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�-� ELECTRICAL PERMIT APPLICATION <br /> I�►� ,-, CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps©everettwagov www.everettwa.govlpermits <br /> P# "SATE INFOR ill "IQI <br /> PROJECT ADDRESS: 4'4)01 �larbIr I.avlc, tVet-et/MWA 9g7-b3 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: I2g SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> EI E RiCAL APPLiCAN),Ii INFORMATION :`" <br /> CONTRACT PRICE OF WORK:$ 2 •'t (%C`C <br /> NUMBER OF DEVICES(if low v•tage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 9.15 kW grid tied solar system,roof mounted <br /> NTACT 10001ATION <br /> OWNER NAME: Mary Morgan TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET PO Box 1002 <br /> CITY Everett STATE WA ZIP 98206 <br /> OWNER PHONE: 425-355-9131 OWNER EMAIL: dancefool@netzero.net <br /> CONTRACTOR NAME: Blossom Solar LLC <br /> CONTRACTOR ADDRESS: STREET 1706 Lombard Ave <br /> c rr Everett STATE WA ZIP 98201 <br /> CONTRACTOR PHONE: 425-610-7067 CONTRACTOR EMAIL: info@blossomsolar.com <br /> CONTRACTOR LIC.#(REQUIRED): BLOSSSL823M7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 57621 <br /> PRIMARY CONTACT: D OWNER [Zi CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: Cole Anderson CONTACT PHONE: 425-610-7067 <br /> CONTACT EMAIL: info@blossomsolar.com <br /> AGREEMENT:t hereby certify that!have read and examined this application and know the same to be true and correct. Alt provisions of laws and ordinances governing this type <br /> of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That t am authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Owner uthorized A SI tura Date {Revised 923/2016) <br />