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• i <br /> PUBLIC WORKS <br /> - REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 7/12/2016 <br /> Permit#: PW1607-022 <br /> PROJECT ADDRESS: 2211 GIBSON PL <br /> DESCRIPTION OF WORK: SITE WORK FOR NEW SFR-ROBINETT <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: ROBINETT MARTIN H &LAUREEN A NAME: ROBINETT MARTIN H &LAUREEN A <br /> ADDRESS: 3601 COLBY AVE ADDRESS: 3601 COLBY AVE <br /> EVERETT,WA, 98201 EVERETT,WA, 98201 <br /> PHONE: 4252599000 PHONE: 4252599000 <br /> EMAIL: MARTY@ROBINETTMGMT.COM EMAIL: <br /> CONTACT: ❑ Owner ❑ Applicant ❑Other <br /> NAME: ROBINETT MARTY <br /> PHONE: 4252599000 <br /> EMAIL: marry@robinettmgmt.com <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required? ❑ YES ❑ NO W.O.#: <br /> Notes: 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 /> ICI NO <br /> Explanation: Fir — c J/11'1 3 r �j �f�►.� <br /> r <br /> (Note:Counter Staff to Create Utility Permit for any Wfrrn <br /> 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, 0 Fire Service Size <br /> hi NO $Z NO <br /> Explanation:ika.AV jssie l V/60 7-—0/g 7sr n uu 3/9'' Explanation: <br /> azthp(rt Svz..frit.c- <br /> ❑Water Department Cost Estimate Needed-(lf yes, PW Reviewer to send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? <br /> F(YES—Amount$ Q Af New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYS E D VE OPMENT FEE? <br /> ernt$ 0 See Attached Spreadsheet <br /> NO—No Change o Use/Other <br /> Explanation: 1�� �f�, ���/l,�r� sFA. <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> ❑YES—Amount$ Opt' , 0 See Attached Spreadsheet <br /> Af NO EX (of- !, r1,d'1 rti <br /> ADDRESS LETTER R UIRED? <br /> .!A . (if yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> Xi YES—TYPE See Attached Letter <br /> ❑ NO <br /> 4&uiic Works Revi er Signature <br /> REVISED 2/24/2016 <br />