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PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 4524 31ST AVE SE Permit#: C1901-002 <br /> TENANT: OVERLOOK AT RIVERFRONT * 9601901-O3* <br /> DESCRIPTION <br /> WI9OI-O- <br /> DESCRIPTION OF WORK: NEW SFR-LOTPW 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 /> jP(New Connection to main plus I connections to building 0 New Connection, Si e - 0 Per Cost Estimate <br /> ❑Alteration RE Meter Only, Size 3/q" -0 Per Cost Estimate <br /> ❑ Repair g Water System Development Fee Total:$ q57 00 <br /> ❑Cap-off, quantity $(Sewer System Development Fee Total: $ <br /> ❑ Reconnection to stub ❑ Backflow Prevention(Outside Building): 0 PBA 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:$ ❑ Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA 1S(NOT 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 /> }S(NOT REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit) <br /> Water Service Line(behind meter), Size .7p1 <br /> ❑ Backflow Prevention (Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) ❑ DCDA(for Fire service) <br /> ❑ 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 /> 11(YES, Stormwater Total: $ 622,°= DYES,Traffic Mitigation Total: $ <br /> fJ See Attached Spreadsheet for calculations 0 See Attache Spreadsheet for�c�allq�ulations/credit <br /> ❑ NOT REQUIRED NOT REQUIRED- f� i a'vl PGLII705-o%1 <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> )al YES-TYPE: 14SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> 124.See Attached Letter,2 copies (Permit Techs to is ue one copy to applicant with permits,scan one copy to Jeffrey Marks) <br /> Digital copy attached to permit record, Permit#_MR01-p3 Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES-Type <br /> ,NOT REQUIRED <br /> Reason: FIRE cADE I W ITHIN 3501 of FA <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> EYES, Pe mit#PW Pld-O- <br /> 'M Stormwater NPDES Tab Completed in TRAKiT WADA Tab Completed in TRAKiT EInspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: `jOlJL Date: I-16-20/9 <br /> Worksheet Checked By: Date: <br /> REVISED 1/7/2019 <br />