1921 78TH PL SE 2017-06-29 - Laserfiche WebLink

W �ER I SEWER UT[LITY 'PLIGATiON CITY OF EVERET7 PERMIT S�RV(CES 3200 CEUAR STREET, EVERETT, WA 982d1 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps�a everettwa.gov � www.everettwa.gov/permits PROJECT SITE INF[1RMATION PROJECTApDRESS: 1921- 78TH PL SE EVERETT WA 98204 IF APPLICABLE: ❑ OU7SIDE CITY LIMITS ❑ BUILDING AREA 1816 SF ❑ LOT�# 11 BUILDING TYPE: � SFR ❑ MULTI-FAMIL_Y ❑ COMMERCIAL ❑ INDUSTRIAL CHANGE OF USE? �NO ❑YES, FROM TO UTIL[TY APPLICATION INFORMATION SEWER (check all that apply} WATER(check all ihat apply) ❑SIDE SEWER REPAIR �NEW WATER SERVICE(NSTALLATION ❑SlDE SEWER ALTERATIaN ❑ GOMPLETE SEF2VICE � METER ONLY � NEW SIDE SEWER INSTALLP,1'ION SERVICE/METER USE: ❑INSTALL BACKWATER VALVE(outside the building) �SFR ❑SIDE SEWER CAP-OFF ❑ MULTI-FAMILY-#OF UNI7S: � S(DE SEWER RECONNECTION ❑ COMMERClAL MULTlRLE DOMESTIC WATER SERVICES REQUEST WATER SERVECE TYPE/SIZE: (circle desired size) 0 I AM C3ECLINING MULTIPLE DOMESTIC WATER SERVICES FOR ❑ DOMESTIC: 3l4", 1", 2", O7HER: MY MUI.TI-FAMILY DEVELOPMENT UNDER SINGLE OWNERSHIP. ❑ IRR[GATION: 3/4", 1", 2", OTHER: ❑ I AM OPTING TO INSTALL MULTiPLE bOMESTIC WA7ER ❑ FIRE: t", 2", 4", � 8", OTHER: SERVICES FOR MY MULTI-FAMil.Y DEVELOPMENT UNDER j$3 ppMESTiCIFIf2E COMBO: / 1", / 2", UTHER: SINCLE OWNERSHlP. F1LL OUT RF'VERSE S1b,E OF TH1S FORM. L� CONTACT INFORMATION OWNER NAME:ALPINE HEIGHTS LLC TENANT NAME(If Commercial): OWNER MA(LING ADDRESS: s�EET 120 SW EVERETT MALL WAY SUITE 100 crrv EVERETT SrATE WA 98204 LIP OWNER PHONE: 3 6 0-9 5 3-2 8 0 0 OWNER EMA1L: WWW.SEAPACHOMES.COM CONTRACT�R NAME: SEA PAC HOMES CONTRACTOR ADDRESS: sr�teET 12 0 SW EVERETTT MALL WAY SUITE 10 0 crrv EVERETT S7A,-G WA ziP gg204 CONTRACTOR PHONE 3 6 0-9 5 3-2 8 0 0 C�NTRAC70R EMAlL: WWW.SEAPACHOMES.COM CQNTRACTOR LICENSE#(REQUIREDj: CtTY OF EVERETT BUSINESS LICENSE#(REqUIRED): _ _ . _ _ _ . _:. PRIMARY CON'fACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify�__� __ _ _� CONTACT NAME: STEVE SNYDER CONTAC7 PHONE:4 2 5-319-0122 CONTACT EMAiL: STEVE.S@SEAPACHOMES.COM AGRFFMENT�The undersigned applicant agfess to comply wrth al!provisions of the Everett Municrpal Code 7dle Crty of Evereft O�cial Use Only 14 Waterand Sewer or such othar rules and regulafions now existing or which may be established f�om trme fo FEE time. The applir.ant lurtheragrees,as a condif�on precedent fo receiving service fhat the u!ilities division shall have the riqht at any time,without nofice,tr,shut off cr tum on the,water supAlS'for repairs,constn�r,tion,and nor,payme of charge or for any other reasonabfe ca��se.f am the owner,or 1 am authorrzed by the owner oi this property to erform th ork for which application is made,and 1 comp7y with the State Contractors Law 18.27 PERMIT# RCINa d 96. OOA 3-4-16 `�-� OwnerlAuthorized Ag t Signature Date (l7evised 09.%2bl20i5)