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PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 8/5/2016 <br /> Permit#: PW1608-013 <br /> PROJECT ADDRESS: 4518 SEAHURST <br /> DESCRIPTION OF WORK: SITE WORK FOR NEW SFR <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: NARANJO JEFFREY A/SAWYER TON NAME: OWNER <br /> ADDRESS: 201 2ND ST S APT 109 ADDRESS: <br /> KIRKLAND,WA, 98033 <br /> PHONE: 8137325070 PHONE: <br /> EMAIL: EMAIL: <br /> CONTACT: 0 Owner 0 Applicant ❑Other <br /> NAME: [ContactName] <br /> PHONE: [ContactPhone] <br /> EMAIL: [ContactEmail] <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required? 0 YES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> 0 YES—Type (If yes, add to TRJJAKiiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> EExxppllaanation: F 1 t�& cote '(AI IYI 35O r 9�" rl.ythliit ) Lu LA t)fsrr. <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: j FIRE SERVICE: <br /> IR/YES—Amount$ Q)S 1 LI •I®s ❑YES—Amount$ <br /> 0 Meter Only, Complete Service, Size 3 '/II ❑ 3A" Detect Meter Only, 0 Fire Service Size <br /> 0 N NO <br /> Explanation: Explanation: <br /> OA Water Department Cost Estimate Needed-(/f yes, PW Reviewer to send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? 611 <br /> OYES—Amount$ KNew Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> XYES-Amount$ 9 10.E 0 See Attached Spreadsheet <br /> ❑ NO—No Change of Use/Other <br /> Explanation: IV EAA) SFTt >2061 SF• <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> ❑YES—Amount$ 0 See Attached Spreadsheet <br /> ]ANO Let- <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> WYES—TYPE 5� ErSee Attached Letter <br /> ❑ NO $ ad.olvett �I'AIC.IT <br /> ieldrak <br /> Public Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />