231 E VIEW RIDGE DR 2020-04-02 - Laserfiche WebLink

Mar 19 19,03:13 Holstad's PLUMBING INC, 3605889814 p.1 WATER r SEWER UTILITY APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 231 E. View Ridge Dr. IF APPLICABLE: ❑OUTSIDE CITY LIMITS ❑ BUILDING AREA SF 0 LOT# BUILDING TYPE: ❑SFR ❑TOWNHOUSE ['DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: []COMMERCIAL ❑ACCESSORY. CHANGE OF USE? ❑NO ❑YES, FROM TO UTILITY APPLICATION INFORMATION SEWER(check all that apply) WATER(check all that apply) ®SIDE SEWER REPAIR ❑NEW WATER SERVICE INSTALLATION ❑SIDE SEWER ALTERATION ❑COMPLETE SERVICE ❑METER ONLY ❑NEW SIDE SEWER INSTALLATION SERVICE/METER USE: ❑INSTALL BACKWATER VALVE(outside the building) ❑SFR ❑SIDE SEWER CAP-OFF ❑MULTI-FAMILY-#OF UNITS: O SIDE SEWER RECONNECTION 9 COMMERCIAL MULTIPLE DOMESTIC WATER SERVICES REQUEST WATER SERVICE TYPE!SIZE:(provide calcs to support size choice) 0 I AM DECLINING MULTIPLE DOMESTIC WATER SERVICES FOR ❑DOMESTIC: 03/4" 01" ❑2" ❑Other MY MULTI-FAMILY DEVELOPMENT UNDER SINGLE OWNERSHIP. 0 IRRIGATION: 03/4" 01" 02" [lather: ❑ I AM OPTING TO INSTALL MULTIPLE DOMESTIC WATER 0 FIRE: ❑i" 02" 04" ❑6" ❑8" ❑Other SERVICES FOR MY MULTI-FAMILY DEVELOPMENT UNDER 0 DOMESTIC/FIRE COMBO: 01" 02" ❑Other SINGLE OWNERSHIP.FILL OUT REVERSE SIDE OF THIS FORM. ❑BACKFLOW PREVENTION(Outside):❑RPBA❑DCDA QDCVA CONTACT INFORMATION OWNER NAME: TIM Willie TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: srRecia31 E. View Ridge Dr_ CIT Everett STAr� Wa. $1P 98203 OWNER PHONE:425-348-8235 OWNER EMAIL: CONTRACTOR NAME:Barbara Selfridge CONTRACTOR ADDRESS: STREET2712 Coho Lane Anacortes STATE Wa. 98221 CONTRACTOR PHONE:360-232-1428 CONTRACTOR EMAIL:holrnstadSplumbing@frontier.com CONTRACTOR LIG.#(REQUIRED):CC HOLMSPIOO5M9 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): EB026943 PRIMARY CONTACT: ®OWNER ❑CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4255-259-9131 Terry Selfridge CONTACT EMAIL: AGREEMENT:The undersigned applicant agrees to comply with all provisions ofthe Everett Municipal Code Title 14 Water and Sewer or such other rules and regulations now existing or which may be established from time to time.The applicant further agrees,as a condition precedent to receiving service that the utilities division shalt have the right at anytime.without notice,to shut off orturn on the water supply for repairs.construction.end nonoavment of charges or for any other reasonable cause. am the owner,or l am Applicant Signature / tit\ � b201 ��