FIR2021-0019_Application_2.25.2021_7.56.36_AM_2063407CITY OF EDMONDS M BuildingPermit.com
Fire Application #927106 - Seresun Site
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 2067627500
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 11/3/2022 Fm49R7785 uai—kwm@yahoo.com
Project Location
Number Street Floor Number Suite or Room Number
6502 170TH PL SW
City Zip Code County Parcel Number
EDMONDS 98026 00583500001900
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
Aaron P & Stacy E Seresun
Number Street Apartment or Suite Number
6502 170TH PL SW
City State Zip
EDMONDS WA 98026
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: 2/25/2021 Submitted By: Kelly Mackay
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CITY OF EDMONDS MyBuildingPermit.com
Fire Application #927106 - Seresun Site
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 #: 2067627500
Burien WA 98166
Project Type Activity Type Scope of Work
Single Family Residential Decommission Underground Storage Tank Removal
Project Name: Seresun Site
Description of Work: Decommission 300 Gallon Underground Residential Heating Oil Tank by
Removal.
Project Details
Type of Work
Tank Removal
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