FIR2023-0051_Site_Plan_5.30.2023_10.53.34_AM_3574852or• Eb4f BUILDING PERMIT
APPLICATION
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Development Services
Building Division
121 Sth Ave N / Edmonds, WA 98020
/°c• 425.771.0220
For handouts, submittal requirements, permit status and inspection
scheduling information go to: http://www.edmond$wa.gov/
JOB SITE INFORMATION/LOCATION: (Where the work Is taking place)
Job site Address: 23525 74th Ave W Edmonds, WA 98026
Parcel:
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name: Richard Chung
Mailing Address: 23525 74th Ave W
City/State/Zip: Edmonds, WA 98026
Phone 425-681-2831
Email: rich238(agmai1.com
OWNER INSTALLATION: *If yes, read and sign*
WIII work be performed by the property owner? ❑ Yes K 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: FIICo Company, Inc.
Malling Address: PO BOX 31228
City/State/Zip: Seattle, WA 98103
Phone M 206-547-8347
E-mail: infofilcoinviro.com
GENERAL CONTRACTOR: (if different from applicant)
General Contractor: FIICo Company, Inc.
Mailing Address: PO BOX 31228
City/State/Zip: Seattle, WA 98103
Phone #: 206-547-8347
E-mail: Info filcoenviro.com
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
601 276 033 12/31 /2023
Permit 7#: 1
TYPE OF PERMIT (Provide
Details on ..
❑ Accessory Structure/
❑ Addition
Detached Garage
❑ Demolition
((Mechanical
❑ New Single Family / Duplex
❑ Plumbing
❑ Fire Sprinkler
❑ Remodel
❑ New Commercial/ Mixed Use
❑ Re -Roof
❑ Signs
❑ 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.
I
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 Porch/Patio:
Other sq ft:
PROJECT
Pump out triple rinse and fill with foam
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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: Melin0a Hess
CITY OF EDMONDS BUSINESS LICENSE #: NR-022028 Signature:
Date 3/` 'G
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 Qty
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• Relocated or .. .
Qty Qty
Clothes Washer
Tub/ Showers
Dishwasher
Backflow Device (RPBA, DCDA, AVB)
Drinking Fountain
Pressure Reduction/ Regulator Valve
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 Qty BTUs Qty
A/C Unit
Outdoor BBQ/ Fire pit
Boller
Stove/Range/Oven
Dryer
Water Heater
Fireplace/ Insert
Other:
Furnace
Other:
MEDICAL
(New,
GAS, AIR VACUUM COUNTS
Relocated • r re -piped)
MY
Qty
Carbon Dioxide
Nitrous Oxide
Helium
Oxygen
Medical Air
Other:
Medical - Surgical Vacuum Other:
DEMOLITION
Type of structure to be demolished:
Square footage of structure to be demolished:
AHERA Survey done? Y / N PSCAA Case q:
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
imli
Fill In Place Fill Material: FOAM
Removal ❑ Size of Tank (Gallons) 675
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
•.D
Grading: Cut cubic yards
Fill cubic yards
Cut / Fill in Critical Area: Yes ❑ No ❑
GENERAL•• •
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.
FILCO COMPANY INC.
PO BOX 31228
SEATTLE, WA 98103
LICENSE#FILCOCIO80RU EXP: 12/31/2023
ICC LICENSE # 5050940_
SITE PLAN
HEATING OIL TANK DECOMMISSIONING
JOB SITE: 23525 7+h Ave W Edmonds, WA 98026
OWNER: Richard Chung
PHONE: 425-681-2831
ACTIVITY: Pump and triple rinse and fill in place with foam one 675 gallon underground heating oil
tank. Cut vent and fill pipe below grade. Cap & seal.
23525- House
to