ENG2022-0538_Water Availability_11.3.2022_9.24.20_AM_3201019EC,tUI
16
WATER AVAILABILITY APPLICATION
Complete and submit this form through www.MyBuildingPermit.com.
SECTION A
Applicant Information
Contact/Applicant Name Select Homes, Inc.
Phone Number (425) 742-6044
Email kayla.clark@outlook.com
Address 8304 212th St SW
City Edmonds
State WA
Zip 98026
'
• perty Information
Project Name 19512 88th Ave W. Lot 3 SFR
Associated Permit Number BLD2022-1092
Address 19512 88th Ave W.
City Edmonds
State WA
Zip 98026
Parcel No. 27041800303400
Does the property currently have water service? X Yes (City of Edmonds water) ❑ No
Describe project (number of buildings, number of units, number of stories per building):
One two story single family residence
In what phase is the project?
❑ Design Review ® Building Permit
❑ Preliminary Plat ❑ Rezone or Other
Associated permit application number(s), if applicable:
SECTION B
E7 Applicant certifies that this project is a single-family residence, multi -family project of four units or
less with combo water/fire lines, 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: 8/18/22
APPLICANT PRINTED NAME: Kayla Nichols, Select Homes, Inc.
Form Updated 12/9/2021