2126 61ST ST SE 2023-08-24 - Laserfiche WebLink

BUILDING PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL 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 I NFORMATION: (P) 425-257-88101 (E) PermitServices@everettwa.gov I (W) everetwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: sTIZEEr 2126 61ST ST SE PARCEL #: 00544900200500 CITY Everett STATE Washington ZIP 98203 SUITEIUNIT #: FLOOR #: ADDITIONAL LOCATION INFORMATION (if applicable): TENANT/BUSINESS NAME (if non-residential): LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) CONTACT INFORMATION OWNER NAME: JAVIER PEREZ OWNER MAILING ADDRESS: STREET 212661ST ST BE CITY Everett STATE Washington zip 98203 OWNER PHONE: +14252329654 OWNER EMAIL: HORIZON_AUTOS@YAHOO.COM CONTRACTOR COMPANY NAME: BRS Field Ops, LLC WA STATE CONTRACTOR LICENSE #(REQUIRED): BRSFIFO828M4 CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 60040 CONTRACTOR ADDRESS: STREET 1403 N Research Way CITY Orem STATE UT ZIP 84097 CONTRACTOR PHONE: 385-482-0045 CONTRACTOR EMAIL: Permitting.department@blueravensolar.com PRIMARY CONTACT: ❑ OWNER NTRACTOR HER (Please Specify) CONTACT NAME: Hayden Low CONTACT PHONE: 385-482-0045 CONTACT EMAIL: pe"itting.department@blueravensolar.com BUILDING INFORMATION VALUATION OF WORK: $ 7578.48 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 ILDI HEAT SOURCE: is ctric er BUILDING TYPE: V R vinhouse lex U -Family- I Ucial cessory Structure dition pair ange of Use T OF Pi (check at apply, � w ConstrPnk dular Piroof rior Alterationnk (above ground) cessory Structure nce over 7ft high ckstorage of/Hot Tub (above ground) er: PV Solar Array DESCRIPTION OF WORK: 8.3 kW PV Solar Panel Installation on Roof -- 20 panels ACKNOWLEDGEMENT. 1 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 1 am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 R C W and 296.200A WAC. City of Everett Official Use Only #6?411 Lii Pi Coordinator 06 / 21 / 2023 Owner/Authorized Agent Signature Date (Revised 4/21/2022)