FIR2021-0110+Application+9.23.2021_1.14.15_PM+2425558CITY OF EDMONDS
Fire Application #1024465 - Caraker
Applicant
First Name
Last Name
Kelly
Mackay
Number
Street
126
SW 148th St
City
State
Zip
Burien
WA
98166
Contractor
Company Name
LEFT COAST SERVICES LLC
Number
Street
126 SW 148TH ST STE C100 BOX 4
City
State Zip
BURIEN
WA 98166
MyBuildingPermit.com
Company Name
LEFT COAST SERVICES LLC
Apartment or Suite Number E-mail Address
Suite C100 Box 4 uai kwm(�D_yahoo.com
Phone Number Extension
2067627500
State License Number License Expiration Date UBI #
LEFTCCS829QB 11/3/2022 604267785
Project Location
Apartment or Suite Number
Phone Number Extension
(206)762-7500
E-mail Address
uai kwm@yahoo.com
Number Street Floor Number Suite or Room Number
418 2ND AVE N
City Zip Code County Parcel Number
EDMONDS 98020 00592200000900
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
Audrey Caraker
Number Street Apartment or Suite Number
418 2ND AVE N
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: 9/23/2021 Submitted By: Kelly Mackay
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CITY OF EDMONDS Mysu;laingPerrnit.com
Fire Application #1024465 - Caraker
Project Contact
Company Name: LEFT COAST SERVICES LLC
Name: Kelly Mackay Email: uai_kwm@yahoo.com
Address: 126 SW 148th St Suite C100 Box 4 Phone #: 2067627500
Burien WA 98166
Project Type Activity Type Scope of Work
Single Family Residential Decommission Other
Project Name: Caraker
INSTALLATION OF AN ABOVE GROUND RESIDENTIAL HEATING OIL TANK. Since
Description of "mybuildingermit.com" does NOT have an "Above Ground Tank " install selection available;
Work: Per Christina @ City of Edmonds, we apply as a Decommission and they will change to an
AST install on their end. 9-23-21
Project Details
Storage Tank Work
Date of Decommissioning 10/8/2021
Tank Decommission
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