FIR2024-0108_Site_Plan_11.1.2024_9.39.34_AM_4596310�A Of D
EAgOi BUILDING PERMIT
APPLICATION
Development Services
Building Division
121 Sth Ave N / Edmonds, WA 98020
°C. t'AC) 425.771.0220
For handouts, submittal requirements, permit status and Inspection
scheduling Information go to: httn_:Jjt;;;;; t>rlmnnd;;y_:pyl
JOB SITE INFORMATION/LOCATION: (Where the work Is taking place)
Job Site Address: 19006 80th Ave W Edmonds, WA 98026
Parcel: 00481600600100
Lot /Unit/Suite #: Subdivision:
PROPERTY OWNER:
Name: Pearl Suzette
Mailing Address: 19006 80th Ave W
City/state/zip: Edmonds, WA 98026
Phone #: 360-929-4642
Email: N/A
OWNER INSTALLATION: *If yes, read and sign*
Will work be performed by the property owner? ❑ Yes IN 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: Filco Company, Inc.
Mailing Address: PO Box 31228
City/State/Zip: _ Seattle. WA 98103
Phone M 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 M 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 M NR-022028
01 ire use Only
TYPE OF PERMIT (Provide
❑ Accessory Structure/
-Detached Garage
Details
❑ Addition
❑ Demolition
[(Mechanical
❑ New Single Family / Duplex
❑ Plumbing
❑ Fire Sprinkler
❑ Remodel
❑ New Commercial/ Mixed Use
❑ Re -Roof
❑ Signs
❑ Tank
❑ Tenant Improvement
❑ Other
Kemooei rermlr rees are oasea 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:
Basement sq ft: Finished ❑ Unfinished ❑
1st Floor, sq ft:
2nd Floor, sqft:
Garage/Carport:, sq ft:
Deck/Covered Porch/Patio:
Other sq ft:
Pump out triple rinse and remove one
approximate 300 gallon underground
heating oil tank. Haul tank away
and properly dispose of tank. Seattle
Iron and metal.
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
.. m
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
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:
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
GAS, AIR VACUUM COUNTS
.. ..
Qty
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 N:
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
,
Fill in Place ❑ Fill Material:
Removal X Size of Tank (Gallons) 300 gallon
Critical Areas Determination:
Study Required ❑ Conditional Waiver ❑ Waiver ❑
•,DE/FILL/EXCAVATE
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.
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#FILCOCIO80RU EXP: 12/31/2024
PO BOX 31228 ICC LICENSE # 5050940
SEATTLE, WA 98103
SITE PLAN
HEATING OIL TANK DECOMMISSIONING
JOB SITE: 19006 80th Ave W Edmonds, WA 98026
OWNER: Pearl Suzette
PHONE: 360-929-4642
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 metal.
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