FIR2024-0029_Applicant_Response_4.3.2024_11.52.02_AM_4174114BUILDING PERMIT
APPLICATION
Development Services
Building Division
121 51h Ave N / Edmonds, WA 98020
425.771.0220
For handouts, submittal requirements, permit status and inspection
scheduling Information go to: hkwJiwww.edmondsw,j.govj
JOB SITE INFORMATION/LOCATION: 1Where the work Is taking place)
Job Site Address: 19311 88th Ave W Edmonds, WA 98026
Parcel: 27041800308700
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name. Scott Gann
Mailing Address: 19311 88th Ave W
City/state/zip: Edmonds, WA 98026
Phone #: 206-914-1068
Email: scott.aann27@—gmail.com
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner? ❑ yes X 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 COmpany1.Inc.
Mailing Address: PO Box 31228
City/State/Zip: Seattle. WA 98103
Phone #: 206-547-8347
E-mail: info[@-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) & EXPIRA fION DATE:
601 276 033 12/31 /2024
fa€Y OF EDIVIOND5 FStL i1vF55 i_i ENSE g, NR-022028
7Permil#:
❑ Accessory Structure/
❑ Addition
Detached Garage
C(Mechanical
❑ Demolition
❑ New Single Family / Duplex
❑ Plumbing
❑ Fire Sprinkler
❑ Remodel
❑ New Commercial/ Mixed Use
❑ Re -Roof
❑ Signs
❑ Tank
❑ Tenant Improvement ❑ Other __ __
Remodel Pe►mlt fees are based on:
The value of the work performed. Indicate the value (rounded to
ihp nanracf rinllnrl of nil ant dnmanf mnts 6nlc Infhnr nvarhanri
and the profit for the work indicated on this application.
Valuation:
PROPOSED NEW SQUARE I'CIDIAC�f-FOIITF]ISAPI'LIC,CITION
Basement sq ft: Finished ❑ Unfinished ❑
1st Floor, sq ft:
2nd Floor, sgft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
Other sq ft:
PROJECT•
Pump out triple rinse and fill with foam
one 300 gallon underground oil tank.
I certify that the information I have provided on this (orm/application is true,
correct and cornpletP, and that I am :he property owner or duty authonled
agent of the property owner to sut)mlt i permit application to the. City of
r4lrnonfJs.
Print Name: Melinda Hess
5ii tlatt,re. �=� Datf _413L2-024
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 Ilghting, 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 EQUIPMEN-1 COUNTS (New and Relocated)
BTUs Gas / Elec / Other City
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 • . .e
City City
Clothes Washer
Tub/ Showers
Dishwasher
Backflow Device (RPBA, DCDA, AVR)
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
$inns
Other:
ruilet;
Othi:i
BTUs City BTUs Qty
A/C Unit
Outdoor BBQ / Fire pit
Boller
Stove/Range/Oven
Dryer
Water Heater
Fireplace/ Insert
Other:
Furnace Other:
COUNTSMEDICAL GAS, AIR VACUUM (Now, Relocated or
City Qty
Carbon Dioxide
Nitrous Oxide
Helium
Oxygen
Medical Air
Other:
Medical - Surgical Vacuum Other:
im
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 ❑
Fill in Place CK Fill Material: FOAM
Removal ❑ Size of Tank (Gallons) 300 9allo
l Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
AD
Grading: Cut, cubic yards
Fill _ cubic yards
Cut / Fill in Critical Area: Yes ❑ No ❑
GENERAL PROVISIONS
APPLICATIONS: Applications are valid for a maximum of 1 year.
FSLHA Applications, 2 years.
LICENSING: All Contractors wind sobr-pnt,'artors are r,, squired to be licensed
with Wi'hington State Deparlmr,•_nt of I abnr $� Indu.,,M,,2s and have a
iy of i;dr;laru'� l3�uinea _�rx;�5e.
FILCO COMPANY INC.
PO BOX 31228
SEATTLE, WA 98103
LICENSE#FILCOCI080RU EXP: 12/31/2024
ICC LICENSE /; _ 5050940
SITE PLAN
HEATING OIL TANK DECOMMISSIONING
JOB SITE: 19311 881n Ave W Edmonds, WA 98026
OWNER: Scott Gann
PHONE: 206-914-1068
ACTIVITY: Pump out triple rinse and fill with foam one 300 gallon underground heating oil tank.
•-- N
19311- House
88 tn Ave W
C