ENG2023-0358_Utility_Application_7.11.2023_11.18.46_PM_3660005RECEIVED
Jul 14 2023
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SECTION A
SEWER AVAILABILITY APPLICATION
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
Complete and submit this form through www.MyBuildingPermit.com. Submit as a
new application using the following prompts: Application Type — Utilities, Activity
Type — Utility Availability, Scope of Work — Sanitary Sewer Main.
Applicant Information
Contact/Applicant Name Peter Tang
Phone Number 206-372-2584
Email pntgroupllc@gmail.com
Address 648 Bell ST
City Edmonds
State WA
Zip 98020
Property • •
Project Name Tang Single Family Residence
Address 840 Daley ST
City Edmonds
State WA
Zip 98020
Parcel No. 00434208101000
Does the property currently have sewer service? Xes (City of Edmonds sewer) ❑ No
Describe project (number of buildings, number of units, number of stories per building):
New 2 story single family home with ADU
In what phase is the project?
❑ Design Review
❑ Preliminary Plat
X Building Permit
❑ Rezone or Other
Associated permit application number(s), if applicable: BLD2023-0433
SECTION B
Applicability
Exemptions from Utility Availability Study: 1) Single-family residence; 2) Multi -family project of four
units or less; 3) Short plat subdivision (four single-family lots or less). Please check one of the following:
X 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 www.MyBuildingPermit.com.
❑ A utility availability study IS requested/required for the project, and associated fees will be
due. Please submit the complete application through www.MyBuildingPermit.com.
APPLICANT SIGNATURE: /Oa&4' ?Gaut' DATE: July 12, 2023
APPLICANT PRINTED NAME: Peter Tang
Form Updated 3/28/2023