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girPUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 8/25/2016 <br /> Permit#: PW1608-067 <br /> PROJECT ADDRESS: 7921 19TH DR SE <br /> DESCRIPTION OF WORK: CONSTRUCT NEW TOWNHOUSE UNIT <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: ALPINE HEIGHTS DEVELOPMENT NAME: STEVE SNYDER <br /> ADDRESS: 120 SW EVERETT MALL WAY ST100 ADDRESS: 120 SW EVERETT MALL WAY <br /> EVERETT,WA, 98204 EVERETT,WA,98204 <br /> PHONE: PHONE: 3609532800 <br /> EMAIL: EMAIL: MATTR@SEAPACHOMES.COM <br /> CONTACT: 0 Owner 0 Applicant ❑Other <br /> NAME: [ContactName] <br /> PHONE: [ContactPhone] <br /> EMAIL: [ContactEmail] <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required?, 1 YES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: C)6 4,-0S6 <br /> 0 S <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> . 'YES—Type / D (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 /> V DOMESTIC SERVICE: FIRE SERVICE: <br /> ❑YES—Amount$ .1erc ❑YES—Amount$ <br /> RfMeter Only, ❑ Complete Service, Size 0 3/" Detect Meter Only, 0 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 /> u� , YES—Amount$ 7o Lo <br /> (New Connection, 0 Alteration/Repair, ❑ Cap-off/Reconnect <br /> 0N <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? �-7 <br /> YES—Amount$= ' � 6V% ❑ See Attached Spreadsheet I / r56 <br /> ❑ NO—No Change of Use/Other <br /> Explanation: <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> ❑YES—Amount$ cd 0 See Attached Spreadsheet <br /> ,NO pa;c/ tu'eh /Da, wqs recoy,c+/cef <br /> / ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> �/ g'YES—TYPE sFg P(See Attached Letter <br /> ❑ NO <br /> 118 ' /26 / k <br /> Public Works Reviewer Signature to <br /> REVISED 2/24/2016 <br />