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BUILDING PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETTSUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION: (P)425.257.8810 1(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 4705 West Glenhaven Drive PARCEL#: 00456700001100 <br /> clTr Everett STATE WA zip 98203 <br /> SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION (if applicable): <br /> TENANT/BUSINESS NAME(if non-residential): <br /> LEGAL DESCRIPTION for new construction: Short Plat/subdivision: Lot No.: (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME:HALVERSON LINNEA PETRIE <br /> OWNER MAILING ADDRESS: STREET 607 Kings Place <br /> CITY Everett STATE WA ZIP 98203 <br /> OWNER PHONE:909.851.0464 1OWNER EMAIL: Ihalverson77@gmall.com <br /> CONTRACTOR COMPANY NAME: Smart Energy Today <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):SMARTET870BS I CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 52463 <br /> CONTRACTOR ADDRESS: STREET 2500 MOttman Rd SW Suite 100 <br /> CITY Tumwater STATE WA z,p 98512 <br /> CONTRACTOR PHONE:360.637.4343 1CONTRACTOR EMAIL: solar@smartenergytoday.net <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:360.464.2344 <br /> Danny Savalza CONTACT EMAIL:permitting@smartenergytoday.net <br /> BUILDING INFORMATION <br /> VALUATION OF WORK:$ ASSOCIATED LAND USE PROJECT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> EXISTING USE OF BUILDING:Residential <br /> PROPOSED USE OF BUILDING:NO Change <br /> HEAT SOURCE: ❑Gas ❑Electric ❑Other NA <br /> BUILDING TYPE: VSFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑Commercial ❑Accessory Structure <br /> TYPE OF PROJECT(check all that apply): ❑New Construction ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Change of Use <br /> ❑Modular ❑Portable ❑Re-roof ❑Exterior Alteration ❑Tank(above ground)�/❑Accessory Structure <br /> ❑Fence over 7ft high ❑RackStorage ❑Pool/Hot Tub ❑Tank(above ground) other: Rooftop Solar Installation <br /> DESCRIPTION OF WORK: <br /> 15 HANWHA Q CELL Q.PEAK DUO BLK ML-G10+ (40OW) MODULES <br /> 15 ENPHASE IQ7PLUS-72-2-US(24OV) MICROINVERTERS <br /> 6.00kWDC //4.43kWAC Rooftop photovoltaic system installation <br /> 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 <br /> 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 <br /> 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, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 04/08/2022 <br /> Owner/Authorized Ag66t Signature Date (Revised 21812021) <br />