3231 COLBY AVE 2019-01-28 - Laserfiche WebLink

PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 9/16/2016 Permit#: PW1609-068 PROJECT ADDRESS: 3231 COLBY AVE DESCRIPTION OF WORK: SITE WORK FOR UNITY CENTER FOR POSITIVE LIVING CONTACT INFORMATION: OWNER: APPLICANT: NAME: UNITY CENTER OF POSITIVE L NAME: WALKER MILES ADDRESS: 3231 COLBY AVE ADDRESS: EVERETT,WA,98201-4306 , PHONE: PHONE: 4252590868 EMAIL: EMAIL: MILES@BNHARCH.COM CONTACT: 0 Owner 0 Applicant ❑Other NAME: WALKER MILES • PHONE: 4252590868 EMAIL: MILES@BNHARCH.COM COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required? 'YES 0 NO W.O.#: Notes: Associated Bldg./PW Permit#: /30(0e-� FIRE SPRINKLER REQUIRED?(by Fire Department/Code) ❑YES-Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) ❑ NO � Explanation: P _ r f►'E 3 M1/11,40 (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) WATER FEES? DOMESTIC SERVICE: FIRE SERVICE: ❑YES-Amount$ 0 YES-Amount$ 0 Meter Only, 0 Complete Service, Size 0 3/4" Detect Meter Only, 0 Fire Service Size 'NO *NO Explanation: Explanation: ❑Water Department Cost Estimate Needed-(/f yes, PW Reviewer to send cost estimate request to Water Department, attach copy) Existing Utility Permit#(if applicable): SEWER FEE? ❑YES-Amount$ 0 New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect ArNO Explanation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENT FEE? ❑YES-Amount$ ❑ See Attached Spreadsheet KNO-No Change of Use/Other Explanation: (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) TRAFFIC MITIGATION FEE? ❑YES-Amount$ 0 See Attached Spreadsheet 1 'NO ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) ❑YES-TYPE 0 See Attached Letter JO 0 kenAUL er41101,11A- Public Works Reviewer Signature Date REVISED 2/24/2016