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PURL WORKS REVIEW WORKS!EET <br /> PROJECT ADDRESS: 5725 COLBY AVE Permit#: C1807-011 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: CONVERT SHOP INTO NEW ADU <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 ❑ Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ Cap-off lEf NOT REQUIRED <br /> ❑ Reconnect Explanation/Utility Permit#: <br /> $NOT REQUIRED <br /> Explanation/Utility Permit#: /J6-0 . t. f ,:.. ��_���_ <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 ❑'/<" Detect Meter Only, Service Size <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA ❑ Backflow Prevention(Outside Building): 0 DCDA <br /> 'F(NOT REQUIRED )4NOT REQUIRED <br /> Explanation/Utility Permit#: 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 /> ' 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) ❑ RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> )4 NOT REQUIRED_U vt. iwas& 710 ADU 1S eadgil s <br /> Building Permits (Note:Permit Technicians t•-..: all items selected below to associated Building Permit) <br /> SYSTEM DEVELOPMENT FEES: _ '� ,4F TRAFFIC MITIGATION FEES: <br /> YES,Water: $©.4® 0 YES, $ <br /> Sewer: $_ O.00S"fOrMAJ `/1175► I 0 See Attached Spreadsheet for calculations/credit <br /> 0 See Attached Spreadsheet for calculations/credit *KNOT REQUIRED <br /> ❑ NOT REQUIRED <br /> Additional Checklists: ''r <br /> ADDRESS LETTER REQUIRED? (If yes(new a igned address), print out Address Letter from TRAKiT Print Menu and include) <br /> YES-TYPE 417() 5725 / Ont1-8 <br /> ggiSee Attached Letter,2 copies(Permit Techs to issue one co y tp applicant with permits, scan one copy to Jeffrey Marks) <br /> 'Digital copy attached to permit record, Permit#PA.//g/0-0q/ <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES-Type <br /> KNOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> 'EYES, Pe mit#PwJ3/o-py <br /> g Stormwater NPDES T-b Completed in TRAKiT ]KADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT /V/fl <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: IA Alit S. aidliA, Date: f0 /5/zei' <br /> Worksheet Checked By Date: /41//3 20!Es <br /> REVISED 8/6/2018 <br />