3513 31ST DR 2018-02-05 - Laserfiche WebLink

PUBLIC WORKS REVIEW WORKSHEET ��r �� (ATTACH 1 SITE PLAN FOR REVIEW) Date: 2/29/2016 Permit#: C1602-021 PROJECT ADDRESS: 3513 31ST DR-4�9P2- �.3� DESCRIPTION OF WORK: NEW TOWNHOME CONTACT INFORMATION: OWNER: APPLICANT: NAME: POLYGON WLH LLC NAME: PNW Riverfront LLC ADDRESS: 11624 SE 5TH ST ADDRESS: 11624 SE 5th Street#200 BELLEVUE, WA, 98005 BELLEVUE,WA, 98005 PHONE: PHONE: 4255867700 EMAIL: EMAIL: nicka@polygonhomes.com CONTACT: ❑ Owner ❑ Applicant ❑Other NAME: PANI ALAN PHONE: 4255867700 EMAIL: ALAN.PANI@POLYGONHOMES.COM COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required? �YES ❑ NO W.O.#: Notes: Associated BIdg./PW Permit#: FIRE SPRINKLER REQUIRED? (bv Fire DepartmenUCode) ❑ YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) �NO xplanation: (Note: Counter Staff to Create Utilify Permit for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: xJ FIRE SERVICE: ❑YES—Amount$ d o '" ? �� ❑YES—Amount$ �Meter Only, ❑ Complete Service, Size�_ ❑ 3�4 Deduct 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 ❑ NO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENTFEE? YES—Amount$ ❑ See Attached Spreadsheet J�q'�J D^/ ��C ��b1�t�fC ❑ NO—No Change of Use/Other Explanation: (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FEE? YES—Amount$ � ❑ See Attached Spreadsheet !'/ �� ` �. ❑ NO �u Q—/'fl4/�- � � u� A DRESS LETTER RE IRED? (If yes (new assigned address), print out A dress Letter from TRAKiT Print Menu and include) ES—TYPE �(See Attached Letter ❑ NO � �� Public Wo eviewer Signature ate REVISED 2/24/2016