FIR2023-0007_Application_2.2.2023_10.15.30_AM_3347304CITY OF EDMONDS M BuildingPermit.com
Fire Application #1263206 - Fox
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 11/3/2024 Fm49R7785 uai—kwm@yahoo.com
Project Location
Number Street Floor Number Suite or Room Number
8106 213TH ST SW
City Zip Code County Parcel Number
EDMONDS 98026 00573200001100
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
Suzanne A Fox
Number Street Apartment or Suite Number
8106 213TH ST S W
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: 2/2/2023 Submitted By: Kelly Mackay
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CITY OF EDMONDS MyBuildingPermit.com
Fire Application #1263206 - Fox
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: Fox
Description of Work: Decommission 300 gallon Residential Underground Heating Oil tank by removal.
Project Details
Storage Tank Size
Tank Size
Type of Work
Tank Removal
Contact Information
Owner Email Address
300
uai_kwm@yahoo.com
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