FIR2022-0023_Site_Plan_2.24.2022_3.05.34_PM_2701609BUILDING 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: httE[[i�w:v edn,undswr�1ti�y
JOB SITE INFORMATION/LOCATION: (Where the work Is taking place)
Job Site Address:23615 74th Ave W Edmonds, WA 98026
Parcel: 27043200301100
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name: Gail Meyerson
Mailing Address: 23615 74th Ave W
City/State/zip: Edmonds, WA 98026
Phone #: 206-795-8086
Email: meyersongOaol.com
OWNER INSTALLATION: *If yes, read and sign*
WIII work be performed by the property owner? ❑ Yes ❑ 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: Filco Company, Inc.
Mailing Address: PO Box 31228
City/State/zip: Seattle, WA 98103
Phone #: 206-795-8086
E-mail: info@filcoenviro.com
GENERAL CONTRACTOR: (If different from applicant)
General Contractor: Filco Company, Inc.
Mailing Address: PO Box 31228
City/State/Zip: Seattle, WA 98103
Phone #: 206-547-8347
E-mail: info(Wfilcoenviro.com
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
FILCOCIO80RU 12/31 /2022
CITY OF EDMONDS BUSINESS LICENSE #: NR-024111
Permit #:1
❑ Accessory Structure/ ❑ Addition
Detached Garage
❑ Demolition X Mechanical
❑ New Single Family / Duplex ❑ Plumbing
❑ Fire Sprinkler ❑ Remodel i
❑ New Commercial/ Mixed Use ❑ Re -Roof
❑ Signs IXTank
❑ Tenant Improvement 1 ❑ 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.
Vnhinrinn-
PROPOSED NEW SQUARE FOOTAGE 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:
PROJECTDESCRIPTION
Pump out triple rinse and fill with Foam one 500
gallon underground eating 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: 4elindA Hess
Signature: Date 2/24/2022
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
COUNTSMECHANICAL EQUIPMENT
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 Bldg)
Other:
PLUMBING FIXTURE COUNTSor re -piped)
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
Boiler Stave/Range/Oven
Dryer Water Heater
[Fireplace/ Insert I Other:
Furnace I I I Other:
City City
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:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
Fill in Place 54 Fill Material: Foam
Removal ❑ Size of Tank (Gallons)
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: 12/31/2022
ICC LICENSE # 5050940
SITE PLAN
HEATING OIL TANK DECOMMISSIONING
JOB SITE: 23615 741h Ave W Edmonds, WA 98026
OWNER: Gail Meyerson
PHONE: 206-795-8086
ACTIVITY: Pump out, triple rinse and foam fill one 500 gallon underground heating oil tank.
23615- House
V wd 00uc >'
MOT
�v�sWes
Ivor -M`k Dn�i?w0�
N
74 th Ave W