2212 PINE ST 2019-06-11 - Laserfiche WebLink

• PUBLIC WORKS REVIEW WORKSHEET (ATTACH 1 SITE PLAN FOR REVIEW) Date: 11/15/2017 Permit#: PW1711-012 PROJECT ADDRESS: 2212 PINE ST DESCRIPTION OF WORK: SFR ADDITION AND REMODEL CONTACT INFORMATION: OWNER: APPLICANT: NAME: BANWAIT GURMAIL&KAUR BALBIR NAME: [AppName] ADDRESS: 2212 PINE ST ADDRESS: [AppAdd] EVERETT,WA, 98201-2557 [AppCi], [AppSt], [AppZip] PHONE: PHONE: [AppPhone] EMAIL: EMAIL: [AppEmail] CONTACT: 0 Owner 0 Applicant ❑Other NAME: CORREA KEVIN PHONE: 4252202856 EMAIL: KEVINCORREA22@YAHOO.COM COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: PW Permit Required? 0 YES 0 NO W.O.#: Notes: Associated Bldg./PW Permit#: C1609-003 FIRE SPRINKLER REQUIRED?(by Fire Department/Code) ❑YES—Type (If yes, add to TRAKiT under Reviewer Comments on Bldg Permit and Stamp Drawings) rxNO planation: (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 xplanation: Explanation: ❑ RPBA Needed at premise?-(Plumbing permit for backflow device needed due to High-Hazard Site per Tim Markham's review) ❑Water Department Cost Estimate Needed-(lf 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 rxNO planation: Existing Utility Permit#(if applicable): SYSTEM DEVELOPMENT FEE? ❑YES—Amount$ 0 See Attached Spreadsheet ( 10—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 ?a 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 pi NO PW Reviewer: Date: /(/ / lA P2- REVISED 10/11/2016