4205 RIDGEMONT DR 2023-08-01 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1(E)PermitServices@everethva.gov I wvw/.everethva.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:4205 Ridgemont Dr BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑✓ TENANT IMPROVMENT []REMODEL BUILDING USE: ❑✓ SFR []TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION& DESCRIPTION OF WORK- CONTRACT PRICE OF WORK:$ ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Roof Top Solar, Micro Inverters, Combiner Box and Rapid Shutdown Roof Top Solar, Micro Inverters, Combiner Box and Rapid Shutdown THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO Z YES-Select Scope:❑Service Z Feeder ❑Circuits-#:2 ❑Complete Re-wire LOW VOLTAGE WORK? ❑NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED) ❑Data ❑Intercom ❑Thermostat ❑Audio ❑Secure Access ❑Security System ❑Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional Fire Alarm Permit is required for review of device location and installation approval. ❑✓ Other(List All):Solar CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓ NO U YES--See Below&Pg.2 ❑ By checking this box, I am stating that I have read and understand all of WAC 296-466-900,selected the specific reason on page 2 of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not See Page 2 require Plan Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:ZNO []YES-See Below&Pg. ❑ Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease without the proper electrical licensing and certification, or exemption. By checking this box, I am stating that I have completed and See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME:Lynn Nixon TENANT BUSINESS NAME If Commercial): OWNER MAILING ADDRESS: ITRIIT4205 Ridgemount Dr ,,n Everett STATE WA 2.P 98203 OWNER PHONE:425-343-9972 OWNER EMAIL:lynnanixon@Comcast.net CONTRACTOR NAME;Fire Mountain Solar, LLC CONTRACTOR ADDRESS: sTREET18388 Perwinkle Lane ,,n Mount Vernon STATE WA Z,P98274 CONTRACTOR PHONE:360-422-561 O CONTRACTOR EMAIL:team@fmSolar.COm CONTRACTOR LIC.#(REQUIRED):FIREMMS835KR ICITY OF EVERETT BUSINESS LIC.#(REQUIRED):57373'•- PRIMARY CONTACT: [DOWNER i]CONTRACTOR E]OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-422-5610 Tim NelSon I CONTACT EMAIL:tim@fmsolar.com AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions o/laws and ordinances governing this type of work will be completed whelher specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That/am atithorized by the owner of this property to perform the work for which application is made and I comply wilh the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Oklclal Use Onty PERMIT#: 10/29/2022 E nor/Authorized Agent Signature Date (Revised 4/512022), Page 1-Application