3523 BROADWAY 2017-07-27 - Laserfiche WebLink

PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 3/16/2016 Permit#: B1603-048 PROJECT ADDRESS: 3523 BROADWAY AVE DESCRIPTION OF WORK: INSTALL"WAVING BEAR" MONUMENT ON CONCRETE FTG-BROWN BEAR � I�W� CONTACT INFORMATION: �r b 1 �-Gt OWNER: APPLICANT: NAME: TOSCO MARKETING CO NAME: CAR WASH ENTERPRISES INC. ADDRESS: PO BOX 52085 ADDRESS: 3977 LEARY WAY NW PHOENIX, AZ, 85072 SEATTLE,WA, 98107 PHONE: PHONE: 2067893700 EMAIL: EMAIL: CONTACT: ❑ Owner ❑ Applicant []Other NAME: [ContactName] PHONE: [ContactPhone] EMAIL: [ContactEmail] COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required? ❑ YES Nf�&tM14-W.O.#: Notes: 4 SAssociated Bldg./PW Permit#: S� Nb ��v C�eraE,U 8/cDoE work- FIRE SPRINKLER REQUIRED? (by Fire Department/Code) ❑ YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) 5ZNO 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 ❑%" Detect Meter Only, ❑ Fire Service Size UNO WIN Explanation: Explanation: ❑ 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$ ❑ New Connection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect 1;�rN O Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENT FEE? ❑ YES—Amount$ ❑ See Attached Spreadsheet 15`NO—No Change of Use/Other Explanation: (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FEE? ❑ YES—Amount$ ❑ See Attached Spreadsheet _�ErN O ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) ❑ ES—TYPE ❑ See Attached Letter I NO Public Works Reviewer Signature Date REVISED 2/24/2016