FIR2021-0063_Applicant_Response_6.22.2021_2.25.32_PM_2263455t
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BUILDING PERMIT
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: tttta://www.edmondswUov/
JOB SITE INFORMATION/LOCATION: (Where the work is taking place)
Job Site Address: 613 Aloha Way Edmonds,WA 98020
Parcel: 00436500000200
Lot /Unit/Suite #; Subdivision:
PROPERTY OWNER:
Name: Tom Hawley Family Trust -c/o Maria Freed
Mailing Address: 613 Aloha Way
City/State/zip: Edmonds, WA 98020
Phone #: 425-299-1035
Email: mmfreed@outlook.com
OWNER INSTALLATION: 'if yes, read and sign'
WIII work be performed by the property owner? ❑ Yes IX 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: Tim Ayres
Mailing Address: __ PO Box 31228
city/state/zip: Seattle, WA 98103
Phone #: 206-547-8347
E-mail: Tim&lrnPnviro rim
GENERAL CONTRACTOR: (If different from applicant)
General Contractor: Fllco Company Inc.
Mailing Address: PO Box 31228
City/State/Zip: Seattle, WA 98103
Phone #: 206-547-8347
E-mail: info anfilcoenviro.com
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
FILCOCIO80RU 12/31/2021
CITY OF EDMONDS BUSINESS LICENSE #: N R-0241 11
Permit ff:
TYPF OF PERMIT (Provide Deloils on Page 2) Accessory Structure/
❑Addition
Detached Garage
❑ Demolition
i(Mechanical
❑ New Single Family / Duplex
❑ Plumbing
❑ Remodel
❑ Re -Roof
❑ Fire Sprinkler
❑ New Commercial/ Mixed Use
❑ Signs
X Tank
❑ Tenant Improvement
❑ Other
Remodel Permh fees ore based on:
The value of the work performed. Indicate the value (rounded to
the nearest dollar) of all equipment. materials, labor, overhead.
and the protlt for the work Indicated on this application.
Valuatlon:
PROPOSED NEW �QUARL Foo rAGE 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, excavate and remove
one 300 residential heating oil tank.
Haul tank away and properly dispose of tank.
I certify that the Information I 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 Name. McIin0a Hess /
Signature: 1[/��.4iQ,� Date 6/3/2021
GENERAL •
Occupancy Group(s): Occupant Load(s):
Type(s) of Construction: Fire Sprinklers: Yes ❑ No ❑
WA STATE ENERGY CODE: If your project affects the building envelope,
mechanical systems, and/or lightln& you must complete the
appropriate WSEC forms.
DEFERRED SUBMITTALS: All commercial building permits that will require
associated plumbing, mechanical, fire sprinkler, and/or fire alarm
permits are applied for separately.
TI / CHANGE OF USE / NEW BLDG: Include TRAFFIC IMPACT worksheet
EQUIPMENTMECHANICAL •
BTUs Gas / Elec / Other Qty
A/C Unit /Compressor
Air Handler /VAV
Boiler
Dryer Duct
Exhaust Fans
Fireplace
Furnace
Heat Pump Unit
Hydronic Heating
Roof Top Unit (Provide eleva-
tions If a Commercial Bldgl
Other:
PLUMBING• ..-
Qty City
Clothes Washer Tub/Showers
Dishwasher Backflow Device (RPBA, DCDA, AVB)
Drinking Fountain Pressure Reduction/ Regulator Valve
Floor Drain/Sink Refrigerator Water Supply
Hose Bibs Water Heater - Tankless? Y or N
Hydronic Heat Water Service Line
Sinks Other:
Toilets Other:
BTUs Qty BTUs Qty
A/C Unit Outdoor BBQ/ Fire pit
Boller Stove/Range/Oven
Dryer Water Heater
Fireplace/ Insert I I I Other:
I Furnace I I I Other.
Carbon Dioxide Nitrous Oxide
Helium Oxygen
Medical Air Other:
Medical - Surgical Vacuum Other:
Type of structure to be demolished:
Square footage of structure to be demolished:
AHERA Survey done? Y / N I PSCAA Case p:
Critical Areas Determination:
Study Required ❑ Conditional Walver ❑ Waiver ❑
Fill In Place ❑ Fill Material:
Removal OD ( Size of Tank (Gallons) 300
Critical Areas Determination -
Study Required iv Conditional Waiver ❑ Waiver ❑
Grading: Cut cubic yards
Fill _ cubic yards
Cut / Fill in Critical Area: Yes ❑ No ❑
APPLICATIONS: Applications are valid for a maximum of 1 year.
ESLHA Applications, 2 years.
LICENSING: All contractors and subcontractors are required to be licensed
with Washington State Department of Labor & Industries and have a
current City of Edmonds Business License.