FIR2022-0107_Applicant_Response_10.12.2022_2.43.13_PM_31609380\; k1j,110 BUILDING PERMIT
1 APPLICATION
Development Services
Building Division
121 5th Ave N / Edmonds, WA 98020
"c t8co 425.771.0220
For handouts, submittal requirements, permit status and inspection
scheduling information go to: htt}r/ wvnv ecJmonrlsuLa ov
JOB SITE INFORMATION/LOCATION: (Where the work Is taking place)
Job site Address: 529 9th Ave N Edmonds, WA 98020
Parcel: 27032400220900
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name: CDKK Ventures LLC- Karim Khoury
MallingAddress: 15117 Main St, B-106
City/State/Zip: Mill Creek, WA 98012
Phone m 425-971-8614
Email: kkhouU(d)remax.net
OWNER INSTALLATION: *If yes, read and sign*
WIII work be performed by the property owner? ❑ Yes 119 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 #: 206-547-8347
E-mail: infofilcoinviro.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(a_filcoenviro.com
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
601 276 033 12/31 /2022
CITY OF EDMONDS BUSINESS LICENSE #: N R-022028
7-I!,14M
:
(ProvideTYPE OF PERMIT
❑ Accessory Structure/
Detached Garage
Details
❑ Addition
[Mechanical
❑ Plumbing
❑ Remodel
❑ Demolition
❑ New Single Family / Duplex
❑ Fire Sprinkler
❑ New Commercial/ Mixed Use
❑ Signs
❑ Re -Roof
❑ Tank
❑ Tenant Improvement ❑ Other
Remodel Permit fees are based on:
The value of the work performed. Indicate the value (rounded to
the nearest dollar) of all equipment, materials, labor, overhead,
and the profit for the work indicated on this application.
Valuation:
PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION
Basement sq ft: Finished ❑ Unfinished ❑
1st Floor, sq ft:
2nd Floor, sq ft:
Garage/Carport:, sq ft:
Deck/Covered Parch/Patio:
Other sq ft:
PROJECTDESCRIPTION
Pump out triple rinse and fill with foam one
500 gallon residential 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: M Ilnda ess
Signature:j2L/ Date 10/12/202
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.
TI / CHANGE OF USE / NEW BLDG: Include TRAFFIC IMPACT worksheet
MECHANICAL •COUNTS
BTUs Gas / Elec / Other City
A/C Unit /Compressor
Air Handler /VAV
Boiler
Dryer Duct
Exhaust Fans
Fireplace
Furnace
Heat Pump Unit
Hydronlc Heating
Roof Top Unit (Provide eleva-
tions if a Commercial Bldg)
Other:
PLUMBING•
City City
Clothes Washer
Tub/Showers
Dishwasher
Backflow Device (RPBA, DCDA, AVB)
Pressure Reduction/ Regulator Valve
Drinking Fountain
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 City BTUs City
A/C Unit
Outdoor BBQ / Fire pit
Boller
Stove/Range/Oven
Dryer
Water Heater
Fireplace/ Insert
Other:
Furnace
Other:
COUNTSMEDICAL GAS, AIR VACUUM
Relocated .
City
City
Carbon Dioxide
Nitrous Oxide
Helium
Oxygen
Medical Air
Other:
Medical - Surgical Vacuum Other:
Type of structure to be demolished:
Square footage of structure to be demolished:
AHERA Survey done? Y / N
I PSCAA Case #:
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
J
Fill in Place ❑ Fill Material: FOAM
Removal ❑ Size of Tank (Gallons) 500
i
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
GRADE/FILL/EXCAVATE
Grading: Cut cubic yards
FIII cubic yards
Cut / Fill 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. I
I