FIR2024-0022_Site_Plan_3.4.2024_11.15.19_AM_4099904of EDMo BUILDING PERMIT
APPLICATION
Development Services
Building Division
121 5th Ave N / Edmonds, WA 98020
�nQ' 1g9� 425.771.0220
For handouts, submittal requirements, permit status and Inspection
scheduling information go to: htto://Mvw.edmondswa.gov/
JOB SITE INFORMATION/LOCATION: (Where the work Is taking place)
Job Site Address: 654 4th Ave S Edmonds WA 98020
Parcel: 00409600101100
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name: Jay Fulton
Mailing Address: 654 4th Ave S
City/state/zip: Edmonds, WA 98020
Phone #: 425-827-4470
Email: Jay.fulton1(aD-gmail. corn
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner? ❑ Yes t9 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: Fllco Company Inc.
Mailing Address: PO BOX 31228
City/State/Zip: Seattle. WA 98103
Phone #: 206-547-8347
E-mail: info(cD_filcoinviro.com
GENERAL CONTRACTOR: (If different from applicant)
General Contractor: Filco 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 /2024
CITY OF EDMONDS BUSINESS LICENSE #: NR-022028
01 ice Use Only
TYPE OF Details
❑ Accessory Structure/ ❑ Addition
Detached Garage
❑ Demolition
[(Mechanical
❑ New Single Family / Duplex
❑ Plumbing
❑ Fire Sprinkler
❑ Remodel
❑ New Commercial/ Mixed Use
❑ Re -Roof
❑ Tank
❑ Signs
❑ 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.
Valuation:
PROPOSED NEVV 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 rise and remove
one 300 gallon underground heating oil
tank. Haul tank away and properly dispo
tank Seattle Iron metals.
I certify that the information I have provided on this Form/appllcadon 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: Melinda Hess/ ,tt _
Signature: >°d o� Date 3/4/2024
of
COMMERCIALGENERAL
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
EQUIPMENTMECHANICAL • .Relocated)
BTUs Gas / Elec / Other Qty
A/C Unit /Compressor
Air Handler /VAV
Boiler
Dryer Duct
Exhaust Fans
Fireplace
Furnace
Heat Pump Unit
Hydronic Heating
Roof Top Unit (Provide eleva-
tions If a Commercial Bldg)
Other:
COUNTSPLUMBING FIXTURE ..-.
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:
BTUs Qty BTUs Qty
A/C Unit Outdoor BBQ / Fire pit
Boiler Stove/Range/Oven
Dryer Water Heater
Fireplace/ Insert Other:
Furnace I I I Other:
Qty Qty
Carbon Dioxide Nitrous Oxide
Helium Oxygen
Medical Air Other:
Medical -Surgical Vacuum Other:
Type of structure to be demolished:
Square footage of structure to be demolished:
AHERA Survey done? Y / N PSCAA Case Is:
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
Fill in Place ❑ Fill Material:
Removal I Size of Tank (Gallons) M
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver
Grading: Cut cubic yards
Fill cubic yards
Cut / FIII in Critical Area: Yes ❑ No ❑
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. LICENSE#FILCOCI080RU EXP: 12/31/2024
PO BOX 31228 ICC LICENSE # 5050940
SEATTLE, WA 98103
SITE PLAN
HEATING OIL TANK DECOMMISSIONING
JOB SITE: 654 41h Ave S Edmonds, WA 98020
OWNER: Jay Fulton
PHONE: 425-827-4470
ACTIVITY: Pump out triple rinse and remove one approximate 300 gallon underground heating oil
tank. Haul tank away and properly dispose of tank Seattle Iron Metals.
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