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FIR2022-0049_Application_5.4.2022_10.21.04_AM_2846274CITY OF EDMONDS M BuildingPermit.com Fire Application #1136799 - UST Removal Applicant First Name Last Name Company Name Diane Kamacho Dianes Tank Removal Services LLC Number Street Apartment or Suite Number E-mail Address 18720 Sound View PI dianestank@hotmail.com City State Zip Phone Number Extension Edmonds WA 98020 (206) 510-9497 Contractor Company Name DIANE'S TANK REMOVAL SRVCS LLC Number Street Apartment or Suite Number 18720 Sound View PI City State Zip Phone Number Extension Edmonds WA 98020 (206) 510-9497 State License Number License Expiration Date UBI # E-mail Address Dianetr906lm 6/26/2022 Rningggis dianestank@hotmail.com Project Location Number Street Floor Number Suite or Room Number 22421 98TH AVE W City Zip Code County Parcel Number EDMONDS 98020 00450701200006 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 Deborah Petersen Number Street Apartment or Suite Number 22421 98TH AVE W City State Zip EDMONDS WA 98020 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: 5/4/2022 Submitted By: Diane Kamacho Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Fire Application #1136799 - UST Removal Project Contact Company Name: LDia es Tank Removal Services Name: Diane Kamacho Email: dianestank@hotmail.com Address: 18720 Sound View PI Phone #: (206) 510-9497 Edmonds WA 98020 Project Type Activity Type Scope of Work Single Family Residential Decommission Underground Storage Tank Removal Project Name: UST Removal Description of Work: Removal of one 300 gallon heating oil UST, located on south side of driveway, 4ft west of SW garage corner. Project Details Storage Tank Size Tank Size Type of Work Tank Removal 300 Page 2 of 2