1105 SUMNER LN 2024-06-06 - 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)everetteps@everettwa.gov I (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1105 Sumner Ln PARCEL#: 00422000000300 CITY Everett STATE WA 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:Madan, Akshat OWNER MAILING ADDRESS: STREET 1105 Sumner Ln CITY Everett STATE WA ZIP 98203 OWNER PHONE:3234205309 OWNER EMAIL: akshatmadanl35@gmail.com CONTRACTOR COMPANY NAME:Puget Sound Solar WA STATE CONTRACTOR LICENSE#(REQUIRED):PUGETSS920RH CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 49544 CONTRACTOR ADDRESS: STREET 805 Rainier Ave S CITY Seattle STATE WA ZIP 98144 CONTRACTOR PHONE:(206) 706-1931 CONTRACTOR EMAIL:permitting@pugetsoundsolar.com PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(206) 822-4351 Nazifullah Nazif CONTACT EMAIL:permitting@pugetsoundsolar.com BUILDING INFORMATION VALUATION OF WORK: $$42,132 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:SFR PROPOSED USE OF BUILDING:SFR HEAT SOURCE: [-]Gas ❑Electric DOther N/A BUILDING TYPE: OSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure TYPE OF PROJECT(check all that apply): ❑New Construction ElAddition ❑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: DESCRIPTION OF WORK: Installation of rooftop Solar Photovoltaic System consisting of 16.4kW - (40) REC 410W. (40) Enphase IQ8A. 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 PERMIT# 12/13/23 Owner/�Author¢ed Agent Signature Date (Revised 2/8/2021)