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46.7." PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 11/9/2017 <br /> Permit#: C1711-004 <br /> PROJECT ADDRESS: 2008 23RD ST <br /> DESCRIPTION OF WORK: NEW SFR <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: JUBIE ALFRED/KATHLEEN NAME: SAME <br /> ADDRESS: 2008 23RD ST ADDRESS: <br /> EVERETT,WA,98201 <br /> PHONE: PHONE: <br /> EMAIL: EMAIL: <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#: G" <br /> PW Permit Required?igi YES 0 NO W.O.#: <br /> Notes: R' 1 r z lc. A t, I sez, Associated Bldg./PW Permit#: PiW/O j-030 <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 /> 0 N <br /> Explanation: <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? ` _ -�y <br /> DOMESTIC SERVICE: 00 �t g oc ckni N ? FIRE SERVICE: <br /> EYES-Amount$ 6®:'" tri" °n J sgrYi - ❑YES-Amount$ <br /> 0 Meter Only, 0 Complete Service, Size 0 3/4" Detect Meter Only, 0 Fire Service Size <br /> ❑ NO 14 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 /> ►JlfrWater Department Cost Estimate Needed-(lf yes, PW Reviewer to send cost estimate request to Water Department, attach copy) <br /> Existing Utility Permit#(if applicable): <br /> SEWER FEE? /pt <br /> eo <br /> EYES-Amount$ (cV., 0 New Connection, 0 Alteration/Repair, XCap-o -econnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> OYES-Amount$ (g,- See Attached_Spreads et <br /> y4(NO-No Change of Use/Other �Ji / 5E4' C% ....tt_ . �'Iauk)auk) 5J'�.t ( tZci' � /t /� <br /> Explanation: lSF hoN�f . —Cxth' X - C� 'A71A,d 11ZSs hcusc éZ ) <br /> -4'V,° <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? <br /> ❑YES 1-Amount$ Q h 0 See Attached Spreadsheet <br /> 'NO 42ii.00 -or r&cf to+#1,40> %40,9° Due. <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print o t Addr s Letter fr I� T�AI�iT rir Menu and include) <br /> trYES-TYPE 8PR )irSee Attached Letter a-�\ ��- 1� f�Lt7I ' _1 <br /> ndj <br /> heifE <br /> PW Reviewer: Date: J <br /> 01/4"6.4k <br /> REVISED 10/11/2016 <br />