ENG2024-0081_Utility_Application_2.22.2024_10.05.47_AM_4075463RECEIVED
of EDA40NO�
SECTION A
WATER AVAILABILITY APPLICATION
Feb 22 2024
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 Information
Contact/Applicant Name Joseph Rowett for Landsverk Quality Homes, Inc
Phone Number 425-760-9218
Email joseph@lqh-inc.com
Address 24113 56th Ave W
city Mountlake Terrace
state WA
zip 98043
Property• •
Project Name Talbot Lot A
Address 7925 Cyrus LN
City Edmonds
State WA
zip 98026
Parcel No.
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):
2 story sinale familv residence on a vacant lot
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
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
® 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: Joseph Rowett DATE: 2/22/2024
APPLICANT PRINTED NAME: Joseph Rowett
Form Updated 3/28/2023