4205 RIDGEMONT DR 2023-08-01 - 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)425-257-88101(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 4205 Ridgemont Dr PARCEL#: 00464700007201 clTv Everett STATE WA ZIP 98203 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME(if non-residential):Lynn Nixon & William Larter LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME:Lynn Nixon OWNER MAILING ADDRESS: STREET 4205 Ridgemount Dr clTv Everett STATE WA zia 98203 OWNER PHONE:425-343-997Z 1OWNER EMAIL: Iynnanixon comcast.net CONTRACTOR COMPANY NAME:Fire Mountain Solar, LLC WA STATE CONTRACTOR LICENSE#(REQUIRED):FI REMMS835KR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57373 CONTRACTOR ADDRESS: STREETS 8388 Periwinkle Lane c,TY Mount Vernon STATE WA zla 98274 CONTRACTOR PHONE:360-422-561 O CONTRACTOR EMAIL:team@fmsolar.com PRIMARY CONTACT: ❑OWNER ©CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-422-5610 Tim Nelson CONTACT EMAIL:tim@fmsolar.com BUILDING INFORMATION VALUATION OF WORK:$24,000 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: PROPOSED USE OF BUILDING: HEAT SOURCE: ❑Gas ❑Electric ❑Other BUILDING TYPE: 1ZSFR ❑Townhouse []Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair LIT.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:Grid-Tied Solar Electric&Micro Inverters DESCRIPTION OF WORK:Roof Top Solar with Micro Inverters, combiner box and rapid shutdown switch 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 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/am authorized by the owner of this property to perform the work for which application is made, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only F77 IT# O er/Authorized Agent Signature Date (Revised 4/21/2022)