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01"7- PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 4/19/2018 <br /> \ Permit#: BI$03-0q <br /> PROJECT ADDRESS: /0101 g7- SE 0)J <br /> DESCRIPTION OF WORK: INSTALL(1)NEW PORTABLES LANDING/WELCOME RAMP- OMIT£ E.Atn . <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: EVERETT SCHOOL DIST 2 NAME: COLLINS J <br /> ADDRESS: 4730 COLBY AVE ADDRESS: <br /> EVERETT,WA, 98203 , <br /> PHONE: PHONE: 4253854195 <br /> EMAIL: EMAIL: JCOLLINS@EVERETTSD.ORG <br /> CONTACT: 0 Owner 0 Applicant ❑Other <br /> NAME: [ContactName] <br /> PHONE: [ContactPhone] <br /> EMAIL: [ContactEmail] <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required? AYES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: PAM304 O.7 i <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> ❑YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> ANO <br /> Explanation: <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: FIRE SERVICE: <br /> ❑YES—Amount$ 0 YES—Amount$ <br /> 0 Meter Only, 0 Complete Service, Size ❑%"Detect Meter Only, 0 Fire Service Size <br /> 'NO 'i(NO <br /> Explanation: Explanation: <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? <br /> ❑YES—Amount$ 0 New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> lit NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> AYES—Amount$ 1,054, 24 See Attached Spreadsheet <br /> ❑ NO—No Change of Use JUse/Other <br /> Explanation: ,Sketeitic <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> EYES—Amount$ $;0?13V 5'5 0 See AttaTed Spreadsheet . <br /> ❑ NO $Z f l000SF x Sib spar l p k .Agi381.5-„+exit p&r GikonTiaA17t i day £', 0iwiuy &c4001v. <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑YES—TYPE 0 See Attached Letter <br /> lit NO <br /> PW Reviewer: 4/410U <br /> Date: <br /> .../efejakA. <br /> /7 zea <br /> RFvrcFn 1n/11//01R <br />