1927 78TH PL SE 2017-06-30 - Laserfiche WebLink

1N� =R ! SEINER UTILITY � PLIGATlON C1TY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVE.RETT, WA 98201 {P)425-257-8810 � FAX 425-�57-8857 ( (E)everetteps�everettwa.gov f www.everettwa.gov/permits PROJECT SITE INFCIRMATION PROJECTADDi2ESS: 1927- 78TH PL SE EVERETT WA 98204 IF APPLICABLE: ❑ OUTSIDE CITY LIMI7S Q BUILDING AREA 1816 SF ❑ LOT# 8 BUiLDING TYPE: � SFR ❑ MULTI-FAMILY ❑ GOMMERCIAL ❑ INDUSTRIAL CHANGE OF USE? �� ❑YES, FROM TO UTILITY APPLICATION INFORMATION SEWER (checic all that appiy) WATER(check all ihat apply) ❑ SIDE SEWER REPAIR �]NEW WATER SFRVICE fNSTALLATION ❑SIDE SEWER ALTERATfON C7 COMPLETE SERVICE � METER ONLY � NEW SIDE SEWER INSTALLATlON SERVICE 1 METER USE: � (NSTALL BACKWATER VALVE (outside the buiiding) �SFR ❑SIDE SEWER CAP-OFF ❑ MULT(-FAMILY-#OF UN17S: �SfDE SEWER RECONNECTION � COMMERClAL MU�TIPLE DOMESTIC WATER SERVICES REQUEST WATER SERVICE TYPE 1 SIZE:{circ(e desired size) ❑I AM DECLINWG MULTfPLE DOMESTIC WATER SERVICES FOR �DOMESTIC: 3/4", 1", 2", �THER: MY MUL.TI-FAMILY DEVELOPNlENT UNDER 51NGLE OWN�RSHIP. ❑ �RRIGATION: 314", 1", 2", OTH�R: 0 I AM OPTIMG TO fNSTALt�MULTIPLE DOMESTIC WATER ❑ FIRE: 1", 2~, 4", 6", 8", OTHER: SERVECES FOR MY MULTI-FAMILY DEV�LOPMENT UNDER �] DOMESTiC1F1RE COMBO: 1", 2", UTNER: SINGLE OWNERSHiP. FILL OUT REVERSE 51DE�F THlS FORM. CQNTACT INFORMATION OWNER NAME:ALPINE HEIGHTS LLC TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sn�EeT 120 SW EVERETT MALL WAY SUITE 100 arv EVERETT SrA7E WA 98204 zir� OWNERPH�NE: 360-953-2800 OWNEI2EMAIL: WWW.SEAPACHOMES.COM CONTRACTOR NAME: SEA PAC HOMES COi�ITRACTOR ADDRESS: sTREET 120 SW EVERETTT MALL WAY SUITE 100 crrv EVERETT S;A;G WA ziP 98204 CONTRACTOR PHONE 3 6 0-95 3-2 8 0 0 CONTRACTOR EMA1L: WWW.SEAPACHOMES.COM CONTRACTOR LICENSE#{REQUIRED}: CtTY OF EVERETT BUSINESS LICENSE#(REQufRED}_ _ PRIMARY GON7ACT: ❑OWNER �CONTRACTOR ❑OTHER(Piease Specify) CONTACT NAME: STEVE SNYDER CONTACT PHONE: 425-319-0122 CONTACT EMAtL• STEVE.S@SEAPACHOMES.COM AGREEMF_NT. The undersigned applicant agrees to compJy with a1!provisions of ihe Everetf Municrpal Code lifle City o(Evereft Q�cial Use Only 14 Waterand Sewer or such ofhar rules and regu7ations now exisling or which may be established frorrt trme to FEE trme. The applicant IurUier agrees,as a condit�on precerlerit to recerving servrce that the ufilrfres division shafl have the rrght at any fime,withot�!notice,to shv!off or tum on the water supply for repairs,construction,and nonpayme of charge or for any ofher reasonable cause.1 am the owner,or 1 am au(laorrzed by the oavner oi this pmperly t ertorm th ork for which application is made,and J comp7y ti�ith the Sta1e Coniracfors Law 18.27 PERMIi'# RCW a�d 9E. OOA . � 3-4-16 v OwnerlAuthotized Ag t Sigrtature Date (Revised 09%2,5/2015J