ENG2023-0261+Utility_Application+5.24.2023_3.07.46_PM+3567606-LFRECEIVED
of EVA'10
ANC. 1890
SECTION A
May 25 2023
CITY OF EDMONDS
DEVELOPMENT SERVICES
DEPARTMENT
WATER AVAILABILITY APPLICATION
Complete and submit this form through rNiww.MYBuil(lingPermit.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
Daren Honner
Phone Number
425-876-2265
Email
dhopper@sea-mountain.com
Address
11924 42nd DR SE
city
Everett State WA Zip 98208
Property •
Project Name
•
Daren & Kari Hopper New Home Build
Address
loor, OINTrnnic Avenue
City
Edmonds State WA Zip 8020
Parcel No.
007661-000-oio-oo
Does the property currently have water service? o Yes (City of Edmonds water) Q No
Describe project (number of buildings, number of units, number of stories per building):
_Single Family dwelling. One floor with a daylight basement
In what phase is the project?
❑ Design Review 12 Building Permit
❑ Preliminary Plat ❑ Rezone or Other
Associated permit application number(s), if applicable: Not submitted
SECTION B
Applicability
Exemptions from Utility Availability Study: 1) Single-family residence; 2) Multi -family project of four
units or less with combo water/fire lines; 3) Short plat subdivision (four single-family lots or less). Please
check one of the following:
C[ 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 wN%-x.w.MvBtiildingPermit.cotn.
❑ A utility availability study IS requested/required for the project, and associated fees will be
due. Please submit the comple plication throu X.? wtw.M !Buildin Permit.com.
APPLICANT SIGNATURE: / DATE: �/24/202�
APPLICANT PRINTED NAME: Daren 1Vt-Hopper
Form Updated 3/28/2023