FIR2021-0091_Application_8.11.2021_9.19.44_AM_2350434CITY OF EDMONDS M BuildingPermit.com
Fire Application #1004216 - Rosi tank decommissioning
Applicant
First Name Last Name Company Name
Heather Hendricks Tanks by Dallas
Number Street Apartment or Suite Number E-mail Address
17552 Ballinger Way NE tanksbydallas@tanksbydallas.net
City State Zip Phone Number Extension
Lake Forest Park WA 98155 (206) 365-0291
Contractor
Company Name
Tanks by Dallas
Number Street Apartment or Suite Number
17552 Ballinger Way NE
City State Zip Phone Number Extension
Lake Forest Park WA 98155 (206) 365-0291
State License Number License Expiration Date UBI # E-mail Address
tanksd*001 kf 5/6/2023 FD1 q7941 R tanksbydallas@tanksbydallas.net
Project Location
Number Street Floor Number Suite or Room Number
633 ALDER ST
City Zip Code County Parcel Number
EDMONDS 98020 00434209502800
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
Lynda L Rosi
Number Street Apartment or Suite Number
633 ALDER ST
City State Zip
EDMONDS WA 98020-3415
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: 8/11/2021 Submitted By: Heather Hendricks
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CITY OF EDMONDS MyBuildingPermit.com
Fire Application #1004216 - Rosi tank decommissioning
Project Contact
Company Name: Tanks by Dallas
Name: Heather Hendricks Email: tanksbydallas@tanksbydallas.net
Address: 17552 Ballinger Way NE Phone #: (206) 365-0291
Lake Forest Park WA
98155
Project Type Activity Type Scope of Work
Single Family Residential Decommission Other
Project Name: Rosi tank decommissioning
Description of Work: Pump out contents, triple rinse, fill in place (1) 300-gallon UST with sand/slurry
mixture.
Project Details
Storage Tank Work
Tank Decommission
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