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FIR2023-0008_Application_2.2.2023_2.43.11_PM_3348227CITY OF EDMONDS M BuildingPermit.com Fire Application #1263476 - Hardesty- Foam fill Decommission 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 425 7TH AVE S City Zip Code County Parcel Number EDMONDS 98020 00434209103702 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 Judy L & Donald E Hardesty Number Street Apartment or Suite Number 425 7TH AVE S 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: 2/2/2023 Submitted By: MELINDA HESS Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Fire Application #1263476 - Hardesty- Foam fill Decommission 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: Hardesty- Foam fill Decommission Description of Work: Pump out triple rinse and fill with foam one 300 gallon underground heating oil tank. Project Details Storage Tank Work Date of Decommissioning Tank Decommission Contact Information Owner Email Address 2/28/2023 hardestyjudy@gmail.com Page 2 of 2