FIR2021-0027_Site_Plan_3.23.2021_1.43.40_PM_2107320,r1c. 1 R`'"
BUILDING PERMIT
APPLICATION
Development Services
Building Division
121 5th Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements go to: www.edmondswa.gov.
To apply for permits, schedule inspections, or check application status
go to: www.mybuildinapermit.com
JOB SITE INFORMATION/LOCATION: (Where the work is taking place)
Job Site Address: 8219 Sierra Dr. Edmonds
Parcel: 00572500000700
Lot /Unit/Suite #: Subdivision:
BUSINESS OR PROPERTY OWNER:
Name: SPENCER LINTON
Mailing Address: 8219 SIERRA DR
City/State/zip: EDMONDS, WA 98026
Phone #: 425.418.1979
Email: SPENCERLINTON1
GMAIL.COM
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner? Yes IV/] No
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: TANKS BY DALLAS
Mailing Address: 17552 BALLINGER WAY NE
City/state/zip: LAKE FOREST PARK, WA 98155
Phone #: 206.365.0291
E-mail: TAN KSBYDALLAS@TANKSBYDALLAS�
GENERAL CONTRACTOR: (If different from applicant)
General Contractor:
Mailing Address:
City/State/Zip:
Phone #:
E-mail:
STATE UBI #: 601-972-418
CITY OF EDMONDS BUSINESS LICENSE #: #NR-026479
WA STATE CONTRACTOR L & I #: (CCB) & EXPIRATION DATE:
TANKSD*001 KF 5/6/2023
Office Use Only
TYPE OF
Details on Page
Accessory Structure/
Addition
Detached Garage
Demolition
Mechanical
❑ New Single Family/Duplex
Plumbing
Fire Sprinkler
Remodel
New Commercial/Mixed Use
Re -Roof
Signs
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 on this application.
Valuation:
PROPOSED NEW SQUARE FOOTAGE
FOR THIS APPLICATION
Basement sq ft: Finished ElUnfinished
1st Floor, sq ft:
2nd Floor, sq ft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
# of NEW Bedrooms:
# of NEW Bathrooms:
PROJECT•
I certify that the information 1 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: TANKS BY DALLAS/HEATHER HENDRICKS
Sign
Date 3
GENERAL COMMERCIAL DATA
Occupancy eoupti): Occupant Load(s):
T ype(sjof Construction:
Fire Sprinklers: Yes El No EL
WA -STATE- ENERGY CODE. If your prdject.affects the building envelope,.
mechanical -systems,* and/or lighting, you must completethe
appropriate WSECfbilms.*
DEFERREP*SUBMITTALS; All commercial building-perrhits thatmill. require.
.ass.ociated.pl.u.mb.in&.rAechariic.aI fire- sprinkler; *and/or fire.ala.rm-
permits are applied.f6r separately.
TIJ CHANGE OF USE / NEW BLDGl* Include -..TRAFFIC IMPACT Woeksheet-
MECHANICAL EQUIPMENT COUNTS (New and Relocated)
BTUs Gas./Ilec/Other - Qty
A/C Unit. /Compressor
Air Handler /VAV
Boiler
Dryer Dud
ExhaustFans;
Fireplace
Furnace
Heat Pump Unit
Hydronic Heating
Roof Top. Unit. (Provldegleva-
tio.ns if a.Cqmmercial Bldg)
Other:
PLUMBING FIXTURE COUNTS (New, Reloeated or're piped.)
Jaty Qty
Clothes Washer
Tub/ Showers
Dishwasher
Baclkflow Device (RPBA, DCDA, AVB)
Drink.ing.FOuntai.n
Pressure.Red.6cbon/ Regulator Valve
Floor Drain/Sink
RefrigeratprWater. Supply
Hose Bibs.
Water *Heater — Ta.nkless? Y or N*
Hydronic Heat.
Water Service Line
.Sinks
Other:
Toilets
Other:
GAS/FUEL CONNECTION COUNTS (New, Relocated or r6 plp6d.).
BTUs Qty 8TUs I(*
A/C. Unit
Outdoor B8.Q/ Fire pit -
Boiler
Stove/Range/Oven
Dryer
Water Heater
Fireplace/ Insert
Other:
Furnace. Other:
M EDICAL GAS Al R VACU UM -CO UNTS
New; Relocated.or re pip6d)
Qty Qty
Carbon Dioxide
Nitrous Oxide
Helium
Oxygen
Medical Air
Other:
Medical - Surgical Vacuum -
DEMOLITION
Type..JDf. -structure to. be.denjolished.
-Square footage of structure to be demollshedt
AHERA Survey**done'?Y[]/N[]
FpsC Cas-`#:
Critical Areas Determinatiorit
Study Required.b Conditional WaiverEl WafverED
Fill in Placef:] * Fill Material,
Aimov al [Z]
size of Tank (Gallons) :300'-GAL
Critical Areas Determination:
StiliclyRequired..11111111 Conditional Waiv*e*r Waiver
GRADE/FILL/EXCAVATE
Gr.ading:.Cut cubic yards
Fill cubic yards
Cut./ Fill:ln Critical Area: Yes.0 No El
GENERAL PROVISIONS
APPLICATIONS4.-Appi ications are valid fora maximum.of*1 year.
ESLHA.Applications, 2 years. -
LICENSING: -All contractorsandsubcoritractorsare reou.i red to be licerised
with Washington State Department of Labor & Industries: and have a-.
current City-& Edmonds -Business License..
#P20
Critical Areas File #:
❑ Initial Determination -$110
❑ Subsequent Determination - $0
Date Received:
Date Mailed to Applicant:
The purpose of this checklist is to enable City staff to
determine whether any critical areas and/or buffers are
located on or adjacent to the subject property. Critical
areas, such as wetlands, streams and steep slopes, are
ecologically sensitive or hazardous areas that are
regulated to protect their functions and values. The City's
critical area regulations are contained within Edmonds
Community Development Code (ECDC) Chapters 23.40
through 23.90.
Property Owner's Authorization
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
www.edmondswa.gov
A property owner, or an authorized representative, must
fill out the checklist, sign and date it, and submit it to the
City. Staff will review the checklist, conduct a site visit,
and make a determination of whether there are critical
areas and/or critical area buffers on or near the site. If a
"Critical Area Present" determination is issued, a report
addressing the applicable critical area requirements of
ECDC Chapters 23.40 through 23.90 may be required
depending on the scope of the proposed activity.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject
property for the purposes of inspection attendant to this application. The undersigned owner, and his/her/its heirs, and
assigns, in consideration on the processing of the application agrees to release, indemnify, defend and hold the City of
Edmonds harmless from any and all damages, including reasonable attorney's fees, arising from any action or infraction
based in whole or part upon false, misleading, inacc or incomp ete information furnished by the applicant, his/herits
agents or employees.
SIGNATURE OF OWNER ` DATE 7 � Ql�
Owner:
SPENCER LINTON
Name
8219 SIERRA DR
Street Address
EDMONDS WA 98026
Applicant/Agent:
TANKS BY DALLAS
Name
17552 BALLINGER WAY NE
Street Address
LAKE FOREST PARK WA 98026
City State Zip City
Telephone: 425.418.1979
Email address: SPENCERLINTONI3@GMAIL.COM
State
Zip
Telephone: 206.365.0291
Email Address: TANKS8YDALL4S@TANKSBYDALLAS.NET
Revised on 114117 P20 - Critical Areas Checklist Page I of 2
CA File No: #P20
Critical Areas Checklist
Site Information
1. Site Address/Location 8219 SIERRA DR. EDMONDS, WA 98026
2. Property Tax Account Number. 00572500000700
3. Approximate Site Size (acres or square feet): .36 acres
4. Is this site currently developed? R Yes ❑ No
If yes, how is the site developed? RESIDENTIAL PROPERTY
5. Describe the general site topography. Check all that apply.
R( Flat to Rolling: No slope on/adjacent to the site or slopes generally less than 15% (a vertical
rise of 10-feet over a horizontal distance of 66-feet).
❑ Moderate: Slopes present on/adjacent to site of more than 15% and less than 40% (a vertical
rise of 10-feet over a horizontal distance of 25 to 66-feet).
❑ Steep: Slopes of greater than 40% present on/adjacent to site (a vertical rise of 10-feet over a
horizontal distance of less than 25-feet).
6. Have there been landslides on or near the site in the past? ❑ Yes VNo
If yes, please describe:
7. Site contains areas of year-round standing water? ❑ Yes (approx. depth dNo
8. Site contains areas of seasonal standing water? ❑ Yes (approx. depth UNo
If yes, what season(s) of the year?
9. Site is in the floodway or floodplain of a water course? ❑ F000dway ❑ Floodplain
10. Site contains a creek or an area where water flows across the grounds surface? ❑ Yes 0 No
If yes, are flows year-round or seasonal? ❑ Year
r--round ❑ Seasonal (time of year: )
11. Obvious wetland is present on site? ❑ Yes V No
For City Staff Use Only
1. Zoning':
3. SCS mapped soil type(s):
3. Critical Areas inventory or CA. map indicates Critical Area on site:
4. Site within designated North Edmonds Earth Subsidence and Landslide Hazard Area (E i A)?
DFIERAGNATION
CRITICAL AREAS PRESENT WAIVER
Reviewed by: Date:
Revised an 114117 P20 - Critical Areas CheckUst Page 2 of 2
BID LOCATE
SOIL SAMPLES
RECORD SEARCH COMPLETED
PLIA
RESIDENTIAL
COMMERCIAL
NAME DATE 2,1
SITE ADDRESS ��lvl J��►'yt QY �' IOt 1�J ZIP (/
PHONEyT �_l� I REFERRED BY
�0111
TANK SIZE FILL PIPE ( ">
FILL GRADE ` `� LENGTH
CONTENTS: OIL
OFFICE NOTES:
WATER
FIELD NOTES: ITAWDa4DH// WEccf(,jc
DIAMETER `)'3 TOTAL
GROUND COVER , , ,
OTHER_
u �N
TOTAL
ANIMALS Y VACANT Y N WATERY/N POWER Y/N NO PARK SIGNS Y/N LINEWORK Y/N
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BID COMPLETED BY: L�VVIJ\,) JOB COMPLETED BY:
Site info taken by: LC�W'(��n Deadline:_