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411. <br /> PUBLIC WORKS y REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 10/21/2016 <br /> Permit#: PW1610-032 <br /> PROJECT ADDRESS: 3121 TULALIP AVE <br /> DESCRIPTION OF WORK: SITE WORK FOR SFR ADDITION <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: WATSON DORA&JEFFREY A NAME: WATSON DORA&JEFFREY A <br /> ADDRESS: 3121 TULALIP AVE ADDRESS: 3121 TULALIP AVE <br /> EVERETT,WA,98201-4153 EVERETT,WA, 98201-4153 <br /> PHONE: PHONE: 4255124611 <br /> EMAIL: EMAIL: <br /> CONTACT: 0 Owner ❑ Applicant ❑Other <br /> NAME: WATSON JEFF <br /> PHONE: 4255124611 <br /> EMAIL: watsonjeff13@gmai.com <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required?'YES ❑ NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: C 14/ D08 <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$ 0 YES—Amount$ <br /> 0 Meter Only, 0 Complete Service, Size ❑'/" 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-(/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 /> �NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? 4exis-firt5 <br /> Cp <br /> YES—Amount$ 0 See Attached Sr eadsheet /4NO—No Change of Use/Other q+ I�'IAX. S r ze 4 rge house) QZread�{. t1 <br /> Explanation: <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> ,p YES—Amount$ 0 See Attached Spreadsheet <br /> *10 <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> 0 YES—TYPE 0 See Attached Letter <br /> ❑ NO <br /> PW Reviewer: n Date: I/ ,4b <br /> REVISED 10/11/2016 <br />