FIR2021-0003_Site_Plan_1.11.2021_11.21.12_AM_1983315BUILDING PERMIT
j ?o APPLICATION
Development Services
Building Division
121 Sth Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements, permit status and inspection
scheduling information go to: I tR.I _v} ,eJmorniscw�,Kcw(
JOB SITE INFORMATION/LOCATION: (Where the work Is taking place)
Job Site Address: 8917 220th St SW Edmonds, WA 98026
Parcel: 00380300101100
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name: Carolyn Munn
Mailing Address: 8917 220th St SW
City/State/zip: Edmonds, WA 98026
Phone #: 206-948-6272
Email: carolynmunn@gmail.com
OWNER INSTALLATION: *If yes, read and sign'
WIII work be performed by the property owner? ❑ Yes CXNo
I own, reside In, or will reside in the completed structure.
This installation Is being made on property that I own which Is
not intended for sale, lease, rent, or exchange according to
RCW 18.27.090.
Owner Signature: _
APPLICANT / CONTACT INFORMATION:
Name of Applicant: Tim Ayres _
Mailing Address: _ PO Box 31228
City/State/Zip: Seattle, WA 98103
Phone #: 206-547-8347
GENERAL CONTRACTOR: (If different from applicant)
General Contractor: Fll.co Com aj ny Inc.
Mailing Address: PO BOX 31228
City/State/Zip: Seattle, WA 98103
Phone #: 206-547-8347
E-mail: info@filcoenviro.com
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
FILCOCIO80RU 12/31/2021
CITY OF EDMONDS BUSINESS LICENSE M N R-024111
Permit #:
DetailsTYPE OF: PERMIT (Provide
❑ Accessory Structure/ ❑ Addition
Detached Garage
❑ Demolition IXMechanical
❑ New Single Family / Duplex ❑ Plumbing
❑ Fire Sprinkler ❑ Remodel
❑ New Commercial/ Mixed Use ❑ Re -Roof
❑ Signs )8j Tank
❑Tenant Improvement ❑ Other
Remodel Permit fees are based on:
The value of the work performed. Indicate the value (rounded to
the nearest dollar) of all equipment, materials, labor, overhead,
and the profit for the work indicated an this application.
1 Valuation:
PROPOSED•UARE FOOTAGE FOR THIS APPLICATION
Basement sq ft: Finished ❑ Unfinished ❑
1st Floor, sq ft:
2nd Floor, sq ft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
Other sq ft:
PROJECT DESCRIPTION
Pump out triple rinse and fill with foam
one 300 residential heating oil tank.
I certify that the Information 1 have provided on this form/appllcation 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 Namp elinda„I-less /
—
ill A f I
Signature: L Y' V V Date 1 /11 /ZU21
Occupancy Group(s):
Occupant Load(s):
BTUs Qty BTUs Qty
A/C Unit Outdoor BBQ / Fire pit
Type(s) of Construction:
Fire Sprinklers: Yes ❑ No ❑
WA STATE ENERGY CODE: If your project affects the building envelope,
Boller
Stove/Range/Oven
mechanical systems, and/or lighting, you must complete the
Dryer
—
Water Heater
appropriate WSEC forms.
DEFERRED SUBMITTALS: All commercial bullding permits that will require
associated plumbing, mechanical, fire sprinkler, and/or fire alarm
permits are applied for separately.
Fireplace/ Insert
Other:
Furnace Other:
MEDICAL GAS, AIR VACUUM COUNTS
(New, Relocated or re -piped)
TI / CHANGE OF USE / NEW BLDG: Include TRAFFIC IMPACT worksheet
MECHANICAL EQUIPMENT COUNTS (New and Relocated)
BTUs Gas / Elec /Other Qty
Qty Qty
Carbon Dioxide
Nitrous Oxide
i
A/C Unit /Compressor
Helium
Oxygen
Air Handler /VAV
Medical Air
Other:
Boiler
- -
Medical - Surgical Vacuum Other:
Dryer Duct
-- -- - —
DEMOLITION
Exhaust Fans
Type of structure to be demolished:
Fireplace
Square footage of structure to be demolished:
Furnace
AHERA Survey done? Y / N PSCAA__ Case fi:
Heat Pump Unit
_
Critical Areas Determination:
-
Hydronic Heating
Study Required ❑ Conditional Waiver ❑ Waiver ❑
Roof Top Unit (Provide eleva-
tions If a Commercial Bldg)
—/
Fill in Place 9d FIII Material: Foam
Other:
_
— -- --
Removal ❑ Size of Tank (Gallons) 300
PLUMBINGaUNTS Relocated
Critical Areas Determination: 1
City Qty
Study Required ❑ Conditional Waiver ElWaiver ❑
GRADE/F ILL/ EXCAVATE
Grading: Cut ^ _ cubic yards
Clothes Washer
Tub/ Showers
Dishwasher
Backflow Device (RPBA, DCDA, AVB)
- - — - - - - - - —
Fill _ _ -cubic yards
Drinking Fountain
Pressure Reduction/ Regulator Valve
- -
Cut / Fill in Critical Area: Yes ❑ No ❑
Floor Drain/Sink
Refrigerator Water Supply
GENERAL PROVISIONS
Hose Bibs
Water Heater - Tankless? Y or N
-- -
APPLICATIONS: Applications are valid for a maximum of 1 year.
Water Service Une
Hydronic Heat
ESLHA Applications, 2 years.
Sinks
Other:
LICENSING: All contractors and subcontractors are required to be licensed
with Washington State Department of Labor & Industries and have a
Toilets
Other:
current City of Edmonds Business License.
FILCO COMPANY INC. LICENSE#FILCOCIO80RU EXP: 12/31/2021
PO BOX 31228 ICC LICENSE # 8291441
SEATTLE, WA 98103
SITE PLAN
HEATING OIL TANK DECOMMISSIONING
JOB SITE ADRESS: 8917 22011 St SW Edmonds, WA 98026
OWNER: Carolyn Munn
PHONE: 206-948-6272
ACTIVITY: Pump out, triple rinse and fill in place with Foam one 300 gallon underground residential
heating oil tank.
8917 — House
IiJZ'
a
v
41 Yaelh T
220th St SW