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BLD2022-1165_Application_8.31.2022_11.05.19_AM_3083074CITY OF EDMONDS MyBuildingPermit.com Electrical Application #1195727 - Leslie Brown Applicant First Name Last Name Company Name Beth Morin Revolution Energy Systems Inc Number Street Apartment or Suite Number E-mail Address 9981 190th St Suite K permits.wa@revolutionsolar.com City State Zip Phone Number Extension Mokena IL 60448 (708) 995-1643 Contractor Company Name Revolution Energy Systems Inc Number Street Apartment or Suite Number 9981 190th St Suite K City State Zip Phone Number Extension MOKENA IL 60448 (708)694-2035 State License Number License Expiration Date UBI # E-mail Address REVOLES7831_2 6/22/2024 FD4q15746 permits.wa@revolutionsolar.com Project Location Number Street Floor Number Suite or Room Number 21412 96TH AVE W City Zip Code County Parcel Number EDMONDS 98020 27032500107000 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 Leslie K Brown Number Street Apartment or Suite Number 21412 96TH 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: 8/31/2022 Submitted By: Beth Morin Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Electrical Application #1195727 - Leslie Brown Project Contact Company Name: Revolution Energy Systems Inc Name: Beth Morin Email: permits.wa@revolutionsolar.com Address: 9981 190th St Suite K Phone #: (708) 995-1643 Mokena IL 60448 Project Type Single Family Residential Activity Type Scope of Work New Photo -Voltaic Project Name: Leslie Brown Description of Work: Install Residential Rooftop Solar System Project Details Alternate Power Source Solar Photovoltaic System Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) 1 Install Residential Rooftop Solar system Page 2 of 2