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o <br /> mmi <br /> Bu ILDING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425-257-8810 I(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 10330 Evergreen Way PARCEL#: 00535200001400 <br /> CITY Everett STATE WA ZIP 98204 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION(if applicable): <br /> TENANT/BUSINESS NAME(if non-residential):Glint Car Wash <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision:Olivia Park DIV 1 Bb Lot No.: 14 (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:Indo Nordic Retail Estate Holdings LLC <br /> OWNER MAILING ADDRESS: STREET 1500 E. Katella Ave. #5 <br /> CITY Orange STATE CA ZIP 92867 <br /> OWNER PHONE:425-577-8586 OWNER EMAIL: rune@glintcarwash.com <br /> CONTRACTOR COMPANY NAME:Artisan Electric Inc <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):ARTISEI936L1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 6('2 3 <br /> CONTRACTOR ADDRESS: STREET969 S Nebraska St <br /> CITY Seattle STATE WA zip 98108 <br /> CONTRACTOR PHONE:206-556-5703 CONTRACTOR EMAIL:evan.bush@artisanelectricinc.com <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR I'l OTHER(Please Specify) GC, Kugel Construction <br /> CONTACT NAME: CONTACT PHONE: 3 6 o I 1 o g <br /> Mike Myers CONTACT EMAIL:mike.myers@kugelconstructio n.com <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$155,488.01 ASSOCIATED LAND USE PROJECT#(if applicabie):Klein-SERJ BSP20-( <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not) <br /> EXISTING USE OF BUILDING:N/A <br /> PROPOSED USE OF BUILDING:Carwash <br /> HEAT SOURCE: ❑Gas ❑Electric ❑Other <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: IZiCommercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ONew Construction ❑Addition ❑Remodel ❑Repair ®T.I. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground) ❑Accessory Structure <br /> ❑Fence over 7ft high DRackStorage ❑Pool/Hot Tub ❑Tank(above ground) ®Other:Solar PV system <br /> DESCRIPTION OF WORK:Install a 61.36 kW solar PV system on the roof of carwash and across (7) south-facing <br /> PV awnings. PV modules will be attached to Unirac RM5 ballasted racking on the roof <br /> and SunModo Sunshield racking at the awnings. The PV system will operate in parallel <br /> to the existing utility supply and will produce approximately 63,422 kWh/year of <br /> electricity. <br /> 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 <br /> 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 <br /> Building Official before being authorized under any circumstance.I am the owner,or lam authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> DCyU S -b c dKoch <br /> m,CN=Ec Koch PERMIT <br /> # <br /> Koc <br /> _ 6/20/22 5 27© (0 — 0(P 3 <br /> -=•.•s•D91B�P0220620162614071)0' <br /> Owner/Authorized Agent Signature Date (Revised 4/21/2022) <br /> vz— <br />