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PUBLIC WORKS <br /> 4.77 <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 8/1/2017 <br /> Permit#: PW1708•r 3 S <br /> PROJECT ADDRESS: 31133 31th Dr LOT 151 <br /> DESCRIPTION OF WORK: SITE WORK FOR NEW TOWNHOME <br /> CONTACT INFORMATION: <br /> OWNER: APPLICANT: <br /> NAME: POLYGON WLH LLC NAME: PNW Riverfront LLC <br /> ADDRESS: 11624 SE 5TH ST ADDRESS: 11 624 SE 5th Street#200 <br /> BELLEVUE,WA,98005 BELLEVUE,WA,98005 <br /> PHONE: PHONE: 4255867700 <br /> EMAIL:` EMAIL: nicka@polygonhomes.com <br /> CONTACT: 0 Owner 0 Applicant !pother <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#:C 604-10 4 I <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 /> ,Ly NO <br /> Explanation: <br /> (Note:Counter Staff to Create Utility Permit for any Water/Sewer/System Development Fees) <br /> WATER FEES? <br /> DOMESTIC SERVICE: p D FIRE SERVICE: <br /> ❑YES—Amount$ �i�Q 0 YES—Amount$ <br /> %Meter Only, 0 Complete Service, Size 0%"Detect Meter Only, 0 Fire Service Size <br /> 0 N .I'S1NO <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 /> ❑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? Q O <br /> ,$I YES—Amount$ 70`— %New Connection, 0 Alteration/Repair, 0 Cap-off/Reconnect <br /> 0 N <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? / Vi <br /> 3'YES Amount$ , 7 q(p 0 See Attached Spreadsheet <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$ 0 See Attached Spreadsheet <br /> NI NO f"c�rctt-Qtdy 0-7 6uI'_� <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address),print out Address Letter from TRAKiT Print Menu and include) <br /> ..1 YES—TYPE %See Attached Letter <br /> ❑ NO <br /> PW Reviewer: Date: <br /> Ari? d -2Z--17 <br /> REVISED 10/11/2016 <br />