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1041 B AVE-SITE PLAN.pdf'7, i 60(o►-qLlCb3007n2_ 71> o^� V N� �C'lled�n� P—ES i D�Nir �� - Av,c=- s. Sao US i RE EIVED NOV 08 2017 BUILDING 60/90 39Vd V3S-MS�GAINn L5LLZ9L90Z 6T:TT LTOZ/80/TT DEVELOPMENT SERVICES PLUMBING, MECHANICAL, TANK, & DEMOLITION PEtI IIT APPLICATION 121 51s Avenue N, Edmonds, VGA 98020 st. I ZVO Phone 425.771.0220 Q Fax 425.771.0221 City of Edmonds PLEASE RgFER TO THE pt UMBING & ,WECIIANICAL CRECKLIST FOR SUBMITTAL REQUIREMENTS PROJECT ADDRESS (Street, Suite #, City State, Zip), Parcel #: 10 LA l A-V f--- �� nee N� t.-1 !k `� a O'er b l6( do 3 oC)�I o L Associated Permit #: IS THIS WORIK ASSOCIATED WITH ANOTHER PROJECT? Y'es E] No APPLICANT: Address (Street, City, State, Zip): S . s �� PROPERTYr� Address (Street, City, State, Zip): 1yo ALAMf_-b A D� twEES I,END'ING AGENCY: Address (Street, City, State, Zip): LAc_AaVne,S _ l4 L S:T. Ar© "L-& r--A CONTRACTOR:* A " _ ONt le_LSAL, Address (Street, City State, Zip)_ SI f S w rt t,..Y.- . db-76• Pax: 24L7-?t-z_• Phone: Zz E-Mail Address: oq, 'AAkr-- Phone: Fax: 15'• 1Zz-'bs3 9rs PS-7 E-Mail Address: A 4o6l Phone: Fax: '"Contractor must have a°valid Caty ofEdmonds business license prior to doing work in the City. Contact the City Clerks Office at 425-775.2525 NG TANK E-Mail Address: Phone: rax: ` Ao- 76t '7 000 1 ?A6 .17� E-Mail Address: J A,r - KEN /tom - co OVA State License #/Exp. Date: tz 7 t 1 2 City Business License #/E p. Date: kz DETAIL THE SCOPE OF WORK- —Ma Vl'� iZ_� I o Ja N➢I�-- , I declare under penalty of perjury laws that the information I have provided an this formhWlication 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. K _ , Owner 0 Agent/other (specify): Print Name: �•i'l�j/ Signature: / li Date: FORM C 'L:\Bt I DING DIVISION I'r1.ESDONE & x-(erred to L-8uilding-New drive\Fonn C 2014.docx Updated: 1/17/2014 60/b0 39tld d3S _1VSd3l1INn L5LLZ9L90Z GT:TT LTOZ/80/TT Type of structure to be demolished (e.g. house, shed, garage, etc_): Floor area of structure to be demolished: rr-----tt sq. ft. Critical Areas Determination: Study Required Conditional, Waiver ❑ Waiver L 1 FSCAA Case No. Additional comments: AREYtA Survey done? (required) p' ORM C X :\BUILDING bTVISION FII8SUDONi: & x-ferred to L-Building-New driveTorm C 2014.docx ' Updated: 1 / 1712014 60/90 30dd V3S -1VSa3AINn L9LLZ9L90Z 6Z-ZZ LZ36/80/ZZ CITY OF EDMONDS r 121 5TH AVENUENORTH - EDMONDS, WA 98020 PHONE: (425) 771-0220 - FAX: (425) 771-0221 Wednesday, November 15, 2017 This Application has been accepted by the City of Edmonds for review. More information and changes may be required during this process. The review target date is: Your City Contact is CHRISTINA WAYLAND Application Number: BLD20171623 Project Address: 1041 B AVE, EDMONDS KAREN ANDERSEN UNIVERSAL APPLICATORS INC C/O DISCLAIMER TRUST ANDERSEN C/O KELLY MACKAY 142 ALAMEDA DE LAS PULGAS 515 S SOUTHERN ST REDWOOD CITY, CA 94061 SEATTLE, WA 98108 (415)722-7053 (206) 762-7500 Work Description: Remove and replace 300 gallon underground residential heating oil tank in same location. Outstanding Items at Time of Submittal: It is anticipated that the following departments will be reviewing your application: - Building - i Planning l i Engineering r Fire Please wait to re -submit corrections until after you have received comments from all reviewing departments. I HEREBY AC KNOW LEDGE THAT I HAVE READ THIS APPLICATION THAT THE INFO RMATION GIVEN IS CORRECT AND THAT I AM THE PROPERTY OWNER, OR THE DULY AUTHORIZED AGENT OF THE PROPERTY OWNER TO SUBMITA BUILDING PERMIT APPLICATION TO THE CITY. SIGNATURE (OWNER OR AGENT) PRINT NAME DATE S IGNED To view up to date information about your application please visit the City of Edmonds Development Services website at http.://www.ednwndswa.gov.