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PUBLIC WORKS <br />' REVIEW WORKSHEET <br />(ATTACH 1 SITE PLAN FOR REVIEW) Date: 1/19/2016 <br />( Permit #: B1601-028 <br />PROJECT ADDRESS: 909 N BROADWAY --- - <br />DESCRIPTION OF WORK: TI TO RENOVATE OFFICE INTO CLASSROOMS - ECC <br />CONTACT INFORMATION: <br />OWNED: APPLICANT: <br />NAME: EVERETT COMMUNITY COLLEGE NAME: OBORN ARCHITECTS INC <br />ADDRESS: 2000 TOWER ST ADDRESS: <br />EVERETT, WA, 98201-9253 <br />PHONE: PHONE: <br />EMAIL: EMAIL: <br />CONTACT: 0 Owner D Applicant ®Other <br />NAME: OSBORNEJERRY <br />PHONE: 2069206348 <br />EMAIL: <br />COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT #: <br />PW Permit Required? ❑ YES XNO W.O. #: <br />Notes: Associated Bldg./PW Permit #: <br />FIRE SPRINKLER REQUIRED? (by Fire Department/Code) <br />❑ Y -Type (If yes, add to TRlA/KiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br />xplaanation: Z-�/Z_ _ Jr�J%it -r\ <br />(Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br />WATER FEE? <br />❑ YES - Amount $ ❑ Meter Only, ❑ Complete Service, Type/Size <br />.-P4O <br />Explanation: <br />Existing Utility Permit # (if applicable): <br />SEWER FEE? <br />❑ YY S - Amount $ ❑ New Connection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect <br />t_' N O <br />Explanation: <br />Existing Utility Permit # (if applicable): <br />SYSTEM DEVELOPMENT FEE? <br />iI YES - Amount $ l� 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 $ ❑ See Attached Spreadsheet <br />ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br />❑ YES - TYPE ❑ See Attached Letter <br />,Er'N O <br />I- cDL7v 6 <br />PubliclWores Reviewer Si nature Oate <br />REVISED 1/5/2016i <br />