Laserfiche WebLink
477 PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 3/21/2017 <br /> Permit#: PW17Q—c4 <br /> PROJECT ADDRESS: 5357 31th Dr LOT /6 5' <br /> DESCRIPTION OF WORK: SITE WORK FOR NEW TOWNHOME/TRAFFIC MITIGATION <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: 0 Owner 0 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 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#:C /&D?`433 <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> 0 YES—Type (If yes,add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> NO <br /> Explanation: <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: 0v FIRE SERVICE: <br /> %YES—Amount$ 45'O 3� ❑YES—Amount$ <br /> 0 Meter Only, 0 Complete Service, Size rh 0 3/4"Detect Meter Only, 0 Fire Service Size <br /> ❑ NO *NO <br /> Explanation: Explanation: <br /> ❑ RPBA Needed at premise?-(Plumbing permit for backflow device needed due to High-Hazard Site per Tim Markham's review) <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$ '72 ArNew Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> 0 N <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? 0 <br /> YES—Amount$ JO 947 0 See Attached Spreadsheet ?LL et c(fi o Med,Sf Z e <br /> ❑ NO—No Change of Us4/Other <br /> Explanation: <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? 00 <br /> )(YES—Amount$ 357 0 See Attached Spreadsheet <br /> ❑ NO k. Per ivii ke , h',ck e ma;C, <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ,rYES—TYPE .Sf7Z %See Attached Letter <br /> ❑ NO <br /> PW Reviewer: Date: <br /> 3--23'17 <br /> REVISED 10/11/2016 • <br />