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BLD2023-1549_Application_12.4.2023_3.53.40_PM_3933077CITY OF EDMONDS MyBuildingPermit.com Electrical Application #1412488 - Ghenov Solar Project Applicant First Name Last Name Company Name Stephanie Stewart Blossom Solar LLC Number Street Apartment or Suite Number E-mail Address 3609 168th St NE 3507 office@blossomsolar.com City State Zip Phone Number Extension Arlington WA 98223 (425) 610-7067 Contractor Company Name BLOSSOM SOLAR LLC Number Street Apartment or Suite Number 3609 168th St NE 3507 City State Zip Phone Number Extension Arlington WA 98223 (425) 610-7067 State License Number License Expiration Date UBI # E-mail Address BLOSSSL823M7 7/27/2024 FD4D7gRR7 office@blossomsolar.com Project Location Number Street Floor Number Suite or Room Number 8909 218TH ST SW City Zip Code County Parcel Number EDMONDS 98026 00602600002600 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 David Ghenov Number Street Apartment or Suite Number PO BOX 771 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: 12/4/2023 Submitted By: Stephanie Stewart Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Electrical Application #1412488 - Ghenov Solar Project Project Contact Company Name: Blossom Solar LLC Name: Stephanie Stewart Email: office@blossomsolar.com Address: 3609 168th St NE 3507 Phone #: (425) 610-7067 Arlington WA 98223 Project Type Activity Type Scope of Work Single Family Residential Alteration Photo -Voltaic Project Name: Ghenov Solar Project Description of Work: 7.38kW grid tied roof mounted solar system Project Details Alternate Power Source Solar Photovoltaic System 1 Work Location Work Description/Location (example: 1st floor, Rooftop Master Bath, Garage) Page 2 of 2