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BLD2022-0985_Application_7.25.2022_9.30.43_AM_3008889CITY OF EDMONDS MyBuildingPermit.com Electrical Application #1177830 - Ho Solar Project Applicant First Name Last Name Company Name Nicholas Anderson Blossom Solar LLC Number Street Apartment or Suite Number E-mail Address 1706 Lombard Ave office@blossomsolar.com City State Zip Phone Number Extension Everett WA 98201 (425) 610-7067 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 4256107067 State License Number License Expiration Date UBI # E-mail Address BLOSSSL823M7 7/27/2024 F6467gRR7 office@blossomsolar.com Project Location Number Street Floor Number Suite or Room Number 8600 193RD PL SW City Zip Code County Parcel Number EDMONDS 98026 00614600000700 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 Robert S & Mira R Ho Number Street Apartment or Suite Number 8600 193RD PL SW City State Zip EDMONDS WA 98026-6132 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: 7/25/2022 Submitted By: Nicholas Anderson Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Electrical Application #1177830 - Ho Solar Project Project Contact Company Name: Blossom Solar LLC Name: Nicholas Anderson Email: office@blossomsolar.com Address: 1706 Lombard Ave Phone #: (425) 610-7067 Everett WA 98201 Project Type Single Family Residential Activity Type Scope of Work Alteration Photo -Voltaic Project Name: Ho Solar Project Description of Work: 8.88 kW grid tied roof mounted solar system. Project Details Alternate Power Source Solar Photovoltaic System Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1 8.88 kW grid tied roof mounted solar system. Page 2 of 2