Laserfiche WebLink
Ab <br /> PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 10/6/2016 <br /> Permit#: PW1610-013 <br /> PROJECT ADDRESS: 3105 44TH ST SE <br /> DESCRIPTION OF WORK: SITE WORK FOR NEW SFR BASIC/2015 IRC - RB1502-005-LOT 68 <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: POLYGON WLH LLC NAME: POLYGON WLH LLC <br /> ADDRESS: 11624 SE 5TH ST SUITE 100 ADDRESS: 11624 SE 5TH ST SUITE 100 <br /> BELLEVUE,WA, 98005 BELLEVUE,WA, 98005 <br /> PHONE: 4255867700 PHONE: 4255867700 <br /> EMAIL: jamie.aubrey@gmail.com EMAIL: jamie.aubrey@gmaii.com <br /> CONTACT: ❑ Owner ❑ Applicant ❑Other <br /> NAME: PANI ALAN <br /> PHONE: 4255867700 <br /> EMAIL: ALAN.PANI@POLYGONHOMES.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required?q YES ❑ NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: C 16/9 _00/ <br /> FIRE SPRINKLER REQUIRED? (by Fire Department/Code) <br /> ❑ YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> XNO <br /> Explanation: <br /> (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: o b FIRE SERVICE: <br /> YES—Amount$ 7 ❑ YES—Amount$ <br /> Ji(Meter Only, 13 Complete Service, Size ❑ 3/4' Detect Meter Only, ❑ Fire Service Size <br /> ❑ NO ❑ NO <br /> Explanation: Explanation: <br /> ❑Water Department Cost Estimate Needed-(If yes, PW Reviewer to send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? 00 <br /> OYES—Amount$ 70 KNew Connection, ❑Alteration/Repair, ❑ Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? D p <br /> ;<YES—Amount$ 99/n_ ❑ See Attached Spreadsheet 2 72�:lJ <br /> ❑ NO—No Change of Use/Other <br /> Explanation: <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? 00 <br /> 9YES—Amount$ gs-¢� ❑ See Attached Spreadsheet <br /> ❑ NO tier da-�Qd 4 29 -/,6 <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> YES—TYPE t�'i2 DirSee Attached Letter <br /> ❑ NO <br /> /40 <br /> Public Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />