7807 GRANT DR 2020-06-17 - Laserfiche WebLink

.� WATER / SEWER UTILITY APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 ) FAX 425-257-8857 1(E)everetteps@everettwa.gov( www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 7807 Grant Dr Everett 98203 IF APPLICABLE: I] OUTSIDE CITY LIMITS ❑ BUILDING AREA SF ❑LOT# BUILDING TYPE: ❑✓SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ❑ACCESSORY CHANGE OF USE? ❑NO LI YES, FROM TO UTILITY APPLICATION INFORMATION SEWER (check all that apply) WATER(check alt 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: ❑SIDE SEWER RECONNECTION ❑COMMERCIAL MULTIPLE DOMESTIC WATER SERVICES REQUEST WATER SERVICE TYPE/SIZE: (provide calcs to support size choice) ❑I AM DECLINING MULTIPLE DOMESTIC WATER SERVICES FOR ❑DOMESTIC: 03/4" 01" ❑2" ❑Other: MY MULTI-FAMILY DEVELOPMENT UNDER SINGLE OWNERSHIP. ❑ IRRIGATION: ❑3/4" ❑1" ❑2" ❑Other: ❑I AM OPTING TO INSTALL MULTIPLE DOMESTIC WATER ❑FIRE: 01" 02" 04" 1=16" 08" ❑Other: SERVICES FOR MY MULTI-FAMILY DEVELOPMENT UNDER ❑ DOMESTIC/FIRE COMBO: 01" 02" ❑Other: SINGLE OWNERSHIP. FILL OUT REVERSE SIDE OF THIS FORM. ❑BACKFLOW PREVENTION (Outside): ❑RPBA ❑DCDA ❑DCVA CONTACT INFORMATION OWNER NAME: Mike Mikesell TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sTREET7807 Grant Dr CITU Everett STATE WA Zip 98203 OWNER PHONE:4253471232 OWNER EMAIL: CONTRACTOR NAME:Mr. Rooter Plumbing CONTRACTOR ADDRESS: sTREET2000 South 116th St cin Seattle STATE WA zip 98168 CONTRACTOR PHONE:2066512917 CONTRACTOR EMAIL:charienel@mrrootersea.Com CONTRACTOR LIC.#(REQUtRED):MRROOP`022NE CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 038080 PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify). CONTACT NAME: CONTACT PHONE:2066512917 Charlene CONTACT EMAIL:charlenel@mrrootersea.com 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 lime. 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 turn on the water supply for repairs,construction,and nonpayment of charges or for any other reasonable cause./am the owner,or 1 am authorized by the owner of this property to 5 aim the work for which application is made,and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. /'' City of Everett Official Use Only PERMIT# 1 of kit . , 1827 019 „ l güB = Authorized A=:nt Signatu i• Dae (Revised 10/12/2018)