20160901114440.pdfDEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
121 51h Avenue N, Edmonds, WA 9 020
City of Edmonds Phone 425.771.0220 4 Fax 425.771.0221
PLEASE REFER TO THE PLUMBING & MECHANICAL CHECKLIST FOB SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip): Parcel #:
406 2nd Ave N, Edmonds, WA 98020 00592200000600
Associated Permit #:
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes No�
APPLICANT: Phone: PR7-
Filco Company Inc. 206-547-8347 -548-9352
Address PO Box 12t 8w Seattle, Washin tort 98103 -Mail info@filcoenviro.com
" ' nfo@filcoenviro.com
PROPRTY OWNER: Phone: Fax:
Steve Malone 206-214-8042
Address (Street, City, State, Zip): E-Mail Address:
810 Alder St. Edmonds, WA 98020 stephen.e.maloney@gmail,,.com
LENDING AGENCY: Phone: Fax:
Address (Street, City, State, Zip):- E-Mail Address:
CONTRACTOR:* phone: Fax:
Filco CommCommy Inc, 206-547-8347 06-548-9352
Address (Street, City, Mate, Zip): &Mail Address:
PO Box 31228 Seattle Washington 98103 info@filcoenviro.com
WA State License /Ex
p. Dat
Contractor must i"rmw a valid City ofEdrnonds business license to damn %v rk. FI .COCIO80P1r110 10/2015
in the Cita�, Contact the Cioa Clerk'sOffice at 425.775.2525 +fit Bosiness License N/E
l"1 ��i 201 0205
PLUMBING MECHANICAL i TANK �" DEMOLITION
FDEAIL THESCOPE, OF WORK: Ptttn1 , rinse and fill in place with foat'n, one 30 )gallon
residential heating oil tank. Cut vent and fill pipe below grade.
I declare under penah�17 o) per rrtmyl i'awT�s that the irr rrrration I have provid d on thisforinlap iicadatt i tr�r�e, trtrcet artd crarrt�atcte,
and that I ant tine property oww=,rter or duly authorized agent of the prop rljm owner to submit a perntit alwpiieadon to the City of
idtrronds.
Print Name: 1 �i�� Omer El Agent/Other 12] (.specify): Contractor
SignatLwre: Date: 911/ a;0 1 6
FOR M C T ARnildina A1P rnlA-1A] rnTl(IATF e, v_fo 4 m T _Ru;lA;n , TTn.,. A i,.nU ... 9nT a A-- ,._ , .
��//l„1/i %�!i /!/�%//✓r:/i//r�i//i%///// �/%%//Ji/i // /%r rii ,a, 9�,�,/ i ry' ,, ,;, ,,,,, - ,.; ^�;,, or; �r,i ,,,,, ..>,,, ,.
Method of AbandonmentI 1 1 1 MI 1 I 1 M I I I I' I
Fill Material
.mm
Removal
1
Numberof Gallons:,300• 1 1 of Gallons:
Critical Areas Determination: Study RequiredFj Condit�i�on�al WaWer
FlLCOCOMPANY INC. LICENSE#FILCOCIO8ORUEXP:10/18/2017
POBOX 31ZZ8 ICC LICENSE
SEAl7IE,VVA981U3
SITE PILAF'1.1�
HEATING OIL TANK DECOMMISSIONINTf
30B5DE ADRESS
OWNER:
Estate of Shirley Maigney-
PHONE: 206-214-8042 Steve Maloney
Pump out, rinse and fill in place with foam, one 300 residential heating oil tank. Cut vent and fill
pipe below grade and cap.
2nd Ave North