ENG2023-0500_Utility_Application_10.3.2023_1.34.52_PM_3818704RECEIVED
SEWER AVAILABILITY APPLICATION
Oct 03 2023
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
Complete and submit this form through www.MyBuildingPermit.com.
SECTION A
Applicant
Contact/Applicant Name 5-MM i nompsorT-7W2Y)—Al7ffitecture + Design
Phone Number 206-542-3734
Email sarah@h2darchitects.com
Address Edmonds Way,
city Edmonds state WA
zip 98020
Property
Project Name COCHRAN RESIDENCE
Associated Permit Number
Address 8475 Frederick Place
City EDMONDS
state WA
zip 98026
Parcel No. 00594400006402
Does the property currently have sewer service? ❑ Yes (City of Edmonds sewer) IXNo
Describe project (number of buildin s number of units, number of stories per building):
1 NEVVTWO-STORY S.F.R. BASEMENT
In what phase is the project?
❑ Design Review
❑ Preliminary Plat
IN Building Permit
❑ Rezone or Other
Associated permit application number(s), if applicable:
SECTION B
N 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.
Sarah Thompson sa o ^� �� .- °a 1' , 06-02-2023
APPLICANT SIGNATURE: DATE:
APPLICANT PRINTED NAME: Sarah Thompson
Form Updated 12/9/2021