2926 93RD PL SE 2022-05-23 - Laserfiche WebLink

WATER / SEWER UTILITY APPLICATION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2926 93rd Place SE Everett 98208 IF APPLICABLE: Z OUTSIDE CITY LIMITS ❑ BUILDING AREA SF ❑ LOT # 9 BUILDING TYPE: ❑✓SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI -FAMILY-# OF UNITS: ❑COMMERCIAL ❑ACCESSORY CHANGE OF USE? ❑'' NO ❑ YES, FROM TO llT' ITY 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: ❑ SIDE SEWER RECONNECTION ❑ COMMERCIAL WATER SERVICE TYPE / SIZE: (provide calcs to support size choice) ❑ DOMESTIC: ❑✓3/4" 01" ❑2" ❑Other: MULTIPLE DOMESTIC WATER SERVICES REQUEST ❑✓ I AM DECLINING MULTIPLE DOMESTIC WATER SERVICES FOR MY MULTI -FAMILY DEVELOPMENT UNDER SINGLE OWNERSHIP. ❑ IRRIGATION: ❑3/4" ❑1" ❑2" ❑Other : ❑ I AM OPTING TO INSTALL MULTIPLE DOMESTIC WATER ❑ FIRE: ❑1" ❑2" ❑4" ❑6" ❑8" ❑Other : SERVICES FOR MY MULTI -FAMILY DEVELOPMENT UNDER ❑ DOMESTIC/FIRE COMBO: ❑1" ❑2" ❑Other : SINGLE OWNERSHIP. FILL OUT REVERSE SIDE OF THIS FORM. ❑ BACKFLOW PREVENTION (Outside): ❑RPBA ❑DCDA ❑DCVA CONTACT INFOR„„MATION ... OWNER NAME: Harbour Homes LLC TENANT BUSINESS NAME (If Commercial): OWNER MAILING ADDRESS: ST1EET400 North 34th Street CITY Seattle STATE WA ZIP 98103 OWNER PHONE: (206) 31 5-8130 OWNER EMAIL: AWirtz@harbourhomeS.com CONTRACTOR NAME: Team Northwest Excavating CONTRACTOR ADDRESS: STREET 13930 State Route 9 NE c,n Arlington STATE WA ziP 98223-4973 CONTRACTOR PHONE: (425) 754-6500 1CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): 6032664210010001 JCITY OF EVERETT BUSINESS LIC. #(REQUIRED): 61239 PRIMARY CONTACT: O OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: } Austin Wirtz CONTACT PHONE: (425) 361-5797 CONTACT EMAIL: AWrrtz@harbourhomeS.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 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 turn on the water supply for repairs, construction, and nonpayment of charges or for any other reasonable cause. I am the owner, or I am authorized by the owner of this property to perform 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 # AustinWirtz Oa'eo09018.9Y44925AemaO=awt�dhafturhomes— 8/19/19 U0'0 Owner/Authorized Agent Signature Date (Revised 1011212018)