REVIEWED BLD2022-0046+WATER AVAIL+1.24.2022_10.40.43_AM+2636669RECEIVED
Jan 24 2022
BLD2022-0046
CITY OF EDMONDS
DEVELOPMENT SE ACC EbM0
DEPARTME1�,
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SECTION A
WATER AVAILABILITY APPLICATION
Complete and submit this form through www.MyBuildingPermit.com.
REVIEWED
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Applicant Information
Contact/Applicant Name Select Homes, Inc.
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Phone Number 425.742.6044
Email kayla.clark@outook.com
Address 8304 212th St. SW
City Edmonds
State WA
Zip 98026
Property Inf• •
Project Name 20323 81 st Ave W 2 lot Short Plat - lot 2 SFR
Associated Permit Number BLD2022-0046
Address
City Edmonds
State WA
Zip 98026
Parcel No.
Does the property currently have water service? R Yes (City of Edmonds water) ❑ No
Describe project (number of buildings, number of units, number of stories per building):
One 2 story single family residence
In what phase is the project?
❑ Design Review
❑ Building Permit
❑ Preliminary Plat ❑ Rezone or Other
Associated permit application number(s), if applicable: PLN2021-0007
SECTION B
Kayla Nichols, Select Homes, Inc.
❑x 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.
❑ For 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: 1.24.22
IV
APPLICANT PRINTED NAME: Kayla Nichols, Select Homes, Inc.
Form Updated 12/9/2021