FIR2023-0024_Application_3.22.2023_11.53.26_AM_3436465CITY OF EDMONDS M BuildingPermit.com
Fire Application #1286220 - Swedberg
Applicant
First Name Last Name Company Name
Kelly Mackay LEFT COAST SERVICES LLC
Number Street Apartment or Suite Number E-mail Address
126 SW 148th St Suite C100 Box 4 uai—kwm@yahoo.com
City State Zip Phone Number Extension
Burien WA 98166 (206) 762-7500
Contractor
Company Name
LEFT COAST SERVICES LLC
Number Street Apartment or Suite Number
126 SW 148TH ST STE C100 BOX 4
City State Zip Phone Number Extension
BURIEN WA 98166 (206)762-7500
State License Number License Expiration Date UBI # E-mail Address
LEFTCCS829QB 11/3/2024 Fm49R7785 uai—kwm@yahoo.com
Project Location
Number Street Floor Number Suite or Room Number
24032 79TH PL W
City Zip Code County Parcel Number
EDMONDS 98026 00511600000600
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
Trevor J & Sheena M Swedberg
Number Street Apartment or Suite Number
24032 79TH PL W
City State Zip
EDMONDS WA 98026
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: 3/22/2023 Submitted By: Kelly Mackay
Page 1 of 2
i
CITY OF EDMONDS MyBuildingPermit.com
Fire Application #1286220 - Swedberg
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 #: (206) 762-7500
Burien WA 98166
Project Type
Single Family Residential
Activity Type
Decommission
Scope of Work
Other
Project Name: Swedberg
Description of Work: Decommission 300 gallon Underground Residential Heating Oil Tank by removal.
Project Details
Storage Tank Work
Date of Decommissioning 4/27/2023
Tank Decommission
Contact Information
Owner Email Address uai_kwm@yahoo.com
Page 2 of 2