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477- PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 5117 SEAVIEW WAY Permit#: C1808-002 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: EXTEND DECK 6 FEET ON NORTH SIDE/RE-DO PLUMBING/INSTALL <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: (Not Including Cost Estimates) <br /> ❑ New Connection 0 New Connection, Size <br /> ❑Alteration 0 Meter Only, Size <br /> ❑ Repair 0 Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ Cap-off $.NOT REQUIRED <br /> ❑ Reconnect Explanation/Utility Permit#: <br /> 'SNOT REQUIRED <br /> Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Not Including Cost Estimates) <br /> ❑ New Connection, Size 0 New Connection, Size <br /> ❑ Meter Only, Size ❑3/" Detect Meter Only, Service Size <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA 0 Backflow Prevention (Outside Building): 0 DCDA <br /> KNOT REQUIRED KNOT REQUIRED <br /> Explanation/Utility Permit#: Explanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-Of yes, PW Reviewer to send cost estimate request to Water Department) <br /> • <br /> ❑Yes, Quantity , See attached for reference. <br /> NOT REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit) <br /> ❑Water Service Line(behind meter), Size <br /> ❑ Backflow Prevention(Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> XNOT REQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ❑YES,Water: $ 0 YES, $ <br /> Sewer: $ 0 See Attached Spreadsheet for calculations/credit <br /> ❑ See Attached Spreadsheet for calculations/credit pti NOT REQUIRED <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 <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 /> ix NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> Kason: <br /> NOT REQUIRED <br /> ritUBLIC WORKS PERMIT REQUIRED? <br /> YES, P rmit#PW ib/1• *12. <br /> Stormwater NPDES Tab Completed in TRAKiT kADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑ NOTREQUIRED <br /> Worksheet Completed By: `� Date: !!,O?1Zet <br /> ail 4. <br /> j I 9 <br /> Worksheet Checked By: -.I_'� j/li► �(�j� � Date: fl 11-12(n <br /> REVISED 8/6/2018 <br />