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PUBLIC WORKS ��,v ���� _��� <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 3/1/2016 <br /> Permit#: B1603-003 <br /> PROJECT ADDRESS: 5010 VIEW DR P3 <br /> �� �� <br /> DESCRIPTION OF WORK: NEW 896 SQ FT PORTABLE CLASSROOM-LOWELL ELEMENTARY j���'" u <br /> CONTACT INFORMATION: <br /> �4 <br /> OWNER: APPLICANT: <br /> NAME: EVERETT SCHOOL DIST 2 NAME: DYKEMAN ARCHITECTS <br /> ADDRESS: 4730 COLBY AVE ADDRESS: <br /> EVERETT, WA, 98203 I c, <br /> PHONE: PHONE: � n xiSr���✓ <br /> EMAIL: EMAIL: , ^�.�;�(` C���+ <br /> LF1 ,d i(Y'�= <br /> CONTACT: ❑ Owner ❑ Applicant ❑Other <br /> NAME: ZACH HALL ���J <br /> PHONE: 4252593161 <br /> EMAIL: ZACHH@DYKEMENT.NET <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required? � YES � NO W.O. #: <br /> Notes: l��" '�� ��- ������%�� �-'� � Associated Bldg./PW Permit#: <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 /> �`NO <br /> Explanation: <br /> (Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: FIRE SERVICE: <br /> ❑YES—Amount$ ❑YES—Amount$ <br /> ❑ Meter Only, ❑ Complete Service, Size ❑ 3/<" Deduct Meter Only, ❑ Fire Service Size <br /> �NO ❑ NO <br /> Explanation: . Explanation: <br /> ❑Water Department Cost Estimate Needed-(If yes, PW Reviewer fo send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? <br /> ❑ YES—Amount$ ❑ New Connection, ❑Alteration/Repair, ❑ Cap-off/Reconnect <br /> �NO <br /> xplanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENTFEE? ��/� <br /> �"YES—Amount$ ❑ See Attached Spreadsheet N' ���� �� ,�,�r S f�ti��Y1'�" <br /> ❑ NO—No Change of Use/Other T� <br /> Explanation: X Z� S�Gcc�c�l-,7� = �,S/Q �¢ <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> ��YES—Amount$ �l;bC.' ❑ See Attached Spreadsheet ,,� � � � � , . <br /> sC� i-�� , e ar,c.k.S :.h,r,;� <br /> ❑ NO <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑ YES—TYPE ❑ See Attached Letter <br /> �NO <br /> �2K c�'�Ct�� J' Z �� <br /> Public Works Reviewer Signature Date <br /> REVISED 2/24/2016 <br />