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PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 7910 FOREST GLADE Permit#: PW1808-068 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (Note:Permit Technic ans 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 /> Ip'Alteration it .O 0 Meter Only, Size <br /> ❑ Repair 0 Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ Cap-off Of NOT REQUIRED <br /> ❑ Reconnect Explanation/Utility Permit#: <br /> ❑ NOT 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 0 3/4" Detect Meter Only, Service Size <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA 0 Backflow Prevention (Outside Building): 0 DCDA <br /> g'NOTIp <br /> REQUIRED 'NOT REQUIRED <br /> planation/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 /> KNOT REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add ll items selected below to Plumbing Permit) <br /> I�Water Service Line(behind meter), Size 3*'' <br /> ❑ Backflow Prevention (Inside Building): 0 D VA(for Do estic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> ❑ NOT REQUIRED <br /> Building Permits (Note:Permit Tech icians to add all items selected below to associated Building Permit) <br /> • <br /> TEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> AYES,Water: $ gojo .o N67_ .wic.d. 0 YES, $ <br /> Sewer: $ / C' /, p 0 0 See Attached Spreadsheet for calculations/credit <br /> ❑ See Attached Spreadsheet for calculations/credit YNOT 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 /> D YES-TYPE ./1-"ALI <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# 77CtJ/ 2fo g- 0 6z? <br /> NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> N❑ ES-Type <br /> OT REQUIRED <br /> eason: <br /> LIC WORKS PERMIT REQUIRED? <br /> YES, Permit#PW /4.clA o—O a P <br /> ❑Stormwater NPD Completed in TRAKiT 0 ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br /> W 4 REQUIRED _ <br /> Worksheet Completed By: '= , Date: �/2 g/�12 <br /> Worksheet Checked By: A . �1 Date: R�/Z4//Qi <br /> REVISED 8/6/2018 <br />