ENG2023-0359_Utility_Application_7.11.2023_11.41.00_PM_3660021RECEIVED
Jul 14 2023
of EDA40NO�
SECTION A
WATER 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 — Water Main.
Applicant
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 Peter Tang
Address 840 Daley ST
City Edmonds
State WA
Zip 98020
Parcel No. 00434208101000
Does the property currently have water service? ><Yes (City of Edmonds water) ❑ 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
Exemptions from Utility Availabilit
units or less with combo water/fire
check one of the following:
residence; 2) Multi -family project of four
7ision (four single-family lots or less). Please
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: i`/& —IaofDATE: July 12, 2023
APPLICANT PRINTED NAME: Peter Tang
Form Updated 3/28/2023