1925 78TH PL SE 2017-06-29 - Laserfiche WebLink

W� ER / SEWER U1'ILITY , 'PLIGATiON C1TY OF EVFRETT PERMfT S�RVICES 3200 CEDAR STREET, EVERETT, WA 98201 {P)425-2�7-8810 � FAX 425-257-8857 � (E) everetteps�everettwa.gov � www.everettwa.govlpermits PROJECT SITE INF�ItMAT10N PROJECTADI]12ESS: 1925- 78TH PL SE EVERETT WA 98204 IF APPLICABLE: ❑ OUTSIDE CITY LIMITS ❑ BUI�DING AREA 1816 SF ❑ LpT# 9 BUtLDING TYPE: �SFR ❑ MULTI-FAMILY ❑ GOMMERCIAL ❑ INDUSTRIAL CliANCyE OF USE? �NO ❑YES, FROM TO UTlLlTY APPLICATION INFORMATION SEWER (checic all that apply) WATER(check all ihat apply) ❑SIDE SEWER REPAIR �NEW WATER SERVICE INSTALLATION ❑SIDE SEWER ALTERATION ❑ CC�MPLETE SERVIGE � METER OtVLY � fvEW SIDE SEWER INSTALLATION SERVICE/METER USE: � INSTALL BACKWATER VALVE (outside the building) �SFR ❑SIDE SEWER CAP-OFF ❑ MULTI-FAMILY-#OF UNl7S: �S(DE SEWER RECONNECTION ❑ COMMERClAL MULTiPLE DOMESTIC WATER SERVICES REQUEST WATER SEFtVICE TYPE 1 SIZE:{circle desired size) ❑I AM BECLINING MULTIPLE DOA,iESTIC WATER SERVICES FOR ❑DOMESTIC: 314", 1", 2", O7HFR: MY MULTI-FAMILY DEVELOPMENT UNDER SINGLE OWNERSHIP. [] IRR(GATION: 3l4", 1", 2", OTHER: ❑ I AM OPTING TO INSTALL MULTfPLE bOtv1ESTIC WA7ER ❑ FIRE: 1", 2", 4", 6", 8", OTHER: SERVIC�S FOR N1Y MULTI-FAM!!.Y DEVELOPMENT UNDER �]pOIWESTEC/FIRE COMBO: 1", 2", OTHER: SINGLE OWNERSHlP. FJLL OUT RPVERSE S1D,E OF THIS FORM. CONTACT tNFORM/�T10N OWNER NAME:ALPINE HEIGHTS LLC TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sr�zEeT 120 SW EVERETT MALL WAY SUITE 100 cirv EVERETT S�A�E WA ZiP 98204 OWNER PHONE: 3 6 0-9 S 3-2 8 0 0 OWNEF2 EMA1L: WWW.SEAPACHOMES.COM CONTRACTOR NAME: SEA PAC HOMES CONTt2ACTORADDRESS: sTaEET 120 SW EVERETTT MALL WAY SU:ITE 100 cmr EVERETT s�arE WA z�P 98204 CONTRACTORPHONE 360-953-2800 GONTRAC70FtEMA1L: VdWW.SEAPACHOMES.COM CONTRACTOR LICENSE#{REqUIRED): CITY OF EVERETT BUSINESS LICENS�#{REQUIRED}: _ _ _. _ _ . PRtMARY GON7ACT: ❑ OWNER �CONTRA�TOR ❑OTHER(Please Specify)_ ___ CONTAC7 NAME: STEVE SNYDER CONTAGT PFlONE:425-319-0122 CONTACT EMAtL: STEVE.S@SEAPACHOMES.COM AGREEMENT. The undersigned applicant ay�ess to comply with a!!provisions of the F_verett Municipai Code l itle Cify of Everett O�cia!Use Only 14 Water and Sewer or such othar rules and regulations now exis(ing or which may 6e established from trme to FEE time. The applicant furiher agrees,as a condition precedent to receiving service.that the ulilities division shall hava the right af any fime,without noflr.e,ln shut off or iurn on the water supply for repairs,construction,anct nonpayme of charge or for any other reasonable cause.!am fhe owner,or!am authorized by the owner of this property to erform th ork for which appd'cation rs made,and f conrpty with the State Contractors Law i8.27 PERMIl'# RCINa � 9&. OOA 3-4-16 � OwnerlAuthori2ed Ag t Signature Date (/7evised 09%25/2015) j ` :`, ,�/'?� ..