ENP2022-0018 Water Availability CertificateEC,tUI
16
WATER AVAILABILITY APPLICATION
Complete and submit this form through www.MyBuildingPermit.com.
SECTION A
Applicant Information
Contact/Applicant Name John Trang
Phone Number 206. 227. 1031
Email Johntrang20l2@yahoo.com
Address 14534 27th Ave NE
city shoreline
State wa
zip 98155
Property Information
Project Name Trang Residence
Associated Permit Number BLD 2021-0235
Address 23129 74th AVE W
city Edmonds
State wa
zip 98026
Parcel No. 00488800200410
Does the property currently have water service? 3<es (City of Edmonds water) ❑ No
Describe project (number of buildings, number of units, number of stories per building):
New construction - 2 stories and 3500 sq ft. New fire hydrant built
In what phase is the project?
❑ Design Review ❑ Building Permit
❑ Preliminary Plat ❑ Rezone or Other
Construction phase, currently framing
Associated permit application number(s), if applicable: Permit - BDG 2021-0235
SECTION B
rV
Applicant certifies that this project is a single-family residence, multi -family project of four units or
less with combo water/fire lines, or short plat subdivision (four single-family lots or less), in which case
completion of a full utility availability study shall not be required. Please sign below and submit this form
through www.MyBuildingPermit.com.
>4—Or all other permit types, a utility availability study is required and associated fees will be due. Please
submit the complete application through www.MyBuildingPermit.com.
APPLICANT SIGNATURE:-,� ��' � DATE: ` aD aa.
APPLICANT PRINTED NAME: John Trang
Form Updated 12/9/2021
Information to Be Completed by Water Agency
1. V, a. Water will be provided by serviceonly to an existing
(size) water main that is 100 (feet) from thesite.
OR
6" Ductile Iron
❑ b. Water servicewill requirean improvement to thewater system of:
❑ (1). _______________ feet of water main to reach the site; and/or
❑ (2). The construction of a d i st r i but i on system on the site; and/or
❑ (3). Other (describe)__________________________________
2. V a. The water system is in conformance with aCity approved water comprehensive plan.
OR
❑ b. Thewater system improvement will require a water comprehensive plan amendment.
(Thiswill causea delay in permit issuanceand approval.)
3. 91 a. The proposed project is within the corporate limits of the City, or has been granted
Boundary Review board approval for extension of service outside the City, or is within the City approved
service area of a private water purveyor.
OR
❑ b. Annexation or Boundary Review Board approval will be necessary to provide service.
4. Va. Water ist or will beavailabfe at the rate of flow and duration indicated below at no less than
20 psi -Measured at the nearest fire hydrant 100 __feet from the building/ property (or as marked on
attached map)
Rate of Flow
❑ Lessthan 500 gpm. (approximately _........... gpm)
❑ 500 to 999 gpm
❑ 1500 gpm or more
❑ Less than one (1) hour
❑ One (1) to two (2) hours
❑ Two (2) hours or more
Duration
❑ Flow test of m ❑ Other
❑ Calculation of 1743 m (Commercial building permits requireflow test or
-----------gp calculation)
OR
❑ b. Water system is not capable of providing fire flow.
WaterAgency Certification
Conditions:
Per model, static pressure is 119 psi
At 1000 gpm, residual pressure is 103 psi
At max flow of 1743 gpm, residual pressure is 75 psi
I hereby certify that theabove information istrue. This certification shall bevalid for oneyear from thedateof signature.
City of Edmonds - Engineering
Russell Lynch
(Agency Name
(Signatory Printed Name
(Signature/ Date)
Associate Engineer
Title
Form Updated 12/9/2021