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ILE E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 1630 OAKES AVE Permit#: B1904-038 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: CONSTRUCT 26'X24' DETACHED GARAGE <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (Note:Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) <br /> SANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation&Cost Est.) <br /> ❑ New Connection to main plus connections to building 0 New Connection, Size -0 Per Cost Estimate <br /> Alteration 0 Meter Only, Size -0 Per Cost Estimate <br /> ❑ Repair 0 Water System Development Fee Total: $ <br /> ❑ Cap-off, quantity 0 Sewer System Development Fee Total: $ <br /> ❑ Reconnection to stub 0 Water Service Line(behind meter), Size <br /> ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ NOT REQUIRED ANOT REQUIRED <br /> Explanation/Utility Permit#: Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size 0 New Connection, Size -0 Per Cost Estimate <br /> ❑ Meter Only, Size 0 3/" Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total: $ 0 Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA I11 NOT REQUIRED <br /> qu IJ <br /> NOT REQUIRED Explanation!Utility Permit#: <br /> Explanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> KNOT REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑Backflow Prevention (Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> [i.NOT REQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> YES, Stormwater Total: $ 3'16 „`f3 0 YES,Traffic Mitigation Total: $ <br /> 0 Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit 0 See Attached for calculations!credit <br /> Q9 All Hard Surface Fees to be added to Permit# P&/QOS— ©0e- y NOT REQUIRED <br /> I0 See Attached Spreadsheet for calculations/credit <br /> ❑ NOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑YES—TYPE: 0 SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> ❑ See Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> ❑ Digital copy attached to permit record, Permit# <br /> 0 Saved to Address Folder in Development Tech File <br /> 10 NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> NOT REQUIRED <br /> " <br /> ( eason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> YES, Permit#PWa <br /> ❑ Stormwater NPDES .. ompleted in TRAKiT 0 ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: _ x �0;-�,..,� Date: �� 2 2e" <br /> 017111141 <br /> • <br /> Worksheet Checked By: 1 f 1L A <br /> Date: S. vd <br /> REVISED 4/24/2019 <br />