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PUBLIC WORKS REVIEW_WORKSHEET <br /> PROJECT ADDRESS: 2215 PINEHURST AVE Permit#: B1811-001 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: CONSTRUCT NEW DETACHED GARAGE AND NEW DRIVEWAY <br /> PW Reviewer to select all that apply below: <br /> • <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 ❑ Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> OT REQUIRED kNOT REQUIRED <br /> xplanation/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 3/4"Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA p,'NOT REQUIRED <br /> NOT REQUIRED Explanation/Utility Permit#: <br /> xplanation/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) <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 /> VI,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 /> F1 YES, Stormwater Total:$ 0 YES,Traffic Mitigation Total:$ <br /> ❑ See Attached Spreadsheet for calculations 0 See Attached Spreadsheet for calculations/credit <br /> ❑ NOT REQUIRED KNOT 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 ❑ 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 /> ❑ Saved to Address Folder in Development Tech File <br /> 7NOTREQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES-Type <br /> )41.4\10T REQUIRED <br /> eason: <br /> PUBLIC WORKS PERMIT EQUIRED? <br /> I 'YES, Permit#PW (a/(-- 0 2_6 <br /> 0 Stormwater NPDES T... Gmpleted in TRAKiT 0 ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> 2 <br /> Worksheet Completed By: '! = � Date: / /!" <br /> 10 C(A- n2 t <br /> Worksheet Checked By: '� / i `J i Date: dJ 2�1 <br /> REVISED 1/7/2019 �2/ <br />