Laserfiche WebLink
PUBLIC WORKS 11 <br /> �� REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 3/26/2018 <br /> Permit#: C1803-014 <br /> PROJECT ADDRESS: 1609 5TH ST <br /> DESCRIPTION OF WORK: BUILD NEW SFR DETACHED-2200SF <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: BJELLA KEITH&ERICA NAME: [AppName] <br /> ADDRESS: 550 ALVERSON BLVD ADDRESS: [AppAdd] <br /> EVERETT,WA, [AppCi], [AppSt], [AppZip] <br /> PHONE: PHONE: [AppPhone] <br /> EMAIL: EMAIL: [AppEmail] <br /> CONTACT: ❑ Owner ❑ Applicant Dottier <br /> NAME: BJELLA KEITH <br /> PHONE: 4254220442 <br /> EMAIL: KDBJELLA@ALLIEDCONSTRUCTION.NET <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 /> 1,7 FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> ❑YES—Type (If yes,add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> 18(NO <br /> Explanation: - <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: �1FIRE SERVICE: <br /> $(YES—Amount$ 3016. I II ❑YES—Amount$ <br /> ' <br /> 0 Meter Only, Complete Service, Size ,7 Li 0 3/"Detect Meter Only, 0 Fire Service Size <br /> 0N 0N <br /> Explanation: Explanation: <br /> N'a(0 RPBA Needed at premise?-(Plumbing permit for backflow device needed due to High-Hazard Site per Tim Markham's review) <br /> 00 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 /> tr--SEWER FEE? <br /> )(YES—Amount$ 100 I OHO New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect Eli NW ittekatift gavt <br /> ❑ NO � J� f�i2 a/24> <br /> Explanation: �'�,� / . . <br /> Existing Utility Permit#(if applicable): <br /> ,SYSTEM DEVELOPMENT F E? ++__1 <br /> YES—Amount$ 111 q$9 'f019- dJt 0 See Attached Spreadsheet <br /> ❑ NO—No Change of <br /> Use/Other <br /> Explanation: ZZo 7 lii SF wino pri relic hour(o a46 ( 'iakt_ 4`1g12-P, ss urf.=M'712.°M <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> }RAFFIC MITIGATION FEE? <br /> EYES—Amount$ g4OO.D 0 See Attached S readsh�eett� /�� /r / �,�/ <br /> ❑ NO No tt 01r tF./h9/"""" eilS e -NE.aktrAh a�� C�'1 Swi1/ AS�a <br /> t/ ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiJ Pfint Menu and include)w'ho(/9 <br /> EYES—TYPE SIV, NrSee Attached Letter 4, erril✓1 af'F ib Pcd Prr4m#-`4r/lIc4 l <br /> ety <br /> 0 NO <br /> N S NA 0414424- Uri A HfrrAi Vitoh.s. <br /> PW Reviewer: detitikuu Date: <br /> "7 ;CAP18 <br /> REVISED 10/11/2016 <br />