411 ALVERSON BLVD 2017-08-17 - Laserfiche WebLink

Ah • PUBLIC WORKS Nor REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 8/11/2016 Permit#: C1608-011 PROJECT ADDRESS: 411 ALVERSON BLVD DESCRIPTION OF WORK: SFR ADDITION FOR NEW ATTACHED ADU CONTACT INFORMATION: OWNER: APPLICANT: NAME: Kelly Williamson Margaret Hain NAME: Rod Wickham ADDRESS: 411 Alverson Blvd. ADDRESS: 2812 Colby Ave EVERETT, WA, 98201 EVERETT,WA, 98201 PHONE: PHONE: 4252522789 EMAIL: EMAIL: rad.design@hotmail.com CONTACT: ❑ Owner ❑ Applicant ❑Other NAME: [ContactName] PHONE: [ContactPhone] EMAIL: [ContactEmail] COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required? ❑ YES ONO 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: IQ JIM L1r_411&" (Note: Counter Staff to&eate Utility Permit for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: FIRE SERVICE: ❑ YES—Amount$ ❑ YES—Amount$ ❑ Meter Only, ❑ Complete Service, Size ❑ 3/4" Detect Meter Only, ❑ Fire Service Size )dNO )i�NO Explanation: E Explanation: ❑Water Department Cost Es imate Needed-(If yes, W Reviewer to send cost estimate request to Water Department, attach copy) Existing Utility Permit#(if applicable): SEWER FEE? YES—Amount$ ❑ New Connection, )i l6 atio /Repair, ❑ Cap-off/Reconnect N O Explanation: No �n ' E 01 E 4 Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENT FEE? YES—Amount$ �a L®� `� ❑ See Attached Spreadsheet ❑ NO—No Change of Use/Other Explanation: '4DO (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FEE? ❑ YES—Amount$ ❑ See Attached Spreadsheet X NO >9C)U=:no 7{ia�{c /n"xi-M. ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) ❑YES—TYPE ❑ See Attached Letter E(NO 01- Public omPublic Works Reviewer Signature Date REVISED 2124/2016