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BLD2021-1571_Application_11.17.2021_5.24.44_PM_2526163CITY OF EDMONDS MyBuildingPermit.com Electrical Application #1051592 - Fuentes Solar Applicant First Name Last Name Company Name Jose Gallardo Solgen Power LLC Number Street Apartment or Suite Number E-mail Address 5715 Bedford Street permitting.wa@solgenpower.com City State Zip Phone Number Extension Pasco WA 99301 509-931-1663 Contractor Company Name Solgen Power LLC Number Street Apartment or Suite Number 5715 Bedford St City State Zip Phone Number Extension Pasco WA 99301 509-931-1663 State License Number License Expiration Date UBI # E-mail Address SOLGEPL830RJ 1/24/2022 BD41 R77n.r; permitting.wa@solgenpower.com Project Location Number Street Floor Number Suite or Room Number 18117 80TH AVE W City Zip Code County Parcel Number EDMONDS 98026 00370800100503 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Roberto Fuentes Number Street Apartment or Suite Number 18117 80TH AVE W City State Zip EDMONDS WA 98026-5413 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work requires a licensed contractor to perform the work, the information will be provided prior to permit issuance. Date Submitted: 11/17/2021 Submitted By: Jose Gallardo Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Electrical Application #1051592 - Fuentes Solar Project Contact Company Name: Solgen Power LLC Name: Jose Gallardo Email: permitting.wa@solgenpower.com Address: 5715 Bedford Street Phone #: 509-931-1663 Pasco WA 99301 Project Type Activity Type Scope of Work Single Family Residential New Photo -Voltaic Project Name: Fuentes Solar Description of Work: PV Solar Roof Installation. Project Details Alternate Power Source Solar Photovoltaic System 1 Page 2 of 2