4727 SEAHURST AVE 2017-08-02 - Laserfiche WebLink

PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 3/11/2016 Permit#: C1603-005 PROJECT ADDRESS: 4727 SEAHURST AVE �, � > � U V � 1 DESCRIPTION OF WORK: NEW DETACHED GARAGE �Q y�, ,�J �;.�,�r., CONTACT INFORMATION: OWNER: APPLICANT: NAME: JOHNSON CHRIS &STA NAME: HANSON KRISTIN ADDRESS: 4727 SEAHURST AVE ADDRESS: EVERETT, WA, 98203-1713 PHONE: 4252803522 PHONE: 4257747129 EMAIL: STACIJOHNSON09@GMAIL.COM EMAIL: HANSONDESIGN@HOTMAIL.COM CONTACT: ❑ Owner ❑ Applicant ❑Other NAME: [ContactName] PHONE: [ContactPhone] EMAIL: [ContactEmail] COMMENTS FROM PUBLIC dNORKS REVIEWER: LAND USE PROJECT#: PW Permit Required?F1�YES ❑ NO W.O.#: Notes: �� `�-• "� p `-a ;' Associated Bldg./PW Permit#: ' � � '- " FIRE SPRINKLER REQUIRED? (by Fire DepartmenUCode) ❑ YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) C]'No Explanation: (Note: Counter Staff to Create Utility Permif for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: FIRE SERVICE: ❑ YES—Amount$ ❑ YES—Amount$ ❑ Meter Only, ❑ Complete Service, Size ,❑ 3/4" Qetect Meter Only, ❑ Fire Service Size �NO �NO 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 Fij NO Explanation: Existing Utility Permit# (if applicable): SYSTEM DEVELOPMENTFEE? ❑ YES—Amount$ ❑ See Attached Spreadsheet L"j NO—No Change of Use/Other Explanation: (Note:Public Works Reviewer fo Add Traffic 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 "�N O , e � Public Works Reviewer Signature Date REVISED 1/24/2016