FIR2024-0002_Site_Plan_1.25.2024_10.56.12_AM_4019926BUILDING PERMIT
u 1cJ APPLICATION
Development Services
Building Division
121 Sth Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements, permit status and Inspection
scheduling information go to: htto:/kvww.edniolidswa.i,,ov/
JOB SITE INFORMATION/LOCATION: (Where the work Is taking place)
Job Site Address8107 213th St SW Edmonds, WA 9M
Parcel: 00573200000500
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name: Heidi Shifflette
Mailing Address: Al n7 9 1 'Ith St SW
x11.1• j s •ill_ •
Phone #: _9M-94n-1 R44
Email: N/A
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: Fllco Company, Inc.
Mailing Address: PO Box 31228
City/State/Zip: Seattle. WA 98103
Phone #: 206-547-8347
E-mail: infop_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 a@filcoenviro.com
WA STATE CONTRACTOR L & I # (CCB) & EXPIRATION DATE:
601 276 033 12/31 /2024
CITY OF EDMONDS BUSINESS LICENSE #: NR-022028
Ofliru Use only
TYPE OF
❑ Accessory Structure/
Detached Garage
Details on Page
❑ Addition
❑ Demolition
XMechanical
❑ New Single Family / Duplex
❑ Plumbing
❑ Fire Sprinkler
❑ Remodel
❑ Re -Roof
❑ New Commercial/ Mixed Use
❑ 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.
Valuation:
PROPOSED NEW SQUARE FOOTAGE FOR THIS APPLICATION
Basement sq ft: Finished ❑ Unfinished ❑
1st Floor, sq Ift:
i
2nd Floor, sq ft:
Garage/Carport:, sq ft:
Deck/Covered Parch/Patio:
Other sq ft:
PROJECT DESCRIPTION
Pump out triple rinse and fill with foam
nne approximate 300 gallon
underground heating oil tank.
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: Melinda Hess /
Signature: J Date 1 /25/2024
I
COMMERCIALGENERAL ,
Occupancy Group(s): Occupant Load(s):
Type(s) of Construction:
Fire Sprinklers: Yes ❑ No ❑
WA STATE ENERGY CODE: If your project affects the bullding 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
Boller
Dryer Duct
Exhaust Fans
Fireplace
Furnace
Heat Pump Unit
Hydranic Heating
Roof Top Unit (Provide eleva-
tions If a Commercial Bldg)
Other:
COUNTSPLUMBING FIXTURE .. ..e
MY City
Clothes Washer
Tub/ Showers
Dishwasher
Backflow Device (RPBA, DCDA, AVB)
Drinking Fountain
Pressure Reduction/ Regulator Valve
Floor Draln/Sink
Refrigerator Water Supply
Hose Bibs
Water Heater - Tankless? Y or N
Hydronic Heat
Water Service Line
Sinks
Other:
Other:
Toilets
CONNECTION COUNTS
BTUs City BTUs city
A/C Unit
Outdoor BBQ/ Fire pit
Boiler
Stove/Range/Oven
Dryer
Water Heater
Fireplace/ Insert
Other:
Furnace
Other:
MEDICAL
GAS, AIR VACUUM COUNTS
.. ..
city
city
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 I PSCAA Case #:
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
Fill In Place ❑ FIII Material: FOAM
Removal ❑ Size of Tank (Gallons)
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
GRADE/
Grading: Cut _ cubic yards
I
Fill cubic yards
Cut / FIII in Critical Area: Yes ❑ No ❑
GENERAL PROVISIONS
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.
I
FILCO COMPANY INC. LICENSE#FILCOCIO80RU EXP: 12/31/2024
PO BOX 31228 ICC LICENSE # 5050940
SEATTLE, WA 98103
SITE PLAN
HEATING OIL TANK DECOMMISSIONING
JOB SITE: 8107 2131" St SW Edmonds, WA 98026
OWNER: Heidi Shifflette
PHONE: 206-940-1844
ACTIVITY: Pump out triple rinse and fill in place with foam one 300 gallon underground ground
residential heating oil tank.
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