1929 75TH ST SE 2024-01-16 - 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: STREET 1929 75th ST BE PARCEL #: 00448100000400 CITY Everett STATE WA Zp 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: Corinne Shearer OWNER MAILING ADDRESS: STREET 1929 75th ST SE CITY Everett STATE WA Zp 98203 OWNER PHONE: (425)328-4952 OWNER EMAIL: CI71_shearer@hotmall.com CONTRACTOR COMPANY NAME: Revolution Energy Systems WA STATE CONTRACTOR LICENSE #(REQUIRED): REVOLES7881-7 CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 6049157460010001 CONTRACTOR ADDRESS: STREET 13938 S Sprague Ln, Suite 300 aTy Draper STATE UT Zp 84020 CONTRACTOR PHONE: (801)877-6842 CONTRACTOR EMAIL: permits.wa@revolutionsolar.com PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑✓ OTHER (Please Specify) Nick Lansfeldt, Permit Coordinator CONTACT NAME: Nick Lansfeldt CONTACT PHONE: (801)877-6842 ICONTACT EMAIL: nlansfeldt@revolutionsolar.com BUILDING INFORMATION VALUATION OF WORK: $ 67,947.31 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: Residential PROPOSED USE OF BUILDING: Residential 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.I. ❑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: Rooftop Solar Army DESCRIPTION OF WORK: Grid tied; roof mount; residential solar array. AC System Size: 10.40 kW, DC System Size: 14.40 kW. (32) CANADIAN SOLAR CS3W-450MS 450 PV Modules, (32) ENPHASE IQ8M-72-2-US (240V) Inverters. ACKNOWLEDGEMENT/ 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 RCW and 296.200A WAC. City of Everett Official Use Only 4)4c'&64� /�'� 12/15/22 PERMI T# Owner/Authorized Agent Signature Date (Revised 4121/2022)