2230 MONROE AVE 2016-08-12 - Laserfiche WebLink

• PUBLIC WORKS � REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 2/29/2016 Permit #: C1602-015 PROJECT ADDRESS: 2230 MONROE AVE DESCRIPTION OF WORK: SFR REMODEL, RE-ROOF, NEW FRONT DECK CONTACT INFORMATION: OWNER: APPLICANT: NAME: WETMORE JAMES R NAME: ADDRESS: 2230 MONROE AVE UNIT B ADDRESS EVERETT, WA, 98203 PHONE: EMAIL: CONTACT: ❑ Owner ❑ Applicant ❑Other NAME: [ContactName] PHONE: [ContactPhone] EMAIL: lContactEmail� COMMENTS FROM PUBLIC WORKS REVIEWER: PW Permit Required? ❑ YES �NO Notes: PHONE: EMAIL: [AppName] [AppAdd] [AppCi], [AppSt], [A,ppZip] [AppPhone] [AppEmail] LAND USE PROJECT #: W.O. #: Associated Bldg./PW Permit #: FIRE SPRINKLER REQUIRED? (by Fire DepartmentlCode) ❑ YES —Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) �,NO Explanation: (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: FIRE SERVICE: ❑ YES — Amount $ ❑ YES — Amount $ ❑ Meter Only, ❑ Complete Service, Size _ ❑ 3/<" Deduct Meter Only, '�NO ❑ NO Explanation: Explanation: � Fire Ser��ice Size ❑ Water Department Cost Estimate Needed-(If yes, PW Reviewer to send cost estimate request to Water Department, attach copy) Existing Utility Permit # (if applicable): SEWER FEE? ❑ YES — Amount $ '�,NO Explanation: Existing Utility Permit # (if applicable): SYSTEM DEVELOPMENTFEE? ❑ YES — Amount $ �. NO — No Change of Use / Other Explanation: ❑ New C;onnection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect ❑ See Attached Spreadsheet (Note: Public Works Reviewer to Add Traffic Mitiqation to PW Permit (if applicable)) TRAFFIC MITIGATION FEE? ❑ YES — Amount $ ❑ See Attached Spreadsheet `� N O ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) ❑ YES — TYPE ❑ See Attached Letter '6� N O Public Work� Reviewer Signature Date