Laserfiche WebLink
PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 9/14/2016 <br /> Permit#: PW1609-059 <br /> PROJECT ADDRESS: 3317 30TH DR <br /> DESCRIPTION OF WORK: NEW TOWNHOME/TRAFFIC MITIGATION LOT 83 <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: POLYGON WLH LLC NAME: PNW Riverfront LLC <br /> ADDRESS: 11624 SE 5TH ST ADDRESS: 11624 SE 5th Street#200 <br /> BELLEVUE,WA, 98005 BELLEVUE,WA, 98005 <br /> PHONE: PHONE: 4255867700 <br /> EMAIL: EMAIL: nicka@polygonhomes.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?�YES ❑ NO W.O.#: <br /> Notes: Associated BIdg./PW Permit#: �,1��`�'(}/� <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 /> �N O <br /> Explanation: �t��� �� <br /> (Note: Counter Staff to Create Utility Permit for any WatedSewer/System Development Fees) <br /> VVATER FFFS? <br /> !)OlVIESTIC SF_RVICF_: � FIRE SERVICF_: <br /> �'YES—Amount$ ��'�► „ �� ❑ YES—Amount$ <br /> �Meter Only, ❑ Complete Service, Size `�� ❑ 3/4" Detect Meter Only, ❑ Fire Service Size <br /> ❑ NO $NO <br /> Explanation: Explanation: <br /> ❑Water Department Cost Estimate Needed-(/f yes, PW Reviewer to send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? <br /> �YES—Amount$ ��•� S(New Connection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENTFEE? <br /> �YES—Amount$ - `� ❑ See Attached Spreadsheet <br /> ❑ NO—No Change of Use/Other <br /> Explanation: l J / / � <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> bYYES—Amount$ 5s � `� ❑ See Attached Spreadsheet <br /> ❑ N O ��'.�- B. �l�L�L <br /> � p�� <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> �YES—TYPE � Q(See Attached Letter <br /> ❑ NO <br /> � <br /> ���rt.�,� � �'�-1�-�,�� <br /> Public Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />