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PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 4524 RIVERFRONT BLVD Permit#: C1902-004 <br /> TENANT: OVERLOOK AT RIVERFRONT <br /> DESCRIPTION OF WORK: NEW SFR DETACHED/2015 IRC <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: (Attach Calculation&Cost Est.) <br /> 'KNew Connection to main plus I connections to building 0 New Connection,Si -0 Per Cost Estimate <br /> ❑Alteration 6d'Meter Only, Size 3 0 Per Cost Estimate <br /> ❑ Repair liirWater System Development Fee Total:$ 395 � <br /> 0 Cap-off, quantity Sewer System Development Fee Total: $ 5'!L,/ <br /> ❑ Reconnection to stub 0 Water Service Line(behind meter), Size <br /> ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ NOT REQUIRED 0 NOT REQUIRED <br /> Explanation/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 ❑%" Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total:$ ❑ Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention(Outside Building): 0 DCVA `SNOT REQUIRED <br /> KNOT REQUIRED Explanation/Utility Permit#: <br /> 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 /> YSI 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 /> it NOT REQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> S7tbRMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ES, Stormwater Total:$ 62,2.1% 0 YES,Traffic Mitigation Total: $ <br /> 0 See Attached Spreadsheet for calculations 0 See Attache Spre dsheet for calculati ns/ redit <br /> ❑SNOT REQUIRED 21. 1 '6{14 //,56 941 1556 14'NOT REQUIRED-�� <br /> lW <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> EYES—TYPE: '13'SFR 0 DUPLEX 0 ADU ❑ INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> KSee 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#1903-050 <br /> fit Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> StNOT REQI/IRED I <br /> Reason: A)/'11 fb0 tcze.0 <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> IVES, Permit#PW 1903—O50 <br /> Stormwater NPDES b Completed in TRAKiT ADA Tab Completed in TRAKiT WInspections Added in TRAKiT <br /> ❑ NOT REQUIRED / <br /> Worksheet Completed By: fir E % Date: 3/2520/9 <br /> Worksheet Checked By: Date: <br /> REVISED 2/22/2019 <br />