Laserfiche WebLink
4Err 410 PUBLIC WORKS S <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 8/14/2017 <br /> RI`vexf,-o rd- B lvd o Permit#: PW1708. 06 8. <br /> PROJECT ADDRESS: f S l© "29TI4 AVE-SE- <br /> DESCRIPTION OF WORK: SITE WORK FOR A NEW SFR L Q 1 / ( , <br /> • <br /> CONTACT INFORMATION: • <br /> OWNER: APPLICANT: <br /> NAME: POLYGON WLH.LLC NAME: PANI ALAN/POLYGON <br /> ADDRESS: 1 4695 MACARTHUR CT 8TH FLR ADDRESS: <br /> NEWPORT BEACH,CA,92660 , , <br /> PHONE: PHONE: 4255867700 <br /> EMAIL: EMAIL: <br /> CONTACT: 0 Owner ❑ Applicant ❑Other • <br /> NAME: PANI ALAN <br /> PHONE: 4255867700 <br /> EMAIL: ALAN.PANI@POLYGONHOMES.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required?X YES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#:C/78—,0 �g <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 /> XNO <br /> Explanation: • <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: n 00 FIRE SERVICE: <br /> ❑YES—Amount$ 49 3/- ❑YES—Amount$ <br /> ,Meter Only, 0 Complete Service, Size 3/"Detect Meter Only, ❑ Fire Service Size <br /> ❑NO Xf NO <br /> • <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? p <br /> )DYES—Amount$ ���' KNew Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): • <br /> SYSTEM DEVELOPMENT FEE? 28/S <br /> %YES—Amount$ 10, 947 0 See Attached Spreadsheet <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 /> ,Y NO Paid 4Q'r all. o-F 4fi <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ,(YES—TYPE S F i ,rSee Attached Letter <br /> ❑ NO <br /> PW Reviewer: Date: <br /> 1.(1;, <br /> rk 9- 1 -1 7 <br /> REVISED 10/11/2016 <br />