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lim E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 310 OLYMPIC BLVD Permit#: C1901-018 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: ADD AN ADDITION, EXPAND KITCHEN&MASTER BATH <br /> P Reviewer to select all that apply below: <br /> tility Permits (Note:Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) <br /> ANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation&Cost Est.) <br /> ❑ New Connection to main plus connections to building ❑ New Connection, Size -❑ Per Cost Estimate <br /> 1�Alteration .--$430. - <br /> 0 <br /> 0 ❑ Meter Only, Size -❑ Per Cost Estimate <br /> ❑ Repair 0 Water System Development Fee Total: $ <br /> C] Cap off, quantity <br /> 0 Sewer System Development Fee Total: $ <br /> Q;Reconnection to stub 0 Water Service Line(behind meter), Size <br /> ❑ Backwater Valve 0 Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ NOT REQUIRED KNOT REQUIRED <br /> Explanation/Utility Permit#: u.r Explanation/Utility Permit#: <br /> Qom• <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: $ 0 Backflow Prevention (Outside Building): 0 DCDA <br /> ❑,Backflow Prevention (Outside Building): 0 DCVA IhNOT REQUIRED <br /> nit NOT REQUIRED Explanation/Utility Permit#: <br /> Explanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> Si NOT 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 /> XNOT REQUIRED <br /> Uilding Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> TORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> YES, Stormwater Total: $ zya`3+ Z$ 0 YES,Traffic Mitigation Total: $ <br /> C] Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calculations/credit <br /> lid All Hard Surface Fees to be added to Permit# Cie01-0190 KNOT REQUIRED <br /> 0 See Attached Spreadsheet for calculations/credit <br /> eNOT 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 /> ❑ Saved to Address Folder in Development Tech File <br /> Iili NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES–Type <br /> NOT REQUIRED <br /> eason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ❑YES, Pepnit#PW o 3— S' q. <br /> Stormwater N DES Tab mpleted in TRAKiT litiADA Tab Completed in TRAKiT 0 I s ections Added in TRAKiT <br /> 11 NOT REQUIRED ,r <br /> /IIA <br /> Worksheet Completed By: - A 49/ Date: p K/ 2 ' 0 `� <br /> Worksheet Checked By: -Ia A c_ / , Date: I i tg f r <br /> REVISED 4/24/2019 <br />