UNDER SEPARATE APPLICATION BLD2022-1541+Water_Availability_Certificate+11.9.2022_12.23.22_PM+3211662WATER AVAILABILITY APPLICATION
Complete and submit this form through www.MyBuildingPermit.com.
SECTION A
InformationApplicant
Contact/Applicant NameLauren Golembiewski- Glacier Environmental Services, Inc.
Phone Number 425-355-2826
Email LMiles@glacierenviro.com
Address PO Box 1097
City Mukilteo
State WA
Zip 98275
Property Information
Project Name Glacier Environmental Services- New Construction
Associated Permit Number PLN2022-0028
Address 7509 212th St SW
City Edmonds
State WA
Zip 98o87
Parcel No. 005669004Oo600
Does the property currently have water service? V Yes (City of Edmonds water) ❑ No
Describe project (number of buildings, number of units, number of stories per building):
Proposed project will demo exiting structures and replace with a 2 buildings: a 2 story office space approx 4600SF and a 3200SF
are ouse.
In what phase is the project? RECEIVED
0 Design Review ❑ Building Permit APR 12 2022
❑ Preliminary Plat ❑ Rezone or Other
CITY OF EDMONDS
Associated permit application number(s), if applicable: PLN2022-0028 DEVELOPMENT
SERVICES DEPARTMENT
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.
0 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: Z_dZM,e� a6AM,4 DATE: 4/12i2022
APPLICANT PRINTED NAME: Lauren Golembiewski
Form Updated 12/9/2021
SECTION C
1. ❑ a. Water will be provided by service only to an existing
(size) water main that is 20 (feet) from the site.
OR
8" Cast Iron
❑ b. Water service will require an improvement to the water system of:
❑ (i). feet of water main to reach the site; and/or
❑ (2). The construction of a distribution system on the site; and/or
❑ (3). Other (describe)
2. ❑ a. The water system is in conformance with a City approved water comprehensive plan.
OR
❑ b. The water system improvement will require a water comprehensive plan amendment.
(This will cause a delay in permit issuance and approval.)
3. ❑ a. The proposed project is within the corporate limits of the City, or has been granted
Boundary Review board approval for extension of service outside the City, or is within the City approved
service area of a private water purveyor.
OR
❑ b. Annexation or Boundary Review Board approval will be necessary to provide service.
4. ❑ a. Water is/or will be available at the rate of flow and duration indicated below at no less than
20 psi - Measured at the nearest fire hydrant 65 feet from the building/property (or as marked on
attached map)
Rate of Flow
❑ Less than 500 gpm. (approximately gpm)
❑ 500 to 999 9Pm
❑ 1500 gpm or more
❑ Less than one (1) hour
❑ One (1) to two (2) hours
❑ Two (2) hours or more
Duration
❑ Flow test of gpm ❑ Other
❑ Calculation of 2666 gpm (Commercial building permits require flow test or
calculation)
OR
❑ b. Water system is not capable of providing fire flow.
Water Agency Certification
Comments/Conditions:
Per model, static pressure is 71.53 psi
At 1000 gpm, residual pressure is 68.99 psi
At max flow of 2666 gpm, residual pressure 53.10 psi
I hereby certify that the above information is true. This certification shall be valid for one year from the date of signature.
City of Edmonds - Engineering
Russell Lynch
(Agency Name)
(Signatory Printed Name)
(Signature/Date)
Associate Engineer
(Title)
lez� " 4/21/2022
Form Updated 12/9/2021