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LE V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> I WASHINGTON <br /> PROJECT ADDRESS: 4621 31ST AVE SE -term Permit#: C1907-011 <br /> TENANT: OVERLOOK AT RIVERFRONT 1.IL f�} -114fiA <br /> DESCRIPTION OF WORK: NEW SFR/2015 IRC-RB1810-004 � l V" <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 /> i 'New Connection to main plus connections to building 0 New Connection, Si e -0 Per Cost Estimate <br /> ❑Alteration Meter Only, Size y�r -❑ Per Cost Estimatt <br /> ❑ Repair IS Water System Development Fee Total: $ 3fQ5/',� <br /> ❑ Cap-off, quantity 1111 Sewer System Development Fee Total: $ 5,/2/.9$ <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 ❑W Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total:$ ❑ Backflow Prevention(Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA KNOT REQUIRED <br /> SNOT 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 /> i'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 /> '4 NOT REQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> AYES, Stormwater Total: $ 622.99- ❑YES,Traffic Mitigation Total: $ <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for alcul tions <br /> IR All Hard Surface Fees to be added to Permit# Cl o -011 *NOT REQUIRED— �2 <br /> ❑ See Attached Spreadsheet <br /> /c <br /> readsheet for calculationsredit <br /> ❑ NOT REQUIRED 1962 1.1744( 6� pal 1, 02 r NP4) <br /> Additional Checklists: l <br /> �A,,(DDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> y0F YES-TYPE: I 'SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> 11 See Attached Letter,2 copies(Permit Techs to issue one copy t9 applicant with permits, scan one copy to Jeffrey Marks) <br /> Eir Digital copy attached to permit record, Permit# fG ng0-1 04/ <br /> 0 Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES-Type <br /> trNOT REQUIRED <br /> Reason: file thittei WIN �i' Cr Ft! <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> 78(YES, Permit#PW 1407-O I'f <br /> Stormwater NPDES Tab Completed in TRAKiT 1ADA Tab Completed in TRAKiT ®:Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED 47/WOICIWorksheet Completed By: Date: <br /> Worksheet Checked By: Date: <br /> REVISED 4/24/2019 <br />