ENG2024-0070+Other+2.17.2024_11.15.01_AM+4066618WATER 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.
SECTION A
Applicant
Contact/Applicant Name Richard A. Okimoto, Architect
Phone Number (425)697-0983
Email raoa rc Ou Oo . co
Address 9924 225th Place SW
city Edmonds
state WA
Zip
Property Inforniation
Project Name
Subcleff Custom Residence
Address
8908 189th Place SW
City
Edmonds
state WA
zip 98026
Parcel No.
00728600000300
Does the property currently have water service? IXYes (City of Edmonds water) ❑ No
Describe project (number of buildings, number of units, number of stories per building):
New single-family residence and attached garage; 3-story
In what phase is the project?
❑ Design Review
❑ Preliminary Plat
U Building Permit
❑ 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:
11 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 ap lication through www.MyBuildingPermit.com.
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APPLICANT SIGNATURE. DATE: 'Z
APPLICANT PRINTED NAME: Richard A. Okimoto, Architect
Form Updated 3/28/2023