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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 ( FAX 425-257-8857 I(E)everetteps@everettwa.gov I wwwr.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: PROPERTY TAX#: <br /> 5209 Narbeck Ave Everett,WA 98203 <br /> LEGAL for new construction: Short Plat/subdivisior Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: Tom Berkley TENANT NAME(if Commercial): <br /> OWNER MAILING ADDRESS: STREET 5209 Narbeck Ave <br /> CITY Everett STATE WA <br /> zh 98203 <br /> OWNER PHONE: 425-280-4026 OWNER EMAIL: tomberkley@comeast.net <br /> CONTRACTOR NAME: Forecast Solar LLC <br /> CONTRACTOR ADDRESS: STREET 4463 Russell Rd Suite 105 <br /> Cmr Mulkilteo sTATE WA <br /> zia 98275 <br /> CONTRACTOR PHONE:425-487-6000 CONTRACTOR EMAIL:info@forecastsolar.com <br /> CONTRACTOR LICENSE#(REQUIRED):FORECRS883DG CITY OF EVERETT BUSINESS LICENSE#(REQUIRE ):044167 <br /> PRIMARY CONTACT: ❑OWNER ®CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-487-6000 <br /> Morgan Zehrung CONTACT EMAIL:info@forecastsolar.com <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: Residential lContract Price of Work: 30,000.00 <br /> Proposed Use of Building: Residential lHeat Source: —Gas Elec ❑Other <br /> Building Type: &tSFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ❑New ❑Addition ❑Remodel []Repair ❑T.I. ❑Sin []Sprinkler ❑Demolition ❑Chan e of Use <br /> DESCRIPTION OF WORK: <br /> Roof Mounted PV System <br /> 9.86kW <br /> 34-Panels <br /> ASSOCIATED BUILDING PERMIT#(if applicable): 17-APS YC500 Micro Inv. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New _ Addn _Alteration _ _Repair Type of Project: __New _Addn _Alteration _Repair <br /> #of List of Fixtures #°{ Fixtures Fixtures#of #of <br /> Fixtures Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> AIC—Air Handling Units Heat Pump Toilet Backflow Preventer(Inside Bldg) <br /> Forced Air Systems Unit Heater Bathtub Urinal <br /> Gas Piping Boiler Lavatory(Wash Basin) Fountain <br /> Drinking F <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen Sink&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drains <br /> Clothes Dryer Hookups Other. Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Service/BariMop/etc.) Other: <br /> SPRINKLER I SUPPRESSION`SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT'f 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./am the owner,or t am authorized by the owner of this property to perform the work for which application is made, <br /> and l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> Mt7f,94,YG z�� P R I # <br /> JJ 11/14/2016 <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) ---��• <br />