FIR2022-0097_Application_9.16.2022_10.31.20_AM_3112785CITY OF EDMONDS M BuildingPermit.com
Fire Application #1203100 - Franklin tank decommissioning
Applicant
First Name Last Name Company Name
Heather Hendricks Tanks by Dallas
Number Street Apartment or Suite Number E-mail Address
17552 Ballinger Way NE tanksbydallas@tanksbydallas.net
City State Zip Phone Number Extension
Lake Forest Park WA 98155 (206) 365-0291
Contractor
Company Name
Tanks by Dallas
Number Street Apartment or Suite Number
17552 Ballinger Way NE
City State Zip Phone Number Extension
Lake Forest Park WA 98155 (206) 365-0291
State License Number License Expiration Date UBI # E-mail Address
tanksd*001 kf 5/6/2023 FD1 q7941 R tanksbydallas@tanksbydallas.net
Project Location
Number Street Floor Number Suite or Room Number
20210 81 ST AVE W
City Zip Code County Parcel Number
EDMONDS 98026 00431200002902
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
David Scott & Black Riva D Franklin
Number Street Apartment or Suite Number
20210 81 ST AVE W
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: 9/16/2022 Submitted By: Heather Hendricks
Page 1 of 2
CITY OF EDMONDS MyBuildingPermit.com
Fire Application #1203100 - Franklin tank decommissioning
Project Contact
Company Name: Tanks by Dallas
Name: Heather Hendricks Email: tanksbydallas@tanksbydallas.net
Address: 17552 Ballinger Way NE Phone #: (206) 365-0291
Lake Forest Park WA
98155
Project Type Activity Type Scope of Work
Single Family Residential Decommission Other
Project Name: Franklin tank decommissioning
Description of Work: Pump, triple rinse, fill in place (1) 300-gallon UST with sand/slurry mix.
Project Details
Storage Tank Work
Date of Decommissioning 9/19/2022
Tank Decommission
Contact Information
Owner Email Address davidsfranklin11@gmail.com
Page 2 of 2