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4477 • PUBLIC WORKS <br /> REVIEW WORKSHEET • <br /> i/t(gb -0SR <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 2/24/2016 <br /> Permit#: PW1602-048 <br /> PROJECT ADDRESS: $3 r' 5TH AVE W /70Wn)10mE, or t> <br /> DESCRIPTION OF WORK: PW SITE FOR NEW 13 UNIT TOWNHOMES <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: KULAGA AHMET&SEVALA NAME: KULAGA AHMET&SEVALA <br /> ADDRESS: 1205 130TH ST SE UNIT A ADDRESS: 1205 130TH ST SE UNIT A <br /> EVERETT,WA,98208 EVERETT,WA,98208 <br /> PHONE: 4255016441 PHONE: 4255016441 <br /> EMAIL: KULAGA_A@HOTMAIL.COM EMAIL: KULAGA_A@HOTMAILCOM <br /> CONTACT: ❑ Owner ❑ Applicant ❑Other <br /> NAME: WELAYE MAHER <br /> PHONE: 2068160455 <br /> EMAIL: maherwelaye@gmail.com <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required?ig YES 0 NO W.O.#: <br /> Notes: Associated BIdgJPW Permit#: e1 7-0/—OIS <br /> Pw t�-oa —oi <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> , YES—Type 1✓ (If yes,add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> 0 NO <br /> Explanation: etid <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: / FIRE SERVICE: <br /> ait/YES—Amount$ °9' 7 v� 0 YES—Amount$ <br /> lEfMeter Only, 0 Complete Service, Size /n 0 3/4"Detect Meter Only, 0 Fire Service Size <br /> ❑ NO 'R1NO <br /> Explanation: Ste. MOM .sennostiehr Explanation: <br /> N f-D RPBA Needed at premise?-(Plumbing permit for backfow device needed due to High-Hazard Site per Tim Markham's review) <br /> N f8'❑Water Department Cost Estimate Needed-(If yes, PW Reviewer to send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? J <br /> 131 YES—Amount$ �. lg New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO � <br /> Explanation: $U ATTAfi.,ia. 8egr4b5H€ 4 <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? af,i� <br /> 13 YES—Amount$ SARIC. Q ,nwv in See Attached Spreadsheet <br /> ❑ NO—No Chan <br /> o Use/Other <br /> Explanation: (0UI s '{bwnhernlEi (Ste- Al1ACWEL, SPtzflizsil&€ <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> ❑YES—Amount$ /200. 0 See Attached Spreadsheet <br /> ❑ NO ON Sertig TE, Pa) PEA-Mir <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Addre Lne�tter/fro TRA iT Print M nu acid include) <br /> la'YES—TYPE 'i'bW I�tHOYn& *See Attached Letter —4 ��� !7 a �i Q/! Gp1Lyi 7'b <br /> ❑ NO Girth✓ � eery sash 76 �.1 9`7 y fl <br /> PW Reviewer: ,e Date: ,z/Viq <br /> REVISED 10/11/2016 ( Ir t <br />