ENG2023-0261_Utility_Application_5.24.2023_3.07.46_PM_3567606RECEIVED
May 25 2023
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
WATER AVAILABILITY APPLICATION
Complete and submit this form through rNww.MyBuilclingPermit.com. Submit as a
new application using the following prompts: Application Type — Utilities, Activity
Type — Utility Availability, Scope of Work — Water Main.
SECTION A
Applicant Information
Contact Applicant Name
Daren Honner
Phone Number
425-876-2265
Email
dhopper@sea-mountain.com
Address
11924 42nd DR SE
City
Everett
State WA
Zip 98208
Property•
Project Name
•
Daren & Kari Hopper New Home Build
Address
ioor, Obmnic Avenue_
City
Edmonds State WA
Zip 8020
Parcel No.
007661-000-olo-oo
Does the property currently have water service? o Yes (City of Edmonds water) Q No
Describe project (number of buildings, number of units, number of stories per building):
—Single Family dwelling, One floorAith a daylight basement
In what phase is the project?
❑ Design Review
❑ Preliminary Plat
[2 Building Permit
❑ Rezone or Other
Associated permit application number(s), if applicable: Not submitted
SECTION B
Applicability
Exemptions from Utility Availability Study: 1) Single-family residence; 2) Multi -family project of four
units or less with combo water/fire lines; 3) Short plat subdivision (four single-family lots or less). Please
check one of the following:
CK A utility availability study IS NOT requested/required. The applicant certifies that this project
is exempt from needing a study as described above and is not requesting a full utility availability
study at this time. Please sign below and submit this form through %\r%\!i,�.MvBuildingPermit.com.
❑ A utility availability study IS requested/required for the project, and associated fees will be
due. Please submit the comple plication throu wtN,�w.MvBuildin 1'ermit.com.
APPLICANT SIGNATURE: / DATE: r,/24/2023
APPLICANT PRINTED NAME: Daren 1Vt-Hbpper
Form Updated 3/28/2023