FIR2022-0109_Application_10.28.2022_9.45.30_AM_3190731CITY OF EDMONDS M BuildingPermit.com
Fire Application #1222352 - 9215 Tank Decommission
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
9215 OLYMPIC VIEW DR
City Zip Code County Parcel Number
EDMONDS 98020 27031300101000
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
Marta B & Carranza Mario L Gadda
Number Street Apartment or Suite Number
9215 OLYMPIC VIEW DR
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: 10/28/2022 Submitted By: Heather Hendricks
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CITY OF EDMONDS MyBuildingPermit.com
Fire Application #1222352 - 9215 Tank Decommission
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
Single Family Residential
Activity Type
Decommission
Scope of Work
Other
Project Name: 9215 Tank Decommission
Description of Work: Pump, rinse, and fill in place one (1) 500-gallon UST with foam. Cut and cap fill and
vent pipes.
Project Details
Storage Tank Work
Date of Decommissioning
Tank Decommission
Contact Information
Owner Email Address
11 /2/2022
mariocarranzan@aol.com
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