BLD2021-1591_Application_11.23.2021_11.29.47_AM_2535605CITY OF EDMONDS MyBuildingPermit.com
Electrical Application #1054284 - Stine Solar
Applicant
First Name Last Name Company Name
Nicholas Anderson Blossom Solar LLC
Number Street Apartment or Suite Number E-mail Address
1706 Lombard Ave cole@bloomsolarenergy.com
City State Zip Phone Number Extension
Everett WA 98201 4253304322
Contractor
Company Name
BLOSSOM SOLAR LLC
Number Street Apartment or Suite Number
1706 1706 Lombard Ave
City State Zip Phone Number Extension
Everett WA 98201 (425)330-4322 (425)330-4322
State License Number License Expiration Date UBI # E-mail Address
BLOSSSL823M7 7/27/2022 FD4D7gRR7 cole@bloomsolarenergy.com
Project Location
Number Street Floor Number Suite or Room Number
21702 98TH AVE W
City Zip Code County Parcel Number
EDMONDS 98020 27032500109900
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
Todd A & Sarah L Stine
Number Street Apartment or Suite Number
21702 98TH AVE W
City State Zip
EDMONDS WA 98020
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: 11/23/2021 Submitted By: Nicholas Anderson
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CITY OF EDMONDS MyBuildingPermit.com
Electrical Application #1054284 - Stine Solar
Project Contact
Company Name: Blossom Solar LLC
Name: Weston Ferguson Email: weston@blossomsolar.com
Address: 1706 Lombard Ave Phone #: 4256107067
Everett WA 98201
Project Type Activity Type Scope of Work
Single Family Residential Alteration Photo -Voltaic
Project Name: Stine Solar
Description of Work: 18.4 kW Grid Tied Roof Mounted Solar with 20 kWh Battery
Project Details
Alternate Power Source
Solar Photovoltaic System 1
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