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ENG2023-0134+Utility_Application+3.9.2023_12.13.36_AM+3410433-LF
RECEIVED MAR 09 2023 of EDAfo+O WATER AVAILABILITY APPLICATION CITY OF EDMONDS DEVELOPMENT Complete and submit this form through www.MyBuildingPermit.COVICES DEPARTMENT "NC, i3ao SECTION A Applicant Contact/Applicant Name Motionspace Architecture + Design (contact: Jack Bader) Phone Number 206-495-5847 Email jack@motion-space.com Address 3104 Western Ave #107 city Seattle state WA zip 98121 Property Information Koh Residence Associated Permit Number PRE2022-0010(building permit no TBD Address 15604 75th PI W city Edmonds state WA zip 98026 Parcel No.00513100002410 Does the property currently have water service? ❑ Yes (City of Edmonds water) X No Describe project (number of buildings, number of units, number of stories per building): New 3000 SF. one story sinale family residence with attached aaraae In what phase is the project? we're working toward building permit ❑ Design Review ❑X Building Permit intake, no design review req'd (we did pre -application meeting) ElPreliminary Plat ❑ 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 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: :9�_ APPLICANT PRINTED NAME: Jack bauc. DATE:8 March 2023 Form Updated 12/9/2021