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PERMIT APPLICATION <br /> ep <br /> "` BUILDING/MECHANICAL I PLUMBING/SIGN/SPRINKLER 1 DEMOLITION <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)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: 111 E Beech St, Everett,WA 98203 PROPERTY TAX#: <br /> LEGAL for new construction: Short Plat/subdivisio Lot No. (attach copy of long legal description) <br /> - <br /> 4 <br /> CONTACT INFORMATION <br /> OWNER NAME: Erwin Arlantico TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 111 E Beech St <br /> cmr Everett STATE WA .. zip 98203 <br /> OWNER PHONE(425)308-9226 !OWNER EMAIL: arlaner@yahoo.com <br /> CONACTCR,NAME: A&R SOLAR <br /> CONTRACTOR ADDRESS: STREET 321'1 Martin Luther King Jr Way S, Suite B <br /> QnY Seattle STATE WA ZIP 98144 <br /> CONTRACTOR PHONE 206-707 9937 CONTRACTOR • r <br /> EMAIL:permits@a-rsolar.com <br /> . <br /> CONTRACTOR LICENSE#(REQUIRED):RSOLAS*903JM CITY OF EVERETT BUSINESS LICENSE#(REQUIRED. 153961 <br /> PRIMARY CONTACT: 0 OWNER •CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 360-621-8238 <br /> WendyWen rick <br /> CONTACT EMAIL permits@a-rsolar.com <br /> BUILDING PERMIT APPLICATION <br /> Existin. Use ofBuildin.,. Residential Contract Price of Wor $24,220.00 <br /> Proposed Use of Building:No change to building 9 use Heat Source: OGas" BElectnc ❑Other <br /> Building Type: ❑SFR-Detached MSFR-Attached ❑Duplex ❑Multi-Family-#of Units: ■ ommercial ❑industrial <br /> 'Type.of Project: [New MAddition ❑Remodel ❑Repair ,__❑T.L ❑Sign . OSprinkler _ ■De • ion ❑Change_of Use <br /> DESCRIPTION OF WORK: <br /> Installing photovoltaic system on roof <br /> ASSOCIATED BUILDING PERMIT#(if ap Ucable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project _New_ Addn _Alteration_Repair Type of Project _New _Addn ;Alteration _Repair <br /> #of #of <br /> List of Fixtures List of Fixtures List of Fixtures List of Fixtures <br /> Fixtures Fixtures Fixtures <br /> Fixfines. <br /> A/C—Air Handling Units beat Pump Toilet Backflow Preventer(Inside Bldg)L. , <br /> Forced Air Systems '‘Unit Heater Bathtub �; Urinal <br /> • GasPiping 'Bailer Lavatory(Washbasin) Drinking Fountain <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 Was er Medical Gas <br /> Range Hood.. Water Hea"ter _ Other <br /> `Exhaust Fan Sink"(ServicelBar ttopletcj Other -e <br /> ...- ..�. <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Chemical or Water I No;of Heads <br /> ACKNOWLEDGEMENT:t 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 onty 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.lam the owner,or lam authorized by the owner of this property to perform the work for which application is made, <br /> and/comply with the State Contractors Law 18,27 RCW and 298200A WAC, <br /> fly of Everett Official Use Only <br /> PER <br /> Owner/Authorized Agent Signature Date (Revised ,2015) "' <br />