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Permit File BLD-2021-0051 1815 10th Street
Y C} City of Anacortes Invoice/Permit#: BLD-2021-0051 904 6th Street Applied date: 01/13/2021 P.O.Box 547 Issue date: 01/20/2021 _ 0, Anacortes, WA 98221-0547 Expire date: 07/19/2022 441 (360) 293-1901 Job Address: 1815 10TH ST Permit Type: PV Solar Permit ANACORTES WA98221-1417 Project: APN: P56059 Remarks: INSTALL A GRID-TIED SOLAR PV SYSTEM. Owner: ERIC&AMANDA BALTAZAR Contractor: BANNER ELECTRIC INC. DBA BANNER POWER S Address: PO BOX 922 Address: 130 E HAZEL AVE ANACORTES WA 98221-0922 BURLINGTON WA 98233 Phone: (360)293-5364 Phone: (360)770-2185 License#: General Information: Fees: Building Valuation 3574 Building Permit Fee 97.25 Plan Review Fee 63.21 State Building Code Fee Resi 6.50 Total Calculated: 166.96 Deposits/Receipts: 0.00 Total Due: 166.96 The issuance or granting of this permit shall not be construed to be a permit for,or approval of, any violation of this Code or any other ordinance or order of the City, of any state or federal law, or of any order, proclamation, guidance advice or decision of the Governor of this State. To the extent the issuance or granting of this permit is interpreted to allow construction activity during any period of time when such construction is prohibited or restricted by any state or federal law, or order, proclamation, guidance advice or decision of the Governor of this State, this permit shall not authorize such work and shall not be valid. The building official is authorized to prevent occupancy or use of a structure where in violation of this Code, any other City ordinances of this jurisdiction or any other ordinance or executive order of the City,or of any state or federal law,or of any order, proclamation, guidance advice or decision of the Governor. The building official is authorized to suspend or revoke this permit if it is determined to be issued in error or on the basis of incorrect, inaccurate or incomplete information, or in violation of any City ordinance, regulation or order, state or federal law, or any order, proclamation, guidance or decision of the Governor.This permit becomes null and void if work or construction authorized is not commenced within 180 days or if construction work is suspended or abandoned for a period of 180 days at any time after work is commenced. I have read and examined this application and know the same to be true and correct. SIGNATURE OF OWNER OR AUTHORIZED AGENT ISSUED BY Eric L Baltazar CITY OF ANACORTES 1815 10th Street PLANNING AND BUILDING DEPT: Anacortes, WA 98221 360-202-6430 APPROVED PLANS ifIy430@hotmail.com REVIEWED FOR CODE COMPLIANCE Site Overview PERMIT#: BLD-2021-0051 ADDRESS: 1815) Oth T , 2 APPROVED BY: .r - Kan qciCa 10th S€. g 'I17h S.t: - I Oth St, . . '4...-*'"millirril - .n1 .461 i II . ; I. o -1-riL4 - - mit! . . -War OW 4 . %11 s* --I.T. 4.....*"). '4, , X k — )4 AL, - , -,_,,, '_.,, _1 ."-k-, 1., "•;oilp .,,. . . l•0 w . Tiiktii, Itt -"'",-• 041rw' ) 6--.` - I ablio a • T '+ T I w w 4 a I t•r 9 I 'r r �C?. :7 ;oo, I r 4 67":11 • Eric L Baltazar 1815 10th Street Anacortes, WA 98221 360-202-6430 if1y430@hotmail.com Solar Panel Layout - _ __ _ - _ Roof Slope = 5/12 or 23° �_ = - = - ii\i -- _ - North ■ k>':i l! :i Roof Slope = 4/12 or 18° .l / ::i121 111111 111 j/ i. IMP" \ / Eric L Baltazar 1815 10th Street Anacortes, WA 98221 360-202-6430 ifly430@hotmail.com Solar Panel Layout with Setbacks from hips/valleys SOUTH ROOF L 2'4" INS" 1' Eric L Baltazar 1815 10th Street Anacortes, WA 98221 360-202-6430 ifIy430@hotmail.com Solar Panel Layout with Setbacks from hips/valleys WEST ROOF 0 10' 2" 4- 0 0 1\i'4 \ I ri \ 1 H Eric L Baltazar 1815 10th Street Anacortes, WA 98221 360-202-6430 ifly430@hotmail.com Solar Array and Roof Square Footage in Plan View Roof Total Sq Footage = 2484 Solar total Sq Footage =409 Solar Sq Footage percent of Roof Sq Footage = 16.5% I 2075 ft2 —f 305 ft2 I I .- 104 ft2 5/11/2018 Chapter 6: Building Services and Systems, Fire Code 2015 of Washington I UpCodes 605.11.1.2 Solar Photovoltaic Systems For Group R-3 Residential and STATE Buildings Built Under The International Residential Code AMENDMENT Solar photovoltaic systems for Group R-3 residential and buildings built under the International Residential Code shall comply with Sections 605.11.1.2.1 through 605.11.1.2.5. Exceptions: 1. Residential dwellings with an approved automatic fire sprinkler system installed. 2. Residential dwellings with approved mechanical or passive ventilation systems. 3. Where the fire code official determines that the slope of the roof is too steep for emergency access. 4. Where the fire code official determines that vertical ventilation tactics will not be utilized. 5. These requirements shall not apply to roofs where the total combined area of the solar array does not exceed 33% as measured in plan view of the roof area of the structure, where the solar array will measure 1,000 ft2 or less in area, and where a minimum 18 inches unobstructed pathway shall be maintained along each side of any horizontal edge. 605.11.1.2.1 Size of Solar Photovoltaic Array STATE AMENDMENT 1. Each photovoltaic array shall be limited to 150 feet (45,720 mm) by 150 feet (45,720 mm). Multiple arrays shall be separated by a 3-foot wide (914 mm) clear access pathway. 2. Panels/modules shall be located up to the roof ridge where an alternative ventilation method approved by the fire code official has determined vertical ventilation techniques will not be employed. https://up.codes/viewer/washington/ifc-2015/chapter/6/building-services-and-systems#605 6/9 Baltazar - 1815 10th Street (#722822) 28357 INDUSTRIAL BLVD., HAYWARD,CA 94545 pitched roof Project Details Name Baltazar- 1815 10th Street Date 01/12/2021 Location 1815 10th Street,Anacortes, WA 98221 Total modules 24 Module Silfab: SIL-330 BL(38mm) Total watts 7,920 Dimensions 66.93"x 39.37"x 1.5" (1700.0mm x 1000.0mm x 38.0mm) Attachments 44 ASCE 7-10 System Weight Load Assumptions Total system weight 1,262.5 lbs Wind exposure C Weight/attachment 28.7 lbs Wind speed 110 mph Racking weight 230.5 lbs Ground snow load 25 psf Distributed weight 2.8 psf Attachment spacing landscape 8.0' Roof Information Roof material Comp Shingle Building height 20 ft Roof attachment None Roof slope 22 ° Attachment hardware Square Risk category II Span Details XR100 - Landscape Reaction Forces XR100 - Landscape Zone Down Uplift Lateral Zone Max span Max cantilever (Ibs) (Ibs) (Ibs) 1 9' 8" 3' 10" 1 259 143 83 2 9' 8" 3' 10" 2 259 290 83 3 8' 9" 3' 6" 3 259 457 83 Last updated by Andy Bourne on 01/12/21 01:53 PM Page 1 of 5 Baltazar - 1815 10th Street (#722822) 28357 INDUSTRIAL BLVD., HAYWARD,CA 94545 pitched roof Roof Section 1 Definition Roof Section Weights Roof Section (all segments) 6 modules Total weight: 326.7 lbs Provided rail: 90' [2 x 17', 4 x 14'] Landscape orientation Weight/attachment: 23.3 lbs Attachments: 14 Graphical entry Total Area: 111.7 sq ft Splices: 0 Distributed weight: 2.9 psf Clamps: 6 Diagram ME. 71M T I- 16' 10"—i Segments Columns Length Cantilever Cantilever Violations Rail Attachments Splices Clamps 1 5' 9" 0" None 28' [2 x 14'] 4 0 0 2 11' 4" 1' 8" None 28' [2 x 14'] 4 0 2 3 17' 6" None 34' [2 x 171 6 0 4 Roof Section 2 Definition Roof Section Weights Roof Section (all segments) 18 modules Total weight: 945.5 lbs Provided rail: 220' [8 x 17', 6 x 141 Landscape orientation Weight/attachment: 31.5 lbs Attachments: 30 Graphical entry Total Area: 333.0 sq ft Splices: 6 Distributed weight: 2.8 psf Clamps: 28 Diagram in Fr, MINIMMIMM 1 I 33' 7" I Segments Columns Length Cantilever Cantilever Violations Rail Attachments Splices Clamps 3 17' 6" None 34' [2 x 17'] 6 0 4 4 22' 7" 3' 3" None 56' [4 x 141 6 2 6 5 28' 2" 2' 1" None 62' [2 x 14', 2 x 171 8 2 8 6 33' 9" 11" None 68' [4 x 171 10 2 10 Last updated by Andy Bourne on 01/12/21 01:53 PM Page 2 of 5 Baltazar - 1815 10th Street (#722822) 28357 INDUSTRIAL BLVD., HAYWARD,CA 94545 pitched roof Splice Details I r r Clamp Detail PrkPV MODULE PV MODULE oplir-iim FRAME FRAME .. mop �_ � RAIL1 ) ��Oellik CAMO CAMO - 7 RAIL CAMO End Clamp, Plan CAMO End Clamp, Front Last updated by Andy Bourne on 01/12/21 01:53 PM Page 3 of 5 Baltazar - 1815 10th Street (#722822) 28357 INDUSTRIAL BLVD., HAYWARD,CA 94545 pitched roof Grounding Diagram KO< 101 loImieli EO< 101 IoLr1_1IioI 1O >Icp NO< 101 1®timui©1TO 1' OK 101 101 101 O O OUFO Clamp • Grounding Lug * -+ Fault Current Ground Path _L Min 10 AWG Copper Wire * Bonded Splice (Rail Connection) *Grounding Lugs and Wire are not required in systems using Enphase microinverters. Last updated by Andy Bourne on 01/12/21 01:53 PM Page 4 of 5 Baltazar - 1815 10th Street (#722822) 28357 INDUSTRIAL BLVD., HAYWARD,CA 94545 pitched roof Bill of Materials Part Spares Total Qty Rails& Splices XR-100-204B 0 10 XR100,Rail 204"(17 Feet)Black XR-100-168B -1 9 XR100,Rail 168"(14 Feet)Black XR100-BOSS-01-M1 0 6 Bonded Splice,XR100 Clamps& Grounding UFO-C L-01-B 1 0 34 Universal Module Clamp,Black CAMO-01-M1 0 28 Hidden End Cam(universal clamp) XR-LUG-03-A1 0 7 Grounding Lug,Low Profile Attachments BHW-SQ-02-A1 0 44 Square-Bolt Bonding Hardware Last updated by Andy Bourne on 01/12/21 01:53 PM Page 5 of 5 Datasheet __I- IRONRIDGE Flush Mount System i .1.,:il, ________-_-___- -- C. .441111406. Built for solar's toughest roofs. IronRidge builds the strongest mounting system for pitched roofs in solar. Every component has been tested to the limit and proven in extreme environments. Our rigorous approach has led to unique structural features, such as curved rails and reinforced flashings, and is also why our products are fully certified, code compliant and backed by a 20-year warranty. Strength Tested PE Certified AllAll components evaluated for superior ® Pre-stamped engineering letters structural performance. available in most states. o Class A Fire Rating Design Assistant Certified to maintain the fire resistance El Online software makes it simple to rating of the existing roof. create, share, and price projects. UL 2703 Listed System 20-Year Warranty ® Entire system and components meet fit Twice the protection offered by newest effective UL 2703 standard. competitors. Datasheet - XR Rails O XR10 Rail XR100 Rail XR1000 Rail Bonded Splices i i —......______........3 --._____...........i --___________.....01 A low-profile mounting rail The ultimate residential A heavyweight mounting All rails use internal splices for regions with light snow. solar mounting rail. rail for commercial projects. for seamless connections. • 6'spanning capability • 8'spanning capability • 12'spanning capability • Self-drilling screws • Moderate load capability • Heavy load capability • Extreme load capability • Varying versions for rails • Clear& black anod. finish • Clear& black anod. finish • Clear anodized finish • Forms secure bonding - Clamps & Grounding O — UFOs Stopper Sleeves Grounding Lugs Microinverter Kits — ....--4,... 7-7 -,.• T - 1- Universal Fastening Objects Snap onto the UFO to turn Connect arrays to Mount Mls or POs to XR bond modules to rails. into a bonded end clamp. equipment ground. Rails. • Fully assembled & lubed • Bonds modules to rails • Low profile • Bonds devices to rails • Single, universal size • 6 different sizes • Single tool installation • Kit comes assembled • Clear& black finish • Clear& black anod. finish • Mounts in any direction • Listed to UL 2703 - Attachments O FlashFoot2 Slotted L-Feet Bonding Hardware Flush Standoffs 1 ...=Atbas, smomM._ _, _ cm, z_z__,_ _ _. _______ __„.., , "` Flash and mount XR Rails Drop-in design for rapid rail Bond and attach XR Rails Raise Flush Mount System with superior waterproofing. attachment. to certified attachments. to various heights. • Twist-on Cap eases install • Secure rail connections • T& Square Bolt options • Works with vent flashing • Wind-driven rain tested • Slot for vertical adjusting • Nut uses 7/16"socket • 4" and 7" lengths • Mill & black finish • Clear& black anod. finish • Assembled & lubricated • Ships assembled - Resources __.7._ _ _ _ esign Assistant NABCEP Certified Training __ 'o from rough layout to fully �' Earn free continuing education credits, NABCEP ngineered system. For free. while learning more about our systems. _ -- o to IronRidge.com/design ��T""`""° Go to IronRidge.com/training ©2016 IronRidge,Inc.All rights reserved.Visit www.ironridge.com or call 1-800-227-9523 for more information.Version 1.20 ,IA& S UNIV1• Cut Sheet We've Got Your Rack! 1. Nano Mount 1.97 NanoMount' (Rafter) [50.0] Of -031 Air. 9 0, 04 1n m © Win? T n: ,..-- 1 _._ o C 1 _ I411 Material:Aluminum [0101.6] ` Finish: Black Powder Coati - 04.00 i 2. I 1I-14 03.66 —— [093.0] — Material: USWR Silicone Foam Gasket with Adhesive 3. Hex Lag Bolt M8X115, DIN 571,304SS s.31 1150) nI.352.51 Part Description: Nano Rafter Mount, Black ,w ►►►►1►n►�►u►�►mn►m►�►►I►►�►n►►�nm►1► n►a►a►ni►v►►ui►au►�►iwi►�a►u►u►uir►\►i►uu��►iIIC Part No.: K50044-BK1 1501 Material:Stainless Steel Finish:Clear Item Description Qty in No. Kit 4. Sealing Washer.33ID X.75X.157 1 Nano Rafter Mount Assembly 1 _ • Nano Rafter Mount • Nano Gasket l 0073 I 1 [13.51 I 00.75 + ] I I [19.0] 2 Lat Bolt Assembly 1 • Hex Lag Bolt M8X115, DIN 571, 304S 1 • Sealing Washer.33 ID X.75 X.157 00.33 03.51 Material: EPDM+ Stainless Steel D10213-V001 Dimensions shown are inches(and millimeters) Details are subject to change without notice SUNM•D Cut Sheet We've Got Your Rack! 1. Nano Mount NanoMount' (Decking) [500] Air 9 iC —0 8] /'1 , 04 in m in com Iim=I n.. dIIC r 1 Material:Aluminum ]gltot.s] Finish: Black Powder Coati 2. I o.za[s.o] ¢3.66 _- - [093.0] Material: USWR Silicone Foam Gasket with Adhesive 3. Self-Drilling Screw,#6.3 X 76 ] 106. - //�� 3.00 IIp\ ■ Part Description: Nano Deck Mount, Black 1rd �6� •�IIIIIIIIIIIOMlllllllllllllllllNONN111RONON011ltOtm Part No.: K50044-BK2 603 Material:Stainless Steel Finish:Clear Item Description Qty in No. Kit 4. Sealing Washer.26ID X.50X.125 1 Nano Deck Mount Assembly 1 • Nano Deck Mount • Nano Gasket i � 16.61 00.59 I00.63 [750] I [18.0] 2 Decking Screw Assembly 4 F__ I • Self-Drilling Screw, #6.3 X 76 ] \\\ • Sealing Washer.26ID X.50X.125 D10214-V001 Dimensions shown are inches(and millimeters) Details are subject to change without notice • A _4. I ANano Deck SOLAR'S ount / FASTESIx M : _ „ . _ ATTACHMEN NanoMountTM s Nano Rafter Mount Damaging roof shingles used The NanoMount Advantage to be one of a solar installers' � The fastest roof attachment in worst challenges. solar Now, the easy, affordable � Versatile mounting options including direct-to-decking solution is NanoMountTM , SunModo's newest solar ./ Eliminates the need to lift mounting innovation. shingles and prevents damage to shingle The mount consists of only two -/ High-Velocity Hurricane Zone components and eliminates Approved - Passed TAS 100 (a) the need for lifting shingle, Wind-Driven Rain Test thus significantly cutting down ,/ All materials are compatible with the installation time. roof shingles Key Features of NanoMountT' 5 levels of protection against Aesthetically pleasing water penetration unibody aluminum cast construction 360-degree positioning, III serrated surface on both sides for rail mounting Versatile mounting option includes direct-to-decking for fast installation • Integrated Ultra Soft Weather Resistant silicone gasket Alignment markers enable easy installation Technical Data Application Composite shingle and rolled asphalt Material High grade aluminum, 304 stainless steel hardware Finish Black powder coating Roof Attachment Rafter and decking Structural integrity IBC and IRC Compliant Warranty 25 years SunModo, Corp. Vancouver, WA., USA • www.sunmodo.com • 360.844.0048 • info@sunmodo.com ....... BC Series SIISI L m3 3i BL SOLAR BAA 25°` JUST TIER 1 � ��° ! -IN- DNV•GL BANKABLE ARRA PRODNTY AUTOMATED TIME oEATOPMEw $$$ HIGH WARRA 126 Cell INDUSTRY LEADING WARRANTY All our products include an industry leading 25-year product workmanship and 30-year performance warranty. Monocrystalline MAXIMUM ENERGY OUTPUT Silfab BC Series utilizes next generation PV Module Back Contact technology to reduce production/manufacturing steps and improve quality while maximizing power. Ideal for residential and commercial projects where maximum power density is preferred. NORTH AMERICAN QUALITY Silfab is the largest and most automated C E .00)- ❑ ®` I EC solar manufacturer in North America. Intertek Intertek Utilizing premium quality materials and cEc G®, Fraunhofer strict quality control management to SSE deliver the highest efficiency, premium quality PV modules 100%made in North America. CHUBB° *Chubb provides error and omission insurance to Silfab Solar Inc. EEE PROVIDES MAXIMUM EFFICIENCY DOMESTIC PRODUCTION 126 high-efficiency half-cut cells combined with a black conducti- Silfab Solar manufactures our PV modules in two automated ve back-sheet resulting in a maximum power rating of 330Wp. locations within North America. Our 300+ North American team 35+ YEARS OF SOLAR INNOVATION is ready to help our partners win the hearts and minds of custo- Leveraging over 35+years of worldwide experience in the solar mers, providing customer service and product delivery that is industry,Silfab is dedicated to superior manufacturing processes direct,efficient and local. and innovations such as Bifacial and Back Contact technologies EEE SUPERIOR POWER to ensure our partners have the latest in solar innovation. Super power achieved through relocation of tabbing ribbon to BAA/ARRA COMPLIANT reduce shading on module front service and circuit resistance. Silfab panels are designed and manufactured to meet Buy EEE AESTHETICALLY PLEASING American Act Compliance.The US State Department,US Military Sleek aesthetics from black cells to black back-sheet without and FAA have all utilized Silfab panels in their solar installations. tabbing or bus-bar ribbons, ideal for residential applications. LIGHT AND DURABLE EEE STABLE PERFORMANCE Engineered to accommodate low load bearing structures up to Enhanced life-time performance through reduced thermal 5400Pa.The light-weight frame is exclusively designed for wide- stresses and increased current flow paths. ranging racking compatibility and durability. EEE PID RESISTANT LOWEST DEFECT RATE PID Resistant due to advanced cell technology and material Total automation ensures strict quality controls during the entire selection. In accordance to IEC 62804-1 manufacturing process at our ISO certified facilities.48.18 ppm as per December 2018. Printed on recycled paper. Crd Electrical Specifications SIL-330 BL mono PERC MWT Technology Test Conditions STC NOCT Module Power(Pmax) Wp 330 246.8 Maximum power voltage(Vpmax) V 34.72 32.51 Maximum power current(Ipmax) A 9.51 7.59 Open circuit voltage(Voc) V 42.24 39.6 Short circuit current(Isc) A 9.83 7.92 Module efficiency % 19.4 18.14 Maximum system voltage(VDC) V 1000 Series fuse rating A 20 Power Tolerance Wp 0/+10 Measurement conditions:STC 1000 W/m2•AM 1.5•Temperature 25°C•NOCT 800 W/m2•AM 1.5•Measurement uncertainty<3% •Sun simulator calibration reference modules from Fraunhofer Institute.Electrical characteristics may vary by±5%and power by 0/+10W. Temperature Ratings SIL-330 BL mono PERC MWT Technology Temperature Coefficient Isc %/°C +0.031 Temperature Coefficient Voc %/°C -0.301 Temperature Coefficient Pmax %/°C -0.419 NOCT(±2°C) °C 40.6 O•eratin• tem•erature °C -40/+85 Mechanical Properties and Components SIL-330 BL mono PERC MWT Technology Module weight(±1 kg) kg 19.5 Dimensions(H x L x D;±1mm) mm 1700 x 1000 x 38 Maximum surface load(wind/snow)* Pa 4000 Pa rear load/5400 Pa front load Hail impact resistance 0 25 mm at 83 km/h Cells 126 high-efficiency half-cut mono-PERC MWT c-Si cells Glass 3.2 mm high transmittance,tempered,DSM antireflective coating Backsheet Multilayer,integrated insulation film and electrically conductive backsheet Frame Anodized Al(Black) Bypass diodes 3 diodes-205Q040(45V,20A) Cables and connectors 1000 mm 0 5.7 mm(4 mm2),Multicontact MC4 connectors(refer to installation manual) Junction Box UL 3730 Certified,IP67 rated Warranties SIL-330 BL mono PERC MWT Technology Module product workmanship warranty 25 years** 30 years 97%end of 1st year Linear power performance guarantee >_90%end of 12th year >_82%end of 25th year >_80%end of 30th ear Certifications SIL-330 BL mono PERC MWT Technology o ULC ORD C1703,UL 1703,FSEC and CEC listed.Product Product durability proven up to 3 x IEC, climate chamber tests up to DH3000-TC600-HF30 UL Fire Rating:Type 1 Factory IS09001:2015 - 38 *Please refer to the Safety and Installation Manual for mounting specifications. woo + 7 f **12 year extendable to 25 years subject to registration and conditions outlined under 1 Z - -o , 'Warranty"at www.silfabsolar.com. ® 01 0 0 A Warning:Read the installation and User Manual before handling,installing and operating - `s modules. E i Modules Per Pallet:26 i Pallets Per Truck:36 ol000mm v^ i i Modules Per Truck:936 0 3 81 - o ' C o Silfab Solar Inc. o ;_ 240 Courtneypark Drive East Mississauga ON L5T 2Y3 Canada ! S i Ifa b Tel+1 905-255-2501 I Fax+1 905-696-0267 [_ 964 .] I 0 SOLAR info@silfabsolar.com I www.silfabsolar.com �/ Grounding Hole u, o N N 11 © ® Silfab Solar Inc. m 800 Cornwall Ave Bellingham WA 98225 USA _ - Tel+1 360-569-4733412 � Y o PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT ��'� Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location:904 6th Street, Anacortes WA 98821 Y `4 86�� Phone: (360)293-1901 FORM BP-1: RESIDENTIAL BUILDING PERMIT APPLICATION 1. PROPERTY INFORMATION Project Address(Street,Suite#): Assessor Parcel Number: 1815 10th St P56059 Subdivision/Lot#: Zoning Designation: Lot area (size): sq.ft. 2. TYPE OF PROJECT ❑ New SFR ❑ New Accessory Dwelling Unit: ❑ Deck/porch (new/repair) ❑ New Duplex ❑ Attached to Primary Unit ❑ Interior remodel ❑ Detached from Primary Unit ❑ New Addition to SFR ❑ Garage, carport or accessory building E Fence or retaining wall or duplex (new/repair) ® Other: Rooftop Solar PV Installation Project Summary: Full installation of grid-tied Solar PV system Project Valuation: $3574 3. PROPERTY OWNER INFORMATION Name: Eric Baltazar Phone: 360-202-6430 Address(Street,City,State,Zip): Email Address: 1815 10th St ifly430@hotmail.com 4. CONTRACTOR INFORMATION Name:* Banner Electric Inc. Phone: 360-755-3030 Contractor's Business Licenses State License#: City License#: *All Contractors&Subcontractors must have a valid City EC BANNEEI965RP 602453660 of Anacortes business license prior to doing work in the Expiration Date: Expiration Date: City. 9-30-2021 9/30/2021 Address(Street,City,State,Zip): Email Address:130 E Hazel Ave, Burlington,WA 98233 info@bannerpowersolutions.com 5. CONTACT PERSON Select one person the city will contact for anything ❑ Applicant ❑ Property Owner ❑x Contractor related to this project: ❑ Other(list below) Name: Andy Bourne Phone: 360-383-8318 or 360-755-3030 Address(Street,City,State,Zip): Email Address: 130 E Hazel Ave,Burlington,WA 98233 andy@bannerpowersolutions.com Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 5 of 18 Y o PLANNING, COMMUNITY, & ECONOMIC DEVELOPMENT DEPARTMENT 4111‘, Mailing Address: P.O. Box 547, Anacortes, WA 98221 Office Location:904 6th Street, Anacortes WA 98821 Phone: (360)293-1901 6. LENDER INFORMATION RCW 19.27.095 requires the City to obtain information with regard to lenders. If there are no lenders involved with your project, write"no lenders"on the Name Line below. Name: no lenders Phone: Address(Street,City,State,Zip): Email Address: 7. ACKNOWLEDGEMENTS & SIGNATURE Read and initial each of the following statements prior to signing this application: I understand that when a building permit application is taken in over the counter it does not mean AB the application has been deemed technically complete and sufficient for staff review. AB I understand that if I submit incomplete, inaccurate, and/or erroneous information it will take the City longer to process my permits. AB I understand and acknowledge that I could be responsible for providing as-built drawings (on paper or electronically) as part of the project's certificate of occupancy process. I understand and acknowledge that Special Inspections could be required as part of my project, and AB if needed I will be required to pay for the cost of these inspections. I understand and acknowledge that financial securities could be required as part of the work I am AB completing and I agree to provide the items needed for the City to calculate these securities and to provide the securities themselves. I understand that if permits are reviewed concurrently such as design review, site plan,traffic AB concurrency, etc., any required revisions to one permit may affect the entire plan set and could add costs and time to the project. I hereby declare that I am either the owner of the property listed on this application or the owner of this property has authorized me to be their representative to act for them. I also declare under penalty of perjury under the laws of the State of Washington that all of the statements and answers contained herein, and the information submitted with this application form is in all respects,true, correct, and complete to the best of knowledge and belief. Andy Bourne ,(Q"� 56Y1 44, January 12,2021 Signature Datc Andy Bourne Printed Name Res.Building Permit Application Submittal Checklist Updated October 10,2019 Page 6 of 18