5402 PARKVIEW LN 2017-08-02 - Laserfiche WebLink

PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 10/10/2016 Permit#: 61610-009 PROJECT ADDRESS: 5402 PARKVIEW LN 1^ � DESCRIPTION OF WORK: TEAR DOWN/REBUILD DECK LIKE IN KIND l _d. ��/� �A/� �v CONTACT INFORMATION: �� OWNER: APPLICANT: NAME: PISKUNOV YURIY M NAME: [AppName] ADDRESS: 5402 PARK VIEW LN ADDRESS: [AppAdd] EVERETT,WA, 98203 [AppCi], [AppSt], [AppZip] PHONE: PHONE: [AppPhone] EMAIL: EMAIL: [AppEmail] CONTACT: ❑ Owner ❑ Applicant ❑Other NAME: [ContactName] PHONE: [ContactPhone] EMAIL: [ContactEmail] COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required? ❑ YES �NO W.O.#: Notes: Associated Bldg./PW Permit#: FIRE SPRINKLER REQUIRED? (bv Fire DeqartmenbCode) ❑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? DOMEST/C SERV/CE: F/RE SERVICE: ❑YES—Amount$ ❑YES—Amount$ ❑ Meter Only, ❑ Complete Service, Size ❑'/<" Detect Meter Only, ❑ Fire Service Size ❑ NO ❑ NO Explanation: Explanation: ❑ RPBA Needed at prem ise?-(Plumbing permit for backflow device needed due to High-Hazard Site per Tim Marlcham's review) ❑Water Department Cost Estimate Needed-(If yes, PW Reviewer to send cost estimate request to Water Department, aftach copy) Existing Utility Permit#(if applicable): SEWER FEE? ❑ YES—Amount$ ❑ New Connection, ❑Alteration/Repair, ❑ Cap-off/Reconnect ❑ NO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENTFEE? YES—Amount$ ❑ See Attached Spreadsheet NO—No Change of Use/Other Explanation: (Note:Public Worlcs Reviewer to Add Tra�c Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FEE? ❑YES—Amount$ ❑ See Attached Spreadsheet ❑ NO ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) ❑YES—TYPE ❑ See Attached Letter ❑ NO PW Reviewer: Date: REV/SED 10/11/2016