ENG2023-0598+Utility_Application+11.21.2023_10.01.42_PM+3914491-LFof EDA40�V
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SECTION A
WATER AVAILABILITY APPLICATION
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
Contact/Applicant Name
Phone Number
Email
Address
City
State
Zip
Property Information
Project Name
Address
City
State
Zip
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):
In what phase is the project?
❑ Design Review ❑ Building Permit
❑ Preliminary Plat ❑ Rezone or Other
Associated permit application number(s), if applicable:
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:
❑ 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: ��— DATE:
APPLICANT PRINTED
Form Updated 3/28/2023