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FIR2022-0107_Application_10.12.2022_2.43.22_PM_3160942CITY OF EDMONDS M BuildingPermit.com Fire Application #1215219 - CDKK Ventures LLC- Foam fill Applicant First Name Last Name Company Name MELINDA HESS Filco Company, Inc. Number Street Apartment or Suite Number E-mail Address PO Box 31228 info@filcoenviro.com City State Zip Phone Number Extension Seattle WA 98103 (206) 547-8347 Contractor Company Name FILCO COMPANY INC Number Street Apartment or Suite Number PO Box 31228 City State Zip Phone Number Extension Seattle WA 98103 (206) 547-8347 State License Number License Expiration Date UBI # E-mail Address FILCOCIO80RU 10/10/2023 FD197FD33 info@filcoenviro.com Project Location Number Street Floor Number Suite or Room Number 529 9TH AVE N City Zip Code County Parcel Number EDMONDS 98020 27032400220900 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 CDKK VENTURES LLC Number Street Apartment or Suite Number 15117 MAIN ST B106 City State Zip MILL CREEK WA 98012 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: 10/12/2022 Submitted By: MELINDA HESS Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Fire Application #1215219 - CDKK Ventures LLC- Foam fill Project Contact Company Name: Filco Company, Inc. Name: MELINDA HESS Email: info@filcoenviro.com Address: PO Box 31228 Phone #: (206) 547-8347 Seattle WA 98103 Project Type Single Family Residential Activity Type Decommission Scope of Work Other Project Name: CDKK Ventures LLC- Foam fill Description of Work: Pump out triple rinse and fill with foam one 500 gallon underground heating oil tank. Project Details Storage Tank Work Date of Decommissioning 10/17/2022 Tank Decommission Contact Information Owner Email Address kkhoury@remax.net Page 2 of 2