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(ATTACH 1 SITE PLAN FOR REVIEW) <br />PROJECT ADDRESS: <br />PUBLIC WORKS <br />REVIEW WORKSHEET <br />3401 31 ST DR LOT 158 <br />Date: 3/24/2017 <br />Permit M PW1703-051 <br />DESCRIPTION OF WORK: SITE WORK FOR NEW TOWNHOME / TRAFFIC MITIGATION <br />CONTACT INFORMATION: <br />OWNER: <br />APPLICANT: <br />NAME: POLYGON WLH LLC <br />NAME: <br />PNW Riverfront LLC <br />ADDRESS: 11624 SE 5TH ST <br />ADDRESS: <br />11624 SE 5th Street #200 <br />BELLEVUE, WA, 98005 <br />BELLEVUE, WA, 98005 <br />PHONE: <br />PHONE: <br />4255867700 <br />EMAIL: <br />EMAIL: <br />nicka@polygonhomes.com <br />CONTACT: ❑ Owner ❑ 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 ❑ NO <br />Notes: <br />W.O. #: <br />Associated Bldg./PW Permit #: C 1603 - C�9l <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 />fNO <br />xplanation: <br />(Note: Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br />WATER FEES? <br />DOMESTIC SERVICE; � 10�i0 FIRE SERVICE: <br />10YES — Amount $ D 0 ."❑ YES — Amount $ <br />Meter Only, ❑ Complete Service, Size ❑ %" Detect Meter Only, ❑ Fire Service Size <br />❑ NO J(NO <br />Explanation: Explanation: <br />❑ RPBA Needed at premise? -(Plumbing permit for backf/ow 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 <br />bNO <br />Explanation: <br />I* New Connection, ❑ Alteration/Repair, ❑ Cap-off/Reconnect <br />Existing Utility Permit # (if applicable): Mu <br />SYSTEM DEVELOPMENT FEE? V7 gip 64 <br />�YES —Amount $ x,c ee Attached Spreadsheet S , f <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 $ �'/ x�i4ct ❑ See Attached Spreadsheet M ' <br />NO <br />ADDRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) <br />YES — TYPE .�' ❑ See Attached Letter <br />NO <br />PW Reviewer: Date: <br />REVISED 10/1112016 <br />