Laserfiche WebLink
IA"' PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 2/22/2018 <br /> VCY Permit#: PW1802-03 <br /> PROJECT ADDRESS: Lis y 00 nvE, S , (LOT <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#: CNN-006' <br /> FIRE SPRINKLER REQUIRED?(by Fire Department/Code) <br /> 0 YES-Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) <br /> V 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$ 5O0%Ill �/ �� ❑YES-Amount$ <br /> ErMeter Only, 0 Complete Service, Size Y 0 3/4"Detect Meter Only, 0 Fire Service Size <br /> 0 N 14NO <br /> Explanation: Explanation: <br /> I11 ] RPBA Needed at premise?-(Plumbing permit for backflow device needed due to High-Hazard Site per Tim Markham's review) <br /> WOO 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 /> la YES-Amount$ . 1)%e IR New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> 13[YES-Amount$ /l M. °° 0 See Attached Spreadsheet <br /> ❑ NO-No Change of Use/Other <br /> Explanation: 9553 81e AfE,(it) Sir. -moi oivaL -i s&o Er' -- ..acid f o hid? psrrni) <br /> (Note:Public Works Reviewer to Add Traffic Mitigation to PW Permit(if applicable)) <br /> TRAFFIC MITIGATION FEE? y,,Et YES-Amount$-4 ,- 0 See Attached Spreadsheet <br /> O NO401i1960—fterniii% S <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> OYES-TYPE cSF)Z. I$'See Attached Letter>C2. —Sam C) +0 1 egny Illa4` <br /> ❑ NO <br /> PW Reviewer: ,, Date: /zizeis, <br /> v <br /> REVISED 10/11/2016 <br />