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04". PUBLIC WORKS <br /> REVIEW WORKSHEET <br /> (ATTACH 1 SITE PLAN FOR REVIEW) Date: 11/21/2017 <br /> Permit#: PW1711-025 <br /> PROJECT ADDRESS: 3214 KROMER AVE <br /> DESCRIPTION OF WORK: SITE WORK FOR NEW SFR <br /> CONTACT INFORMATION: <br /> OWNER: NAME: DAVID SOULE FRAMEWORKS <br /> NAME: MILLER ALAN/GLEN W DRAFTING <br /> ADDRESS: PO BOX 12602 ADDRESS: <br /> EVERETT,WA,98206 <br /> PHONE: 4254222392 PHONE: 3608489832 <br /> EMAIL: EMAIL: frameworksdesign@gmail.com <br /> APPLICANT: at/Applicant CI Owner Applicant ❑Other <br /> NAME: DAVID SOULE FRAMEWORKS DRAFTING <br /> PHONE: 3608489832 <br /> EMAIL: frameworksdesign@gmail.com <br /> COMMENTS FROM PUBLIC WORKS REVIEWER: LAND USE PROJECT#: <br /> PW Permit Required? OYES 0 NO W.O.#: <br /> Notes: Associated Bldg./PW Permit#:C r4 t I ods <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 /> 1111QO <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$ 0 YES-Amount$ <br /> 0 Meter Only, 0 Complete Service, Size 0 3/4" Detect Meter Only, 0 Fire Service Size <br /> Explanation: geVS-e ex► u V1 G 5el'V i Ce 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? leGGerfACc ex,41149 S4-✓utce. <br /> 1311ES-Amount$ 0 New Connection, l AAlteration/Repair, 0 Cap-off/Reconnect <br /> ❑ NO <br /> Explanation: <br /> Existing Utility Permit#(if applicable): <br /> SYSTEM DEVELOPMENT FEE? <br /> ❑YDS-Amount$ 0 See Attached Spreadsheet <br /> IWNO-No Change of Use/Other g PI7ee � ;,16 -E, 5 FCS L �2 -`or- L k-c <br /> Explanation: 1 <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 /> ETNO &place e5cR4Ort75PK, <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑YES-TYPE 0 See Attached Letter <br /> 12111° :wee Xcldrosv.cc c),,eciwg SFr <br /> PW Reviewer: Lnm rcCi, Date: <br /> REVISED 10/11/2016 <br />