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FIR2025-0008_Application_1.15.2025_12.29.00_PM_4712898CITY OF EDMONDS M BuildingPermit.com Fire Application #1601510 - Partch Applicant First Name Last Name Company Name Kelly Mackay LEFT COAST SERVICES LLC Number Street Apartment or Suite Number E-mail Address 126 SW 148th St Suite C100 Box 4 uai—kwm@yahoo.com City State Zip Phone Number Extension Burien WA 98166 (206) 762-7500 Contractor Company Name LEFT COAST SERVICES LLC Number Street Apartment or Suite Number 126 SW 148TH ST STE C100 BOX 4 City State Zip Phone Number Extension BURIEN WA 98166 (206) 762-7500 State License Number License Expiration Date UBI # E-mail Address LEFTCCS829QB 11/3/2026 Fm49R7785 uai—kwm@yahoo.com Project Location Number Street Floor Number Suite or Room Number 19804 MAPLEWOOD DR City Zip Code County Parcel Number EDMONDS 98026 00705100000100 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name Eric N & Suzanne Partch Number Street Apartment or Suite Number 1234 VIEWLAND WAY City State Zip EDMONDS WA 98020 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work requires a licensed contractor to perform the work, the information will be provided prior to permit issuance. Date Submitted: 1/15/2025 Submitted By: Kelly Mackay Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Fire Application #1601510 - Partch Project Contact Company Name: LEFT COAST SERVICES LLC Name: Kelly Mackay Email: uai_kwm@yahoo.com Address: 126 SW 148th St Suite C100 Box 4 Phone #: (206) 762-7500 Burien WA 98166 Project Type Activity Type Scope of Work Single Family Residential Decommission Underground Storage Tank Removal Project Name: Partch Description of Work: Decommission of a 675 gallon Underground Residential Heating Oil Tank in place by Foam Fill. Project Details Storage Tank Size Tank Size Work Location Work Description/Location (example: 1st floor, Master Bath, Garage) Type of Work Other Contact Information Owner Email Address 675 Decommission of a 675 gallon Underground Residential Heating Oil Tank in place by Foam Fill. epartch@gmail.com Page 2 of 2