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• <br /> 41"T PUBLIC WORKS <br /> REVIEW WORKSHEET CA US -O( <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 3/19/2018 <br /> Permit#: PW1803-053 <br /> PROJECT ADDRESS: 3814 HOYT A&B AVE <br /> DESCRIPTION OF WORK: SITE WORK FOR 2 NEW DUPLEX'S <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: 3814 HOYT AVENUE LLC NAME: LEADING EDGE CONSTRUCTION LLC <br /> ADDRESS: 3814 HOYT AVE ADDRESS: 1777 S BURLINGTON BLVD#513 <br /> EVERETT,WA, 98201 BURLINGTON,WA,98233 <br /> PHONE: PHONE: 4258700350 <br /> EMAIL: EMAIL: <br /> CONTACT: ❑ Owner ❑ Applicant ❑Other <br /> NAME: BRAD RZECHULA <br /> PHONE: 4258700350 <br /> EMAIL: bradrzechula@gmail.com <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required? ❑ YES ❑ NO W.O.#: <br /> Notes: • <br /> Associated Bldg./PW Permit#: <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$ ' r V J /� ❑YES—Amount$ <br /> 0 Meter Only, Complete Service, Size �/ 0 3/4" Detect Meter Only, 0 Fire Service Size <br /> ❑ NO ❑ 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-(If 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$ ' i' 41 New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT F E? <br /> ❑YES—Amount$ ' ❑ 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 /> ,Ail YES—Amount$ '2 o 0 See Attached Spreadsheet <br /> ❑ NO <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 /> ❑ NO <br /> PW Reviewer: Date: /� <br /> '47g ?o <br /> REVISED 10/11/2016 <br />