FIR2021-0112_Site_Plan_10.6.2021_9.44.55_AM_2447155BUILDING PERMIT
APPLICATION
Development Services
Building Division
121 5th Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements, permit status and inspection
scheduling information go to, ham://www.edmondswa.aov/
JOB SITE INFORMATION/LOCATION: (Where the work Is taking place)
Job Site Address: 7819 228th St SW Edmonds,WA 98026
11 :111 11
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name: Alta Ashinay
Mailing Address: 7819 228th St SW
City/State/Zip: Edmonds, WA 98026
Phone #: 206-696-9939
Email: atlaw1234@yahoo.com
OWNER INSTALLATION: *If yes, read and sign*
WIII work be performed by the property owner? ❑ yes IXNo
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—filc Pnv Op[p
GENERAL CONTRACTOR: (If different from applicant)
General Contractor: Eilco Company. Inc.
Mailing Address: PO BOX 31228
City/State/Zip: Seattle, WA 98103
Phone #: 206-547-8347
E-mail: info@filcoenviro.com
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
FILCOCIO80RU 12/31/2021
CITY OF EDMONDS BUSINESS LICENSE M N R-024111
7PPermlt #:
OfPERMIT (Provide
DetailsTYPE
❑ Accessory Structure/
Detached Garage
❑ Addition
❑ Demolition
C(Mechanicai
❑ New Single Family / Duplex
❑ Plumbing
❑ Fire Sprinkler
❑ Remodel
❑ New Commercial/ Mixed Use
❑ Re -Roof
❑ Signs
K Tank
❑ Tenant Improvement
❑ Other
Remodel PermlF 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:
Basement sq ft: Finished ❑ Unfinished ❑
1st Floor, sq ft:
2nd Floor, sq ft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
Other sq ft:
PROJECTDESCRIPTION
Pump out tripe rinse and fill with foam
one 300 gallon residential heating oil tank.
I certify that the Information I 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: Melinda Hess)
Signature: /, Date 10/6/2021
GENERAL • DATA
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 lighting, 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 • Relocated)
BTUs Gas / Elec / Other Qty
A/C Unit /Compressor
Air Handler /VAV
Boller
Dryer Duct
Exhaust Fans
Fireplace
Furnace
Heat Pump Unit
Hydronic Heating
Roof Top Unit (Provide eleva-
tions If a Commercial Bldg)
Other:
COUNTSPLUMBING FIXTURE Relocated . .. .
City Qty
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
Boiler Stove/Range/Oven
Dryer Water Heater
Fireplace/ Insert I I I Other:
Furnace ( 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 PSCAA Case #:
Critical Areas Determination:
i Study Required ❑ Conditional Waiver ❑ Waiver ❑
Fill in Place cK Fill Material: F02M
Removal ❑ Size of Tank (Gallons) 300
Critical Areas Determination:
Study Required ❑ 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.
FILCO COMPANY INC.
PO BOX 31228
SEATTLE, WA 98103
LICENSE#FILCOCIO80RU EXP: 12/31/2021
ICC LICENSE # 5050940
SITE PLAN
HEATING OIL TANK DECOMMISSIONING
JOB SITE: 7819 2281h St SW Edmonds, WA 98026
OWNER: Alta Ashinay
PHONE: 206-696-9939
ACTIVITY: Pump out, triple rinse and fill with foam one 300 gallon underground heating oil tank.
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