BLD20160446.PDFCITY of EDMMkTED
STATUS: ISSUED 04/12/2016
Expiration Date: 10/12/2016
Parcel No: 00565600100800
121 5TH AVENUE NORTH - EDMONDS, WA 98020
PHONE: (425) 771-0220 - FAX: (425) 771-0221
Permit #: BLD20160446
Project Address: 18313 OLYMPIC VIEW D
EDMONDS
BETH PENNOCK FILCO CO INC FILCO CO INC
18313 OLYMPIC VIEW DR PO BOX 31228 PO BOX 31228
EDMONDS, WA 98020-2347 SEATTLE, WA 98103- SEATTLE, WA 98103-
(425)774-8420 (206)547-8347 ' (206)547-8347 ,
LICENSE #: FILCOCIO80RU EXP:10/10/2017
JOB DESCRIPTION
PUMP, RINSE AND FILL IN PLACE WITH FOAM ONE 675 GALLON UST. CUT VENT AND FILL 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 DE SC:
ZONE:
NUMBER OF STORIES: 0
VESTED DATE:
NUMBER OF DWELLING UNITS: 0
LOT #:
BASEMENT:0 1ST FLOOR:0 2NDFLOOR: 0
BASEMENT:0 1ST FLOOR:0 2NDFLOOR: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
3RD FLOOR: 0 GARAGE: 0 DECK: 0 OTHER: 0
BEDROOMS:0 BATHROOMS:O
BEDROOMS:0 BATHROOMS:0
FRONTSF.rBACK SIDESETBACK;
REQUIRED: PROPOSED: REQUIRED: PROPOSED: REQUIRED: PROPOSED:
HEIGHT ALLOWED:O PROPOSED:O REQUIRED: PROPOSED:
SETBACK NOTES:
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOINGTHE WORK AUTHORIZED
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATINGTO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27.
THIS APPLICATION ISNOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HISJHER DEPUTY AND ALL FEES ARE PAID. J
Sign r Print Name Date Re ease 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/ IBC110/ IRCI 10.
ONLINE APPLICANT AS S FS S OR 0THER
STATUS: ISSUED BLD20160446
CONDITIONS
• Fire Marshal must be present for tank work (fill, removal, or cap.)
• 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 orpolicies 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 s ites/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.
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)
BUIlAING (425) 771-0220 EXT. 1333 1 FNGINIMING (425) 771-0220 EXT. 1326 1 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 lease 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
DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
121 5 h Avenue N, Edmonds, WA 98020
St.199 o City of Edmonds Phone 425.771.0220 2 Fax 425.771.0221
PLEASE REFER TO THE PE UMBING & MECHANICAL CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip):
Parcel #:
18313 Olympic View Dr, Edmonds, WA 98020
00565600100800
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes No�
Associated Permit #:
APPLICANT:
Filco Company Inc.
Phone:
206-547-8347
ITT-548-9352
Address (Street, City, State, Zip):
E-Mail Address:
PO Box 31228 Seattle, Washington 98103
info@filcoenviro.com
PROPERTY OWNER:
Phone:
Fax:
Beth Pennock
425-774-8420
Address (Street, City, State, Zip):
E-Mail Address:
18313 Olympic View Dr, Edmonds, WA 98020
N/A
LENDING AGENCY:
Phone:
Fax:
Address (Street, City, State, Zip):.
E-Mail Address:
CONTRACTOR:*
Phone:
Fax:
Filco Cornipany Inc.
206-547-8347
106-548-9352
Address (Street, City, State, Zip):
E-Mail Address:
PO Box 31228 'Seattle, Washington 98103
info@filcoenviro.com
WA State License #/Exp. Date:
*Contractor must have a valid City of Edmonds business license prior to doing work FILCOCIO80RU 10/ 10/2015
in the City. Contact the City Clerk's Office at 425.775.2525
City Business License #/Ex . ate:
NY-0205V 131 /2016
PERIMIT APPLICATION
.R
PLUMBING MECHANICAL I TANK DEMOLITION
DETAIL THE SCOPE OF WORK: Pump, rinse and fill in place with foam, one 675 gallon
residential heating oil tank. Cut vent and fill pipe below grade.
I declare under penalty of perjury laws that the 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: Awns
Owner ❑ Agent/Other Z (specify): Contractor
Signature: 4ve=
Date:Cl/ 4— �/�
—
FORM C'. l ARniltiino My PMAn ')A1 n%rV1MP R..._f-A t� 7 _R. ;IA:nn_TTn.., A.;,,nWn.... r )m A A--
. r_
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
INumber of Gallons:
Number of Gallons: 675 gallon
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:
FIr),PXT(' r.%n... IA:__ �m_- ._t n..:,�:--1-.r+—n—_. .,_._._....1.---..
FILCO COMPANY INC. LICENSE#FILCOCIO80RU EXP:10/10/2017
PO BOX 31228 ICC LICENSE # 5050940
SEATTLE, WA 98103
SITE PLAN
HEATING OIL TANK DECOMMISSIONING
JOB SITE ADRESS: 18701 KENLAKE PL NE, KENMORE, WA 98028
OWNER: Christina Von Osdoll
PHONE: 206-920-8189
ACTIVITY: Pump, rinse & fill in place foam, on(-(0 igallon residential heating oil tank. Cut fill pipe and vent
pipe below grade and cap.
garage
�i 18313 ^' house
agL� uen+
i—a
50
Olympic View Drive