20170202105754.pdfDEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
121 5 b Avenue N, Edmonds, WA 98020
Sr Phone 425.771.0220 2 Fax 425.771,0221
City of Edmonds
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PLEASE REFFSR 70 THE I'LUM13I G & MEC: ANIC L CRECKIMTFOR S UBMITT11L1REQUIREAlF.AlTs
PROJECT ADDRESS (Street, Suite #, City State, Zip): Parcel #:
8110 204th PL SW, Edmonds, WA 98026 00614400000700
Associated Permit #:
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes No�
APPLICANT: Phone: F-548-9352
Filco Company Inc. 206-547-8347
Address (Street, City, State, Zip): E-Mail Address:
PO Box 31.228 Seattle, Washin ton 98103 info@filcoenviro.com
PROPERTY OWNER: Phone: Fax:
Brandv Hanson 425-478-5108
Address (Street, City, State, Zip): E-Mail Address:
8110 204th PL SW, Edmonds, WA 98026 hellodaisy77@gmail.com
LENDING AGENCY: Phone: Fax:
Address (Street, City, State, Zip); E-Mail Address:
CONTRACTOR:* Phone: Fax:
lFilco Company Inc. 206-547-8347 06-548-9352
Address (Street, City, State, Zip): E-Mail Address:
PO Box 31228 Seattle, Washington 98103 info@filcoenviro.com
WA State License lE p. Dater
*Contrwaclor must have a valid City o Edrrronds business license prior to doing work FILCOC1080RU
in the City. Contact the City Clerk's Office at 425.775.2525 City Business License &Exp. Date:
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PLUMBING MECHANICAL �TANKDEMOLITION LjII
DETAIL THE SCOPE OF WORK: Pump, rinse and f1111n place with feat"1"'1 one 300
residential heating oil tank. Cut vent and fill pipe below grade,
d dcctare under perrrrl()� crl rer rrr°p tarts that the information I hope provided orr thisfornl"applicadom is true, correct and complete,
and that t am the propertj, owner or duly authorized agent iqf the proper& owner to srrlrnrit a,permit application trr the City of
Edmonds.
Print Name: yee—S Owner Agent/Other(specify): Contractor
Signature°, Date: 04 — e;Z rlC 1-7
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