Laserfiche WebLink
4". PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 7/18/2017 <br /> Permit#: PW1708.-- 007 <br /> PROJECT ADDRESS: 447e 29TH AVE SE t/e9f•/4 <br /> DESCRIPTION OF WORK: SITE WORK FOR A NEW SFR <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: POLYGON WLH LLC NAME: PANI ALAN/POLYGON <br /> ADDRESS: 4695 MACARTHUR CT 8TH FLR ADDRESS: <br /> NEWPORT BEACH,CA, 92660 <br /> PHONE: PHONE: 4255867700 <br /> EMAIL: EMAIL: <br /> CONTACT: 0 Owner 0 Applicant ❑Other <br /> NAME: PANT ALAN <br /> PHONE: 4255867700 <br /> EMAIL: ALAN.PANI@POLYGONHOMES.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required?BYES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: C /707-002_ <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: 8000 FIRE SERVICE: <br /> ❑YES—Amount$ `fCJ 3//' 0 YES—Amount$ <br /> )(Meter Only, 0 Complete Service, Size /�f 0 3A"Detect Meter Only, El Fire Service Size <br /> ,x 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$ 7a_ ,j New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> 2 3 <br /> ,'YES—Amount$ / o)?4-7 El See Attached Spreadsheet 53 <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$ 0 See Attached Spreadsheet <br /> j' NO • <br /> PCeld/l7 74thh, t'/oc c(y <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> )DYES—TYPE S '2t' 0 See Attached Letter <br /> ❑ NO <br /> PW Reviewer: Date: -- <br /> Y-/ <br /> RFVISFn 10/11/2018 <br />