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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 4623 31ST AVE SE --torte/41 Permit#: C1907-012 <br /> TENANT: OVERLOOK AT RIVERFRONT I VV (�O9 -el -15 <br /> OF WORK: NEW SFR/2015 IRC-RB1810-003 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 /> IdNew Connection to main plus 1 connections to building 0 New Connection, Si - 0 Per Cost Estimate <br /> ❑Alteration 'Meter Only, Size 3 n -0 Per Cost Estimate <br /> ❑ Repair E(Water System Development Fee Total:$ 31g5 ,ffi <br /> ❑Cap-off, quantity .Sewer System Development Fee Total: $ 5 (2 ,L9 <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 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 Ig NOT REQUIRED <br /> KNOT 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 /> SNOT 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) ❑ DCDA(for Fire service) <br /> KNOT 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 /> EYES, Stormwater Total: $ 622.02 0 YES,Traffic Mitigation Total: $ <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on P Permit) 0 See Attached for calcul-tions/cr dit <br /> '%All Hard Surface Fees to be added to Permit# (`��q(a�--Olt )31 NOT REQUIRED , , ,,n <br /> ❑ See Attached Spreadsheet for calculations/credit <br /> ❑ NOT REQUIRED ^ ats-042 <br /> 2ta54 41310 (329 4 phi, Inc* NP U <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: $(SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> ter See Attached Letter,2 copies(Permit Techs to issue one copyto applicant with permits, scan one copy to Jeffrey Marks) <br /> NI Digital copy attached to permit record, Permit#1W14707-0145 <br /> Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> 0 YES-Type <br /> ''NOT REQUIRED <br /> Reason: Flyebvci 4,1(1%,‘ so' of FR <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> EYES, Permit#PW19O-"0 <br /> lai;'Stormwater NPDES Tab Completed in TRAKiT l 'ADA Tab Completed in TRAKiT '8(Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED e <br /> Worksheet Completed By: 1 0��,,./ Date: -l9(1l061 tay <br /> Worksheet Checked By: Date: <br /> REVISED 4/24/2019 <br />