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BLD2023-1354_Application_10.26.2023_9.37.33_AM_3862647CITY OF EDMONDS MyBuildingPermit.com Electrical Application #1395612 - Nilsen PV Applicant First Name Last Name Company Name Nazifullah Nazif Puget Sound Solar Number Street Apartment or Suite Number E-mail Address 805 Rainier Ave S permitting@pugetsoundsolar.com City State Zip Phone Number Extension Seattle WA 98144 (206) 706-1931 Contractor Company Name Puget Sound Solar LLC Number Street Apartment or Suite Number 805 Rainier Ave S City State Zip Phone Number Extension Seattle WA 98144 (206) 706-1931 State License Number License Expiration Date UBI # E-mail Address PUGETSS920RH 12/8/2024 ri(».iR4514 permitting@pugetsoundsolar.com Project Location Number Street Floor Number Suite or Room Number 712 7TH AVE S City Zip Code County Parcel Number EDMONDS 98020 27032500205600 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 James & Baurecht Magrit Nilsen Number Street Apartment or Suite Number 712 7TH AVE S 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: 10/26/2023 Submitted By: Nazifullah Nazif Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Electrical Application #1395612 - Nilsen PV Project Contact Company Name: Puget Sound Solar Name: Nazifullah Nazif Email: permitting@pugetsoundsolar.com Address: 805 Rainier Ave S Phone #: (206) 706-1931 Seattle WA 98144 Project Type Activity Type Scope of Work Single Family Residential Alteration Photo -Voltaic Project Name: Nilsen PV Description of Work: Installation of rooftop Solar Photovoltaic System consisting of 11.07kW - (27) Silfab 410W. (27) Enphase IQ8+. Project Details Alternate Power Source Solar Photovoltaic System 1 Work Location Work Description/Location (example: 1st floor, Roof Master Bath, Garage) Page 2 of 2