BLD20151218.PDFof F D,I,
�AI CITY OF EDMONDS
121 5TH AVENUENORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
SCO
STATUS: ISSUED 09/22/2015 Permit #: B'LD201.51218
Expiration Date: 03/22/2016 Project Address: 9112. OLYMPIC VIEW DR,;
EDMONDS
Parcel No: 27041800200700
DOUGLAS W & STARLA S SAGE SEATTLE TANK SERVICES SEATTLE TANK SERVICES
9112 OLYMPIC VIEW DR PO BOX 31516 PO BOX 31516
EDMONDS, WA 98026 SEATTLE, WA 98103- SEATTLE, WA 98103-
(206)938-2280 (206)938-2280 (206) 93 8-2280
LICENSE #: SEATTTT012Q4 EXP:I 1/19/2016
C DESCRIPTION
PUMP, RINSE, AND FILL IN PLACE W ITH FOAM ONE 300 GAL RESIDENTIAL ; I7IIVG QIL..T,ANK. CUT VENT AND FELL PIPE
BELOW GRADE.��`'
VALUATION: $0.00
PERMIT TYPE: Residential
PERMIT GROUP: 70 - Tanks/Fuel
GRADING: N CYDS: 0
TYPE OF CONSTRUCTION:
RETAINING WALL ROCKERY:
OCCUPANT GROUP:
OCCUPANT LOAD:
FENCE: ( 0 X 0 FT.)
CODE: 2012
OTHER: ------- OTHER DESC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNITS: 0
LOT #:
BASEMENT: 0 1ST FLOOR: 0 2ND FLOOR: 0
BASEMENT: 0 1ST FLOOR: 0 2ND FLOOR:0
3RD FLOOR. 0 GARAGE: 0 DECK: 0 OTHER: 0
3RD FLOOR. 0 GARAGE. 0 DECK: 0 OTHER: 0
BEDROOMS:0 BATHROOMS:O
1 BEDROOMS:0 BATHROOMS:0
FRONTSETBACK
ZEQU1RED: PROPOSED: REQUIRED: PROPOSED: REQUIRED: PROPOSED:
iE1GHT ALLOWED:O PROPOSED:O REQUIRED: PROPOSED:
,ETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID.
Print Name Date Released By Date
ATTENTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED. UBC109/ IBCI 10/ IRCI 10.
ONLINE APPLICANT ASSESSOR OTHER <�D
STATUS: ISSUED
BLD20151218
• Final approval on a project or final occupancy approval must be granted by the Building Official prior to use or occupancy of
the building or structure. Check the job card for all required City inspections including final project approval and final
occupancy inspections.
• Any request for alternate design, modification, variance or other administrative deviation (hereinafter "variance") from
adopted codes, ordinances or policies must be specifically requested in writing and be called out and identified. Processing
fees for such request shall be established by Council and shall be paid upon submittal and are non-refundable.
• Approval of any plat or plan containing provisions which do not comply with city code and for which a variance has not been
specifically identified, requested and considered by the appropriate city official in accordance with the appropriate provision
of city code or state law does not approve any items not to code specification.
• Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
of ECC Chapter 5.30 only during the hours of 7:00am to 6:00pm on weekdays and 10:00am and 6:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must comply with the
noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120.
• Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold
harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance for this permit. Issuance of this permit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance nor limit in any way the City's ability to enforce any ordinance
provision.
INSPECTIONS
THIS PERMIT AUTHORIZES ONLY THE WORK NOTED. THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE
PUBLIC DOMAIN (CURBS, SIDEWALKS, DRIVEWAYS, MARQUEES, ETC.) WILL REQUIRE SEPARATE PERMISSION.
PERMIT TIME LIMIT. SEE ECDC 19.00.005(A)(6)
CALL FOR INS PECTIONS
BUILDING 425 771-0220 EXT. 1333 ENGINEERING 425 771-0220 EXT. 1326 FIRE 425 775-7720
PUBLIC WORKS 425) 771-0235 1 PRE-TREATMENT 425) 672-5755 1 RECYCLING 425) 2754801
When calling for an inspection please leave the following information: Permit Number, Job Site Address, Type of Inspection being
requested, Contact Name and Phone Number, Date Prefereed, and whether you prefer morning or afternoon.
• F-Tank Inspection
r.
DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
121 5�' Avenue N, Edmonds, WA 98020
City o Ff Edmonds 1
Phone 425.771.0220 2 Fax 425.771.0221
o
PLEASE REFER TO THE PLUMBING & MECHANICAL CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
Parcel #:
9112 Olympic View Dr, Edmonds, WA 98026
27041800200700
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes❑ NoWl
Associated Permit #:
APPLICANT:
Seattle Tank Services
Phone:
206-938-2280
F
296-933-1967
Address (Street, City, State, Zip):
PO Box 31516 Seattle, Washington 98103
E-Mail Address:
info@seattletank.com
PROPERTY OWNER:
Starla Sae
Phone:
206-604-0875
Fax:
Address (Street, City, State, Zip):
9112 Olvrnipic View Dr, Edmonds, WA 98026
E-Mail Address:
starla_sa e@hotmail.com
LENDING AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):.
E-Mail Address:
CONTRACTOR:*
Phone:
Fax:
Seattle Tank Services
206-938-2280
106-933-1967
Address (Street, City, State, Zip):
PO Box 31516 'Seattle, Washington 98103
E-Mail Address:
info@seattletank.com
*Contractor must have a valid City of Edmonds business license prior to doing work
WA State License #/Exp. Date:
SEATTTT012Q4 .11 / 19/2016
in the City. Contact the City Clerk's Office at 425.775.2525
NCity RTy02O59s icense 12 31 /16 15
PERNIITkPPLICATION
PLUMBING I MECHANICAL TANK
DEMOLITION
DETAIL THE SCOPE OF WORK: Pump, rinse and fill in place with foam, one 300 gallon residential
heating oil tank. Cut vent and fill pipe below grade.
I declare under penalty of perjury laws that lire information I have provided on this form/application is true, correct and complete,
and that I am the property owner or duly authorized agent of the property owner to submit a permit application to the City of
Edmonds. — -
Print Name: TjM k yge5 Owner ❑ Agent/Other (specify): Contractor
Signature: _.^. Date:
FORM C LABuilding New Folder 2010UDONE & x-(erred to L-BuildingNew drive\Fonn C 2014.docx Updated: 1/172014
1 ' , VACUUM
Type of Gas/Air/Vacuum System (new and relocated)
Total#
Oxygen
Nitrous Oxide
Medical Air
Carbon Dioxide
Helium
Medical — Surgical Vacuum
Other:
TOTAL OUTLETS
TANK #1
TANK #2
Method of Abandonment
Method of Abandonment
Fill in Place
Fill Material foam
Fill in Place
Fill Material
Removal
Removal
Number of Gallons: 300 gallons
Number of Gallons:
Critical Areas Determination: Study Required ❑ Conditional Waiver ❑ Waiver
Type of structure to be demolished (e.g. house, shed, garage, etc.):
Floor area of structure to be demolished: sq. ft.
Critical Areas Determination: Study Required ❑ Conditional Waiver ❑ Waiver ❑
PSCAA Case No.
AHERA Survey done? (required) ❑
Additional comments:
FORM C L:\Buildin? New Folder 2010\DONE & x-ferred to L-Building-New drive\Form C 2014.docx Undated: 1/17/2014