5510 OCEAN AVE 2017-09-08 - Laserfiche WebLink

PUBLIC WORKS WS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 3/31/2016 Permit#: PW1603-080 PROJECT ADDRESS: 5510 OCEAN AVE DESCRIPTION OF WORK: SFR ADDITION &ATTACHED GARAGE �O3 _06 CONTACT INFORMATION: OWNER: APPLICANT: NAME: BRUCE JASON R AND HOLLIANN NAME: [AppName] ADDRESS: 5510 OCEAN AVENUE 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?R'YES ❑ NO W.O.#: Notes: Associated Bldg./PW Permit#: �C'f^.l`»r7 tc'r �re� irt<�� COhC��IS pr1� FIRE SPRINKLER REQUIRED? (by Fire Department/Code) ❑YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) JRI 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 ❑3/4" Detect Meter Only, ❑ Fire Service Size Z 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? ❑YES—Amount$ ❑ New Connection, ❑Alteration/Repair, ❑ Cap-off/Reconnect .�1 NO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENT FEE? A,- - ,- y `L'LCIGt f�g�f3 (YES—Amount$ %94 ❑�SeefAtt ched Spr�aidsl ets® �fu_tc �0yn�f �rO�'J �t'p� (p �C`I't ❑ NO—No Change of Use/Other Explanation: VD0 — Z5?6'Z (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FEE? ❑YES—Amount$ ❑ See Attached Spreadsheet 4 NO ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) ❑YES—TYPE ❑ See Attached Letter 4'NO Public Works Reviewer Signature Date REVISED 2/24/2016