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FIR2021-0003_Application_1.11.2021_11.21.44_AM_1983319CITY OF EDMONDS M BuildingPermit.com Fire Application #906013 - Munn - Foam fill Decommission Applicant First Name Last Name Company Name MELINDA HESS Filco Company, Inc. Number Street Apartment or Suite Number E-mail Address PO Box 31228 info@filcoenviro.com City State Zip Phone Number Extension Seattle WA 98103 2065478347 Contractor Company Name FILCO COMPANY INC Number Street Apartment or Suite Number PO Box 31228 City State Zip Phone Number Extension Seattle WA 98103 (206) 547-8347 State License Number License Expiration Date UBI # E-mail Address FILCOCIO80RU 10/10/2021 RD197Rn33 info@filcoenviro.com Project Location Number Street Floor Number Suite or Room Number 8917 220TH ST SW City Zip Code County Parcel Number EDMONDS 98026 00380300101100 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name MUNN CAROLYN TRUSTEE OF THE CAROLYN MUNN Number Street Apartment or Suite Number 8917 220TH ST SW City State Zip EDMONDS WA 98026-8139 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work requires a licensed contractor to perform the work, the information will be provided prior to permit issuance. Date Submitted: 1/11/2021 Submitted By: MELINDA HESS Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Fire Application #906013 - Munn - Foam fill Decommission Project Contact Company Name: Filco Company, Inc. Name: MELINDA HESS Email: info@filcoenviro.com Address: PO Box 31228 Phone #: 2065478347 Seattle WA 98103 Project Type Activity Type Scope of Work Single Family Residential Decommission Underground Storage Tank Removal Project Name: Munn - Foam fill Decommission Description of Work: Pump out triple rise and fill in place with foam one 300 gallon residential heating oil tank. Project Details Type of Work Tank Removal Page 2 of 2