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SEE <br />BUILDING PERMIT APPLICATION <br />EVERETTSUBMInAL <br />CITY OF EVERETT PERMIT SERVICES <br />INSTRUCTIONS: sae applicable submidal checNist far submeall requirements and numberof copies required fix MI <br />WASHINomx <br />Non dmp off completed applimitbn SITE all required submiflal documents No 32M Cadar greet 2nd Flow Intake Dropfox. <br />CONTACT INFORMATION: (P)02525)88f 01(E)evereueps@evemetwa.gov I(W) everefMa.gov/patrons <br />(Blue or Back Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS STREU 1827 126th St SE PARCEL R. <br />c ,w Everett Tat WA ffi 98208 <br />SUITEIUNITk: FLOOR If: ADDITIONAL LOCATION INFORMATION (if applicable): <br />TENANTIBUSINESS NAME (if non-residentialp NIA <br />LEGALDESCRIPPONfornewconsbucbon. Shm Platbubdivifion: Lot No.: Tat h copy of long legal champion) <br />CONTACT INFORMATION <br />OWNER NAME: Mark Brown <br />OWNER MAILING ADDRESS: res, 1827126th St SE <br />E. Everett STATE WA m 98208 <br />OWNER PHONE:(425) 308-7377 <br />OWNER EMAIL: mrbf n_55@yahm.com <br />CONTRACTOR COMPANY NAME: Nationwide Solar <br />WA STATE CONTRACTOR LICENSE RREOUIREnp NAITOS'786CW <br />CT'OF EVERETT BUSINESS LICENSE RREOUIREO): (SHIPS <br />CONTRACTOR ADDRESS: Em.6407 NE 1171h Ave Suite B <br />n, Vancouver STATE WA W dal <br />CONTRACTOR PHONE:(80D) 9OB-8992 ex1 222 <br />CONTRACTOR EMAIL: Fangobung@mynationwide olarcom <br />PRIMARY CONTACT: ❑OWNER ZCONTRACTOR © OTHER (Please Specify) Permit'ht,firim <br />CONTACT NAME: <br />Fabian Angobung <br />CONTACT PHONE: (800) 908-8992 ¢# 222 <br />CONTACT EMAIL FANGOBUNGIAMYNATIONWIDESOLARCOM <br />BUILDING INFORMATION <br />VALUATION OF WORK: s 65509.90 ASSOCIATED LAND USE PROJECT s (ifappli®ble : <br />rv.W.amenal naueeone gnr.ltq mrm.kwlv.mea.ulep«, m.web,.m.ouomemnreaw mmwfa lnewoa. wnemer.cu.ov lea «na.) <br />EXISTING USE OF BUILDING: SINGLE FAMILY HOME <br />PROPOSED USE OF BUILDING: NIA <br />HEATSOURCE: OGes I]EIe c OOlher NIA <br />BUILDINGTYPE: IMSFR OTOwnhouse ODI ❑ADD O11AUM-Family-OUnl6: OCommemord EAmessory Shuclure <br />TYPEOFPROJECT(clredelldkataloal ONew Construction LIAddition ORemodel OReyair OT.I. ❑Chaigeof Use <br />OModular 01"odade ORSI I MExledor Ageredon EITank(aboveground) �Acces. ySWdule <br />OFence over 7R high RackSlosege OPadIHM Tub Qrank(above ground) ElOther: SOLARARRAY INSFALL <br />DESCRIPTION OF WORK: <br />Installation of root mounted 10.00 kW DC solar Plga-VoBaic general system PrescripFlve <br />ACNNOWLEOGEMENT: I M1ew reWewetl Mia apMmtion entl mnfirm DIM inbrmelian mNeinetl Mrein AWe and «meet Wdk vWla pusivN 10 Mtif pnM mutt m^WV wrlh <br />was«NtlaN,Amer ANN GAS Nw. TM Faces a a Permit'My We""' appmuah cant ant He tlan IM1w Mpana S mutlml da ae"Wed vi"I/mm DIM <br />BWSeq OMtiL More beirgaulMvetlumba enyai2umalenre. I am the oHm H. wI emaufhwiae0 by ee oemerollMamass <br />and Ixmpyuve the Slate onsmeas Law 1827 RCWand 2%AAA MAC, <br />CAy N EwMf OlhvalVm only <br />Fab a a Awa6 ua PERMIT# <br />OwnedAuthotlaed Agent Signature Date (ReNmd 24120211 <br />