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PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 11/20/2017 <br /> I ) / Permit#: PW1711-023 <br /> PROJECT ADDRESS: 4947 I IIGHLAND AVE <br /> DESCRIPTION OF WORK: NEW SFR(DADU) <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: JOHNSON LACIE T&BICKLEY NAME: [AppName] <br /> NATHANIEL G ADDRESS: [AppAdd] <br /> ADDRESS: 1917 HIGHLAND AVE [AppCi], [AppSt], [AppZip] <br /> EVERETT,WA, PHONE: [AppPhone] <br /> PHONE: 4257377660 EMAIL: [AppEmail] <br /> EMAIL: nathanielbickley@gmail.com <br /> CONTACT: 0 Owner 0 Applicant ❑Other <br /> NAME: LUIS SLATER SLATER DESIGN <br /> PHONE: 4258777377 <br /> EMAIL: slaterdesign@gmail.com <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required?,,'YES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#:C 17/I 002._ <br /> 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 /> , NO <br /> Explanation: <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: FIRE SERVICE: <br /> ❑YES—Amount$ 0 YES—Amount$ <br /> 0 Meter Only, 0 Complete Service, Size 0 3/4' Detect Meter Only, ❑ Fire Service Size <br /> gNO NO <br /> xplanation: xplanation: <br /> ❑ RPBA 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 p <br /> YES—Amount$ i'© 0 New Connection, Alteration/Repair, 0 Cap-off/Reconnect <br /> O <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> J'YES—Amount$ 24 3/ _ 0 See Attached Spreadsheet 2 AL3/ A D-f <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? <br /> ❑YES—Amount$ 0 See Attached Spreadsheet <br /> %NO I c/ i ' r4' k We have seen C4 ti f'J <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> OYES—TYPE S'r R.• k See Attached Letter <br /> ❑ NO <br /> PW Reviewer: <br /> k;"k/ <br /> Date: ll-z0 7 <br /> REVISED 10/11/2016 <br />