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PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 1/20/2016 <br /> Permit#: PW1601-045 <br /> PROJECT ADDRESS: 2202 BROADWAY <br /> DESCRIPTION OF WORK: SITE DEVELOPMENT DRIVE THRU COFFE SHOP -DUTCH BROS COFFEE <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: SJC PROPERTY LLC NAME: STRELKA JOSEPH/C2K ARCHITECTS <br /> ADDRESS: 1617 5TH AVE N ADDRESS: <br /> SEATTLE, WA, 98109 <br /> PHONE: PHONE: 5034442208 <br /> EMAIL: EMAIL: JSTRELKA@C2KARCH.COM <br /> CONTACT: 0 Owner 0 Applicant ❑Other <br /> NAME: STRELKA JOSEPH/C2K ARCHITECTS <br /> PHONE: 5034442208 <br /> EMAIL: JSTRELKA@C2KARCH.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required?BYES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: <br /> FIRE SPRINKLER REQUIRED? (by Fire Department/Code) <br /> 0 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 /> ZIYES—Amount$ /� 0 YES—Amount$ <br /> 0 Meter Only, 0 Complete Service, Size t 0 3/4" Detect Meter Only, 0 Fire Service Size <br /> ❑Explanation:NO • ❑ NO <br /> 1/C MNec 96 --LX) S �/ 2 Explanation: <br /> .2/Z72./ ON Fi Z.tc <br /> ❑Water Department Cost Estimate Needed-(/f yes, PW Reviewer send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? <br /> 6LYES—Amount$ V-d 0 New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> ❑YES—Amount$ 0 See Attached Spreadsheet <br /> (NO—No Change of Use/Other C-G,7-GZ ih en(-4t�CG(. 14c1�t <br /> Explanation: ,/ <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> .'YES—Amount$ /2` 2e/ ❑ 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 /> _a3 / 411 4 4r2.7).--6 <br /> T- wir orks Reviewer Signat P ate <br /> REVISED 2/24/2016 <br />