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BLD2023-0929_Application_7.25.2023_8.01.43_AM_3686195CITY OF EDMONDS MyBuildingPermit.com Electrical Application #1352767 - Donald Warren PV Applicant First Name Last Name Company Name BRS Permitting Blue Raven Solar Number Street Apartment or Suite Number E-mail Address 1403 N Research Way permitting.department@blueravensolar.com City State Zip Phone Number Extension Orem UT 84097 (385) 482-0045 Contractor Company Name BRS FIELD OPS LLC Number Street Apartment or Suite Number 1403 N Research Way City State Zip Phone Number Extension Orem UT 84097 (385) 482-0045 State License Number License Expiration Date UBI # E-mail Address BRSFIFO820N3 8/23/2024 FD497F51 q permitting.department@blueravensolar.co Project Location Number Street Floor Number Suite or Room Number 23232 92ND AVE W City Zip Code County Parcel Number EDMONDS 98020 27033600110200 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 Donald Warren Number Street Apartment or Suite Number 23232 92ND 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: 7/25/2023 Submitted By: BRS Permitting Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Electrical Application #1352767 - Donald Warren PV Project Contact Company Blue Raven Solar Name: Name: BRS Permitting Email: permitting.department@blueravensolar.com Address: Way N Research Phone #: (385) 482-0045 Orem UT 84097 Project Type Activity Type Scope of Work Single Family Residential New Photo -Voltaic Project Name: Donald Warren PV Description of Work: 4.2 kW PV Solar Panel Installation on Roof Project Details Alternate Power Source Solar Photovoltaic System 10 Work Location Work Description/Location (example: 1st floor, Roof Master Bath, Garage) Page 2 of 2