FIR2021-0061_Application_6.18.2021_12.45.09_PM_2258408CITY OF EDMONDS M BuildingPermit.com
Fire Application #979888 - 19812 77th PI W
Applicant
First Name Last Name Company Name
Paul Anderson Fuel Tank Installation Co Inc
Number Street Apartment or Suite Number E-mail Address
11536 Seola Beach Drive SW FTICompanylnc@gmail.com
City State Zip Phone Number Extension
Seattle WA 98146 2062448020
Contractor
Company Name
Fuel Tank Installation Co Inc
Number Street Apartment or Suite Number
11536 Seola Beach Drive SW
City State Zip Phone Number Extension
Seattle WA 98146 2062448020
State License Number License Expiration Date UBI # E-mail Address
FUELTIC080138 6/11/2022 FD1 1 RF1 W FTICompanylnc@gmail.com
Project Location
Number Street Floor Number Suite or Room Number
19812 77TH PL W
City Zip Code County Parcel Number
EDMONDS 98026 00564000001100
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
Peter F Schuldt
Number Street Apartment or Suite Number
19812 77TH PL W
City State Zip
EDMONDS WA 98026
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: 6/18/2021 Submitted By: Paul Anderson
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CITY OF EDMONDS MyBuildingPermit.com
Fire Application #979888 - 19812 77th PI W
Project Contact
Company Name: Fuel Tank Installation Co Inc
Name: Paul Anderson Email: FTICompanylnc@gmail.com
Address: S1536 Seola Beach Drive Phone #: 2062448020
Seattle WA 98146
Project Type Activity Type Scope of Work
Single Family Residential Decommission Other
Project Name: 19812 77th PI W
Description of Work: 300 gall underground tank decommission pump tank, rinse and fill in place
Project Details
Storage Tank Work
Tank Decommission
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