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PUKE WORKS REVIEW WORKS-EET <br /> PROJECT ADDRESS: 1816 WETMORE AVE Permit#: C1808-004 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: SFR ADDITION, BATHROOM&BEDROOMS <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 SER E: (Not Including Cost Estimates) <br /> ❑ New Connection 0 New Connection,Siz- <br /> ❑Alteration 0 Meter Only, Size <br /> ❑ Repair 0 Backflow Preve on (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ Cap-off g-NOT REQUIR' <br /> ❑ Reconnect Explanation/U 'ity Permit#: <br /> ®-NOT REQUIRED <br /> Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE S' RVICE: (Not Including Cost Estimates) <br /> ❑ New Connection,Size 0 N-, Connection, Size <br /> ❑ Meter Only, Size 0 3/ Detect Meter Only, Service Size <br /> ❑ Backflow Prevention(Outside Building): 0 DCVA ■ :ackflow Prevention(Outside Building): 0 DCDA <br /> NOT REQUIRED - OT REQUIRED <br /> Explanation/Utility Permit#: Explanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW viewer 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:II 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 /> SNOT REQUIRED <br /> Building Permits (Note:Permit Technicians • 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 talc i lations/credit pf NOT REQUIRED <br /> id NOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If y•s(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑YES—TYPE <br /> ❑See Attached Letter,2 co,ies(Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> ❑ Digital copy attached to ermit record,Permit# <br /> KNOT REQUIRED <br /> FIRE SPRINKLERS RE 0 UIRED <br /> ❑YES—Type <br /> 1S-NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT -EP UIRED? <br /> .YES, Permit#PW /810^ 03 f, <br /> I, Stormwater NPDES Tab Completed in TRAKiT ItADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed :y,= %'- --�� �'� Date: /O(ic,4o1 2) <br /> Worksheet Checked By: ›JAW\-Cb•----11ANVkivVDate: L© �5 _1M46 <br /> REVISED 8/6/2018 <br />