908-8992 ext 222 Fabian A n g o b u n g CONTACT EMAIL: FANGOBUNG@MYNATIONWIDESOLAR.COM BUILDING INFORMATION VALUATION OF WORK:$ 65509.90 ASSOCIATED 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: SINGLE FAMILY HOME PROPOSED USE OF BUILDING: N/A HEAT SOURCE: ❑Gas ❑Electric ❑Other N/A BUILDING TYPE: ERSFR ❑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 ❑X Exterior Alteration ❑Tank(above ground) ❑Accessory Structure ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) ❑Other: SOLAR ARRAY INSTALL DESCRIPTION OF WORK: Installation of roof mounted 10.00 kW DC solar Photo-Voltaic generation system Prescriptive ACKNOWLEDGEMENT:1 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.1 am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Owner/Authorized Agent Signature Q Date (Revised 2/8/2021)