3713 BROADWAY 2017-06-20 - Laserfiche WebLink

PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 12/30/2015 Permit#: B1512-040 PROJECT ADDRESS: 3713 BROADWAY DESCRIPTION OF WORK: NEW COMMERCIAL BUILDING-DELITE BAKERY CONTACT INFORMATION: OWNER: APPLICANT: NAME: SUSAN DESPI NAME: ROLLUDA ARCHITECTS ADDRESS: 5314 17TH AVE S ADDRESS: 105 S MAIN ST, SUITE 323 SEATTLE,WA, 98108 SEATTLE,WA, 98104 PHONE: PHONE: 2066244222 EMAIL: EMAIL: richard@rolludaarchitects.com CONTACT: ❑ Owner ❑ Applicant ❑Other NAME: [ContactName] PHONE: [ContactPhone] EMAIL: [ContactEmail] COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required?A YES ❑ NO W.O.#: Notes: Associated Bldg./PW Permit#: FIRE SPRINKLER REQUIRED? (by Fire Department/Code) ❑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 2 ❑%" Detect Meter Only, ❑ Fire Service Size ❑ NO ❑ NO Explanation: Explanation: ❑Water Department Cost Estimate Needed-(/f yes, PW Reviewer to send cost estimate request to Water Department, attach copy) Existing Utility Permit#(if applicable): SEWER FEE? Oa YES—Amount$ �� ❑ New Connection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect NO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENT FEE? / ❑ YES—Amount$ 0 ❑ See Attached Spreadsheet G��tPGv1C{/ L��_r .2A ONO—No Change of Use/Other Explanation: �tlo Ckanje 1'�li n[r f��4k,r►na (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FEE? OV ❑ YES—Amount$ 0 ❑ See Attached Spreadsheet NO -5Ce, :�h�c,i� 71`041A t Brick ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) 0 YES—TYPE CUM See Attached Letter ❑ NO Public Works Reviewer Signature Date REVISED 2/24/2016