408 E MAGNOLIA AVE 2017-10-24 - Laserfiche WebLink

.......... WATER / SEWER UTILITY APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www,everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 408 Magnolia Ave IF APPLICABLE: 0 OUTSIDE CITY LIMITS El BUILDING AREA SF 13 LOT# BUILDING TYPE: IZISFR-DETACHED EISFR-ATTACHED 13DULEX OMULTI-FAMILY-#OF UNITS: OCOMMERCIAL DINDUSTRIAL CHANGE OF USE? 0 NO 0 YES, FROM TO UTILITY APPLICATION INFORMATION SEWER(check all that apply) WATER (check all that apply) *SIDE SEWER REPAIR 0 NEW WATER SERVICE INSTALLATION *SIDE SEWER ALTERATION 0 COMPLETE SERVICE 11 METER ONLY C1 NEW SIDE SEWER INSTALLATION SERVICE/METER USE: 0 INSTALL BACKWATER VALVE(outside the building) 0 SFR 171 SIDE SEWER CAP-OFF E3 MULTI-FAMILY-#OF UNITS: E3 SIDE SEWER RECONNECTION EJ COMMERCIAL MULTIPLE DOMESTIC WATER SERVICES REQUEST WATER SERVICE TYPE/SIZE:(circle desired size) 0 IAM DECLINING MULTIPLE DOMESTIC WATER SERVICES FOR 0 DOMESTIC: 3/4", 1 2", OTHER: MY MULTI-FAMILY DEVELOPMENT UNDER SINGLE OWNERSHIP. El IRRIGATION: 3/4", 1", 2", OTHER: 13 1 AM OPTING TO INSTALL MULTIPLE DOMESTIC WATER CI FIRE: V., 2", 4", 6", 8", OTHER: SERVICES FOR MY MULTI-FAMILY DEVELOPMENT UNDER 0 DOMESTIC/FIRE COMBO: 1 2", OTHER: SINGLE OWNERSHIP, FILL OUT REVERSE SIDE OF THIS FORM. .. I CONTACT INFORMATION OWNER NAME: Sherry Cushman TENANT NAME If Commercial): OWNER MAILING ADDRESS: IT,,,T 408 Magnolia Ave 01TY Everett STATE WA z,P 98203 OWNER PHONE:425-355-3692 OWNER EMAIL, grandmameowl @Hotmaii.com CONTRACTOR NAME: Sposari inc, dba Mr. Rooter Plumbing & Heating CONTRACTOR ADDRESS: IT11IT2000 South 116th St ,,y Seattle STATE WA CONTRACTOR PHONE:206-651-2917 1CONTRACTOR EMAIL: charienel@mrrootersea.com CONTRACTOR LIC.#(REQUIRED).M RROOP*022NE ICITY OF EVERETT BUSINESS LIC.#(REQQIRED):038080 PRIMARY CONTACT: f7l OWNER J;3 CONTRACTOR 0 OTHER(Please Specify) 7� CONTACT NAME: CONTACT PHONE;206-651-2917 L Charlene Lundgren 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 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. /am the owner,or I am authorized by the owner of this property to pert 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# 1-7 U Z I bw4arlAuthorizedAgent ]gnatur Date (Revised 912312016)