7505 SEAWAY BLVD 2022-05-13 - Laserfiche WebLink

WATER / SEWER UTILITY APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 i (E) everetteps@everettwa.gov i www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: Southwest corner of intersection of 75th St W & Seaway Blvd IF APPLICABLE: ❑ OUTSIDE CITY LIMITS 0 BUILDING AREA 560 SF ❑ LOT # BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DULEX 0MULTI-FAMILY4 OF UNITS: ❑COMMERCIAL ❑INDUSTRIAL CHANGE OF USE? ❑ NO V1 YES, FROM Undeveloped TO Transit Center UTILITY APPLICATION INFORMATION SEWER (check all that apply) WATER (check all that apply) ❑ SIDE SEWER REPAIR IX NEW WATER SERVICE INSTALLATION ❑ SIDE SEWER ALTERATION 14 COMPLETE SERVICE ❑ METER ONLY 0 NEW SIDE SEWER INSTALLATION SERVICE / METER USE: ❑ INSTALL BACKWATER VALVE outside the building) ❑ SFR ❑ SIDE SEWER CAP -OFF ❑ MULTI -FAMILY - # OF UNITS: ❑ SIDE SEWER RECONNECTION ❑ COMMERCIAL WATER SERVICE TYPE / SIZE: (circle desired size) DOMESTIC: 3/4", 1", ✓ 2", OTHER: MULTIPLE DOMESTIC WATER SERVICES REQUEST 111 AM DECLINING MULTIPLE DOMESTIC WATER SERVICES FOR MY MULTI -FAMILY DEVELOPMENT UNDER SINGLE OWNERSHIP, IRRIGATION: 3/4", 1", q/ 2", OTHER: ❑ 1 AM OPTING TO INSTALL MULTIPLE DOMESTIC WATER ❑ FIRE: V, 2", 4", 6", 811, OTHER: SERVICES FOR MY MULTI -FAMILY DEVELOPMENT UNDER ❑ DOMESTIC/FIRE COMBO: 1", 2", OTHER: SINGLE OWNERSHIP. FILL OUT REVERSE SIDE OF THIS FORM. CONTACT INFORMATION OWNER NAME: Kelly McGill, Real Estate Manager, Snohomish PUD TENANT NAME If Commercial): OWNER MAILING ADDRESS: STREET PO BOX 1107 CITY Everett STATE WA vP 98206 OWNER PHONE: 425-783-4373 OWNER EMAIL: CONTRACTOR NAME: TBD CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC. EREQUIRED}; CITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR 17 OTHER (Please Specify) ApploCant CONTACT NAME: Dan Jerome, Community Transit CONTACT PHONE: 425-438-7100 ICONTACT EMAIL: dan.jerome@commtrans.org AGREEMENT., The undersigned applicant agrees to comply with all provisions of the 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 shall have the right at any time, without notice, to shut off or tum on the water supply for repairs, construction, and nonpayment of charges or for any other reasonable cause./ am the owner, or I am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Up5- (Revised 923/2016)