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47r PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 12/20/2016 <br /> Permit#: PW1612• O3' <br /> PROJECT ADDRESS: 7' 22 9TH DR SE <br /> DESCRIPTION OF WORK: CONSTRUCT NEW TOWNHOUSE UNIT <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: ALPINE HEIGHTS DEVELOPMENT NAME: STEVE SNYDER <br /> ADDRESS: 120 SW EVERETT MALL WAY ST100 ADDRESS: 120 SW EVERETT MALL WAY <br /> EVERETT,WA,98204 EVERETT,WA,98204 <br /> PHONE: PHONE: 3609532800 <br /> EMAIL: EMAIL: MATTR@SEAPACHOMES.COM <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?EYES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#:C/60 6 -04 Z. <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> YES–Type /.3 D (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> 0 N /� 11 <br /> Explanation: :/I"/ ties TO Sf ee f <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: 00 FIRE SERVICE: <br /> ❑'YES–Amount$ 3 0— 1/ 0 YES–Amount$ <br /> *Meter Only, 0 Complete Service, Size / ❑3/" Detect Meter Only, 0 Fire Service Size <br /> ❑ NO ❑ NO <br /> Explanation: Explanation: <br /> ❑1RPBA Needed at premise?-(Plumbing permit for backflow device needed due to High-Hazard Site per Tim Markham's review) <br /> ❑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? O tJ <br /> OYES–Amount$ 70 )(New Connection, 0 Alteration/Repair, ❑ Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> %YES–Amount$ 0 See Attached Spreadsheet 'ho size caCtvCT 1e i. e ' <br /> ❑ NO–No Change of Use/Other / <br /> Explanation: <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? 11%❑YES–Amount$ CJ 0 See Attached Spreadsheet <br /> pi NO Par0' w,4eh PCaf Oas I-eco pc/e C1 <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> WYES–TYPE Sf–, X'See Attached Letter <br /> ❑ NO <br /> PW Reviewer: 0 Date: /Z ,6 <br /> RFVISED 10/11/2016 <br />