909 58TH PL SW 2023-10-26 - 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 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: STREET 909 58th PI SW PARCEL M 00836700003000 CITY Everett STATE Washington ZIP 98203 SulE/UNIT #: FLOOR M 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: Sylvester Green OWNER MAILING ADDRESS: STREET 909 58th PI SW CITY Everett STATE Washington zip 98203 OWNER PHONE: 4254226902 OWNER EMAIL: sly_green@yahoo.com CONTRACTOR COMPANY NAME: BRS Field Ops, LLC WA STATE CONTRACTOR LICENSE #(REQUIRED): BRSFIF0828M4 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: Bryson Taylor CONTACT PHONE: 385-482-0045 CONTACT EMAIL: permitting.department@blueravensolar.com BUILDING INFORMATION VALUATION OF WORK: $ 4989.17 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: s ctric er BUILDING TYPE: R wnhouse lex U Family its: rFcia�i�lcessory Structure ' dition pair ge of Use T OF PRCnT (check at apply w ConstrPnk dular Urtable -roof norAlterationnk (above ground) cessory Structure nce over 7ft high ckStorage of/Hot Tub (above ground) er: PV Solar Array DESCRIPTION OF WORK: INSTALLATION OF UTILITY INTERACTIVE PHOTOVOLTAIC SOLAR SYSTEM AND ANY NECESSARY ADDITIONAL WORK NEEDED FOR 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 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. I am the owner, or 1 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. &Y'rou ra& Permit Coordinator 12 / 21 / 2022 Owner/Authorized Agent Signature Date City of Everett Official Use Only PERMIT # (Revised 412112022)