REVIEWED BLD2021-1719+SEWER AVAIL+1.3.2022_11.38.12_AM+2599655Form Updated 12/9/2021
SEWER AVAILABILITY APPLICATION
Complete and submit this form through www.MyBuildingPermit.com.
SECTION A
Applicant Information
Contact/Applicant Name
Phone Number
Email
Address
City State Zip
Property Information
Project Name
Associated Permit Number
Address
City State Zip
Parcel No.
Does the property currently have sewer service? □ Yes (City of Edmonds sewer) □ No
Describe project (number of buildings, number of units, number of stories per building):
________________________________________________________________________
________________________________________________________________________
In what phase is the project?
□ Design Review □ Building Permit
□ Preliminary Plat □ Rezone or Other
Associated permit application number(s), if applicable: _______________________________
SECTION B
Applicability
□ Applicant certifies that this project is a single-family residence, multi-family project of four units or
less, 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:___________
APPLICANT PRINTED NAME:_________________________________________
Proposed Development
Select Homes, Inc.
425.742.6044
kayla.clark@outook.com
8304 212th St. SW
Edmonds WA 98026
7918 203rd 2 lot short plat - lot 2 SFR
BLD2021-1719
7918 203rd St. SW.
Edmonds WA 98026
27041900112700
X
One 2 story single family residence
X
1.3.22
Kayla Nichols, Select Homes, Inc.
79
2
2
2
0
3
R
D
S
T
S
W
7922 2033RD ST SW LOT 2
LOT 2
REVIEWED
BY
CITY OF EDMONDS