FIR2022-0025_Application_3.1.2022_12.52.11_PM_2709626CITY OF EDMONDS M BuildingPermit.com
Fire Application #1100304 - Wilson
Applicant
First Name Last Name Company Name
Kelly Mackay LEFT COAST SERVICES LLC
Number Street Apartment or Suite Number E-mail Address
126 SW 148th St Suite C100 Box 4 uai—kwm@yahoo.com
City State Zip Phone Number Extension
Burien WA 98166 2067627500
Contractor
Company Name
LEFT COAST SERVICES LLC
Number Street Apartment or Suite Number
126 SW 148TH ST STE C100 BOX 4
City State Zip Phone Number Extension
BURIEN WA 98166 (206)762-7500
State License Number License Expiration Date UBI # E-mail Address
LEFTCCS829QB 11/3/2022 Fm49R7785 uai—kwm@yahoo.com
Project Location
Number Street Floor Number Suite or Room Number
8324 SIERRA DR
City Zip Code County Parcel Number
EDMONDS 98026 00572500002500
Associated Building Permit Number Tenant Name
CRA2022-0027
Additional Information (i.e. equipment location or special instructions)_
Work Location
Property Owner
First Name Last Name or Company Name
Daniel J Wilson
Number Street Apartment or Suite Number
8324 SIERRA DR
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: 3/1/2022 Submitted By: Kelly Mackay
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CITY OF EDMONDS MyBuildingPermit.com
Fire Application #1100304 - Wilson
Project Contact
Company Name: LEFT COAST SERVICES LLC
Name: Kelly Mackay Email: uai_kwm@yahoo.com
Address: 126 SW 148th St Suite C100 Box 4 Phone #: 2067627500
Burien WA 98166
Project Type Activity Type
Single Family Residential Decommission
Project Name: Wilson
Description of Work: Decommission in place by foam fill.
Project Details
Storage Tank Size
Tank Size
Type of Work
Other
300
Scope of Work
Underground Storage Tank Removal
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