216 MADISON ST 2023-07-13 - Laserfiche WebLink

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)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: sTf;tEeT216 Madison St PARCEL#: 0C) Ot?do Go MY Everett STATE WA Zp 98203 SUITEIUNIT#: FLOOR M ADDITIONAL LOCATION INFORMATION(if applicable): TENANT/BUSINESS NAME(if non-residential)n/a LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Solar array Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Elizabeth Calsyn OWNER MAILING ADDRESS: STREET 216 Madison St cm Everett STATE WA z p 98203 OWNER p>HME 425-387-6065 OWNER EMAIL:bethsimmons44@gmail.com CONTRACTOR COMPANY NAME:Electrical Systems Solutions, Inc A STATE CONTRACTOR LICENSE#(REQUIRED):ELECTSS902JN ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED):65809 CONTRACTOR ADDRESS: STREETPO BOX 16452 CRy SEATTLE STATE WA ZIP 98116 CONTRACTOR PHONE 206-923-937$ CONTRACTOR EMAIL:rich@elessinc.com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:Jonathan Alindayu CONTACT PHONE:206-992-4891 CONTACT EMAIL.jonathan@elessinc.com BUILDING INFORMATION VALUATION OF WORK::16,790 ASSOCIATED LAND USE PROJECT# if applicable): (valuation shall include the prevagng fair market value of all labor,materials,and equipment needed to co the work,wheUror actuaily paid or not.) EXISTING USE OF BUILDING: PROPOSED USE OF BUILDING:Solar array - rooftop installations HEAT SOURCE: ✓❑Gas ❑Electric ❑Other BUILDING TYPE: ©SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.1. ❑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) ❑✓Other.Solar array-rooftop installations DESCRIPTION OF WORK:SOIar panel - rooftop installation 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 WW low. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building OAricial belbre being aulhoM 9d 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 vritl►the State Ir i Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only C�aj� 4/25/2023 PERMIT#