BLD2023-1618_Application_12.18.2023_11.42.55_AM_3958257CITY OF EDMONDS MyBuildingPermit.com
Electrical Application #1418375 - Baron Goldengoose PV
Applicant
First Name Last Name Company Name
BRS Permitting Blue Raven Solar
Number Street Apartment or Suite Number E-mail Address
1403 N 630 E Building J 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 N/A
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
23729 80TH CT W
City Zip Code County Parcel Number
EDMONDS 98026 01023000001200
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
Baron & Bunyatipanon K Goldengoose
Number Street Apartment or Suite Number
23729 80TH CT W
City State Zip
EDMONDS WA 98026
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: 12/18/2023 Submitted By: BRS Permitting
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CITY OF EDMONDS MyBuildingPermit.com
Electrical Application #1418375 - Baron Goldengoose PV
Project Contact
Company Blue Raven Solar
Name:
Name: BRS Permitting
Address: 1403 N 630 E
Building J N/A
Orem LIT 84097
Email: permitting.department@blueravensolar.com
Phone #: (385) 482-0045
Project Type Activity Type Scope of Work
Single Family Residential New Photo -Voltaic
Project Name: Baron Goldengoose PV
Description of Work: 4.51 kW PV Solar Panel Installation on Roof - 11 panels
Project Details
Alternate Power Source
Solar Photovoltaic System 11
Work Location
Work Description/Location (example: 1st floor, Roof
Master Bath, Garage)
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