FIR2022-0080_Site_Plan_8.15.2022_2.15.26_PM_3051398y OV EDdfjG BUILDING PERMIT
Lo 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: htto://www.edmondswa.gov
JOB SITE INFORMATION/LOCATION: (Where the work is taking place)
Job Site Address: 20228 87th Ave W Edmonds, WA 98026
Parcel: 005724000001100
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name: Thomas Garrard
Mailing Address: 20228 87th Ave W _
City/State/Zip: Edmonds, WA 98026
Phone #: 425-776-1175
Email: garrardt@hotmail.com
OWNER INSTALLATION: 'If yes, read and sign*
Will work be performed by the property owner? ❑ Yes K 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: Fllco Company, Inc.
Mailing Address: PO BOX 31228
City/State/Zip: Seattle, WA 98103
Phone It: 206-547-8347
E-mail: info(@_filcoinviro.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@filcoenviro.com
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
601 276 033 12/31 /2022
CITY OF EDMONDS BUSINESS LICENSE #: NR-022028
Permit tF:
OF PERMIT (Provide
❑ Accessory Structure/
Detached Garage
DetailsTYPE
❑ Addition
❑ Demolition
((Mechanical
❑ New Single Family / Duplex
❑ Plumbing
❑ Fire Sprinkler
❑ Remodel
❑ New Commercial/ Mixed Use
❑ Re -Roof
❑ Signs
❑ Tank
❑Tenant Improvement
❑ Other
Remodel Permit fees are based on:
IF It: VUnJCar rrm wLxK (-7CrialrTrCa.Ina1CUIC InC vurue truurruea ru
the nearest dollar) of all equipment, moteriols, lobar, overhead,
and the profit for the work indicated on this application.
r uruunun.
PROPOSED. A•E 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:
PROJECT
Pump out triple rinse and fill with foam one
300 gallon underground 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: /elinda Hess _
Signature: I ate 8/15/2022
GENERAL COMMERCIAL 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.
n / CHANGE OF USE / NEW BLDG: Include TRAFFIC IMPACT worksheet
EQUIPMENTMECHANICAL • .Relocated)
BTUs Gas / Elec / Other Qty
A/C Unit /Compressor
Air Handier/VAV
Boiler
Dryer Dud
Exhaust Fans
Fireplace
Furnace
Heat Pump Unit
Hydronic Heating
Roof Top Unit (Provide eleva-
tions if a Commercial Bldg)
Other:
COUNTSPLUMBING FIXTURE .. ..
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'
CONNECTION COUNTS.. .. .
BTUs Qty BTUs Qty
A/C Unit
Outdoor BBQ / Fire pit
Boller
Stove/Range/Oven
Dryer
Water Heater
Fireplace/ Insert
Other:
Furnace
Other:
MEDICALAIR
VACUUM COUNTS
.. .. .
Qty Qty
Carbon Dioxide
Nitrous Oxide
Helium
Oxygen
Medical Air
Other:
Medical - Surgical Vacuum Other:
• • s
Type of structure to be demolished:
Square footage of structure to be demolished:
AHERA Survey done? Y / N ! PSCAA Case p:
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
Fill in Place Fill Material: FOAM
Removal ❑ Size of Tank (Gallons) 300
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
GRADE/FILL/EXCAVATE
Grading: Cut cubic yards
Fill cubic yards
Cut / FIII In Critical Area: Yes ❑ No ❑
GENERAL PROVISIONS
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. LICENSE# FI LCOCIO80RU EXP: 12/31/2022
PO BOX 31228 ICC LICENSE # 5050940
SEATTLE, WA 98103
SITE PLAN
HEATING OIL TANK DECOMMISSIONING
JOB SITE: 20228 871h Ave W Edmonds, WA 98026
OWNER: Thomas Garrard
PHONE: 425-776-1175
ACTIVITY: Pump out, triple rinse and fill in place with foam one 300 gallon underground heating oil
tank.
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