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PERMIT APPLICATION <br /> BUILDING I MECHANICAL/PLUMBING I SIGN I SPRINKLER/DEMOLITION <br /> "111P•1// 4 <br /> CITY OF EVERETT PERMIT SERVICES <br /> + -� 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1(E)everettepsateverettwa.gov I www.everettwa gov/permits <br /> 4akno or tacit;Inktholy Planoo) _ QCT SITE INEORMATION <br /> PROJECT SITE ADDRESS: 615 Colby Ave, Everett,WA 98201 'PROPERTY TAX#i:00496812900500 <br /> LEGAL for new construction: Shod Plattsubdivision Lot No._ (attach copy of long legal description) <br /> CQNTACT aranstaTiam <br /> OWNER NAME Jim&Judy Kutz TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: srnrr 615 Colby Ave <br /> ow Everett STATE WA zP 98201 <br /> OWNER PHONE: 360-503-9845 OWNER EMAIL: j.a.kutz@gmaii.com <br /> CONTRACTOR NAME: Forecast Roofing&Solar LLC <br /> CONTRACTOR ADDRESS: smeb, 12820 Avondale Way <br /> city Everett STATE WA ziP 98204 <br /> CONTRACTOR PHONE (425)487-6000 CONTRACTOR EMAIL: info@forecastsolar.com <br /> CONTRACTOR LICENSE#(REQUIRED): FORECRL955MK CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: CI OWNER 6YCONTRACTOR O OTHER(Please Specify) <br /> CONTACT NAME CONTACT PHONE: (425)487-6000 <br /> Wil#Habenicht CONTACT EMAIL: info@forecastsotar_com <br /> ANG renorr APPLICATION <br /> Existing Use of Building: SFR Contract Price of Work 2 200 <br /> Proposed Use of Building: SFR Heat Source: OGas CIElectric DOther <br /> Building Type: I 'SFR D +ed OSFR-Attached C/Duplex OMulti--Family-#of Units: Commercial Olndustrial <br /> Type of Project: ONew OAddiiion # kemodel C'Repair OT.I. OSign OSprinkler ODemoliticn OChange of Use <br /> DESCRIPTION OF WORK: <br /> Install 9 kW grid tied, roof-mounted Solar PV system. 30-Itek iT 300SE solar modules. 30-SolarEdge SE-P320-60c <br /> optimizers, 1 -SolarEdge SE-7600H-US HD line inverter,Sunmodo EZ mount racking system. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PST APPLICATIt1Ni1 mamma PERMIT APPLUCAT1OH <br /> Type of Project New Addn Alteration Repair Type of Project New Addn Alteration Repair <br /> S of List of Sof ListofFbn&ues #of List ofFixtures tf of List of Manes <br /> Fbdunes Ralums Fixtures F/xtwos <br /> NC—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) Drinking Fountain <br /> Water Heater Refrigeration Shower Floor Drain <br /> Gas Fireplace Wood Stove Kitchen SrOr&Disposal Grease Trap <br /> Gas Range Ducting Dishwasher Roof Drans <br /> Clothes Dryer Hookups Other Clothes Washer Medical Gas <br /> Range Hood Water Heater Other: <br /> Exhaust Fan Sink(Sen /Mopletjc.) Other: <br /> . fSUPPRESSION SYSTEM <br /> , <br /> Chemical or Water I jNo.of Heads <br /> AUNT•f have;missed this applca ion and confirm the Wcrnsdion contained twain Winn and correct Work dune penman t to(his nemrrtmust comply wlh <br /> cumin ftderal,state,and local law The wanting of penntonly authorizes approved work end no devia6onsthe aboas Deviations mud That be authorized in rating from the <br /> Bi ng Official beim being auaroredunder any circumstance.Iamtheowner,oriamauthorizedbytheownervialsproperlytoperfonmthewoktorwhichappiratkerisrramie, <br /> and f comply wph the state Contractors Law 18.27 RCW and 296.200A WAC <br /> Cly ofEverett Oral Use Only <br /> # ' 6//C/ZO Pas#kz 0q- - O t <br /> Owner/ """"•Agent Signature Date (Revised 823/2016) —o <br /> t <br />