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0$77- PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 2/22/2018 <br /> Permit#: PW1802-025 <br /> PROJECT ADDRESS: 4305 RIVERFRONT BLVD (LOT 148) <br /> DESCRIPTION OF WORK: SITE WORK AND TRAFFIC MITIGATION FOR NEW SFR <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: POLYGON WLH LLC NAME: POLYGON WLH LLC <br /> ADDRESS: 11624 SE 5TH ST SUITE 100 ADDRESS: 11624 SE 5TH ST SUITE 100 <br /> BELLEVUE,WA,98005 BELLEVUE,WA,98005 <br /> PHONE: 4255867700 PHONE: 4255867700 <br /> EMAIL: jamie.aubrey@gmail.com EMAIL: jamie.aubrey@gmail.com <br /> CONTACT: 0 Owner 0 Applicant ❑Other <br /> NAME: PANI ALAN <br /> PHONE: 4255867700 <br /> EMAIL: ALAN.PANI@POLYGONHOMES.COM <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required? YES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#: Ci$Oaq-006 <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 /> VI NO <br /> Explanation: <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: FIRE SERVICE: <br /> 'YES—Amount$ 5500%Ite— / ❑YES—Amount$ <br /> � <br /> ti[Meter Only, 0 Complete Service, Size Yil 0 3/4"Detect Meter Only, 0 Fire Service Size <br /> 0 N 14NO <br /> Explanation: Explanation: <br /> Mk RPBA Needed at premise?-(Plumbing permit for backflow device needed due to High-Hazard Site per Tim Markham's review) <br /> WIC 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 /> IFIYES—Amount$ 70►e a New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> 188 YES—Amount$ i/ 92'/ °O 0 See Attached Spreadsheet <br /> ❑ NO—No Change of Use/Other L <br /> Explanation: '202-2-•8'e NSW SFA -', ai0.JE!'4 sewer - da to 1)1d P <br /> / mt " <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIG' ION FEE? <br /> iiii YE — A mow t$ i '' Aik 0 See Attached Spreadsheet <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned addressj, print out Address Letter from TRAKiT Print Menu and include) <br /> 'EYES—TYPE spm egrSee Attached Letter x2 —Sa t 6) -/ J 1 J lil . <br /> ❑ NO v'(/ <br /> PW Reviewer: Date: /zizea <br /> ...)SE <br /> REVISED 10/11/2016 <br />