26 81ST ST SW 2023-11-28 - 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)425-257-8810 1 (E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 26 81 St SW PARCEL#: 00393500002106 CITY Everett STATE Washington ZIP 98203 SUITE/UNIT#: 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: Richard Duc Phuoc Nguyen OWNER MAILING ADDRESS: STREET 26 81 St SW CITY Everett STATE Washington zip 98203 OWNER PHONE: 4253275920 OWNER EMAIL: huynhvo08@gmail.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 FNTRACTOR HER(Please Specify) CONTACT NAME: CONTACT PHONE: 385-482-0045 Carson Campbell CONTACT EMAIL: permitting.department@blueravensolar.com BUILDING INFORMATION VALUATION OF WORK: $ 3,031.39 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: cial cessory Structure T OF PRC�.I�rT(check at apply, w Construct' dition pair ange of Use dular Urtable -roof rior Alteration nk(above ground) cessory Structure nce over 7ft high ck3torage of/Hot Tub nk(above ground) er: PV Solar Array DESCRIPTION OF WORK: 3.36 kW PV Solar Panel Installation on Roof 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. City of Everett Official Use Only (� n _nou (n _&()V� PERMIT# � Permit Coordinator 09/29/2023 Owner/Authorized Agent Signature Date (Revised 4/21/2022)