BLD20170795-APPROVED PERMIT.pdfSTATUS: 'ISSUI
CIT'Y
121 5TH AVENUE NORTH - EDMONDS, WA98020`
PHONE: (425) 771-0220 FAX: (425) 771-0221
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Parcel No: 27032400204000
JAMES M & CHRYSTAL A LANNING, JAMES M & CHRYSTAL A LANNING FUEL TANK INSTALLATION CO INC
18604 SOUND VIEW PL 18604 SOUND VIEW PL C/O THOMAS ANDERSON
EDMONDS, WA 98020-2356 EDMONDS, WA 98020-2356 11536 SEAOLA BEACH DR SW
SEATTLE, WA 98146
(425),750=3592 (206)244-8020
LICENSE #; FUELT,IC080138_ EXP:06/11/2018 _
Remove residential oil tank
VALUATION: ''$0.00
I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED
THEREBY, NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO
WORKMEN'S COMPENSATION INSURANCE AND RCW 18:27,
THI P LICATI IS NOT ERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID,
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g r tta a � Wre V Date Released By Date
ATTENTION
ITIS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A'FINAL INSPECTION HAS BEEN MADE AND APPROVAL ORA CERTIFICATE OF
OCCUPANCY HAS BEEN GRANTED,;,UBC109/ IBC110/ IRC110,p
ONLINE APPLICANT ASSESSOR OTHER
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DEVELOPMENT SERVICES
PLUMBING, MECHANICAL, TANK, & DEMOLITION
PERMIT APPLICATION
121 5`h Avenue N, Edmonds, WA 98020
Phone 425.771.0220 ft Fax 425.771.0221
City of Edmonds
PLEASE REFER TO THE PLUMBING & MECHANICAL CHECKLIST FOR SUBMITTAL REQUIREMENTS
PROJECT ADDRESS (Street, Suite #, City State, Zip): 1 Parcel #:
Associated Permit #:
IS THIS WORK ASSOCIATED WITH ANOTHER PROJECT? Yes No ❑ ga.. 2 61 (0 \n j_C)
APPLICANT:Phone: Fax;
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Address (Streel„ City, Skate„ Zip) E -Mail Address:
PROPERTY OWWt. I: Phone: Fax:
Address (Street, City, State, Zip): E -Mail Address:
LENDING AGENCY: Phone: Fax:
N E -Mail Address:
Address (Street, City, State, Zip):
COP al"RACTOI. ' Phone: ax:
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At1i1r (Staeet, Cit ,State, Tt)';b: E -Mail Address:
WA State License #/Exp. Date:
*Contractor must have a valid City of Edmonds business license prior to doing work
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m the City. Contact the City Clerk's Office at 425.775.2525 City Business License ltIExp. Da
- o,.(JAC) C/
PLUMBINGTI MECHANICAL TANK DEMOLITION
DETAIL THE SCOPE OF WORKJ�".
... .._
I declare under penalty of perjury laws 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: t1 .��, ...._ Owner Agont/Other ❑ (specify): .�,, .....
Sig
nature:r........._ Date: W� "
FORM O L:\Building New Folder 2010\DONE & x-ferred to LAuilding-New drive\Form C 2014.doex Updated: 1/17/2014
FORM C LABuilding New Folder 2010\DONE & x-ferred to L-Building-New drivc\Form C 2014.docx Updated: 1/17/2014