DNS-BLD2022-1276+Sewer_Availability_Certificate_+9.23.2022_9.10.48_AM+3125614l LU,Vv
SECTION A
RECEIVED
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SEWER AVAILABILITY APPLICATION BLD2022-1276
Complete and submit this form through www.MyBuildingPermit.com.
Applicant Information
Contact/Applicant Name Val Sporleder
Phone Number 206-604-1351
Email val@lADstudio.com
Address 3270 41 st Ave SW
city Seattle
state WA
zip 98116
Property I• •
Project Name Unit C
Associated Permit Number
Address 7606 206th St. SW
City Edmonds
state WA
zip 98026
Parcel No. 00614300000605
Does the property currently have sewer service? X] Yes (City of Edmonds sewer) ❑ No
Describe project (number of buildings, number of units, number of stories per building):
One studio dwelling unit above a 2 car garage. Two stories
In what phase is the project?
❑ Design Review
❑ Preliminary Plat
0 Building Permit
❑ Rezone or Other
Associated permit application number(s), if applicable:
SECTION B
® 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: 09.08.2022
APPLICANT PRINTED NAME: Val Sporleder
Form Updated 12/9/2021