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�y. PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 4610 31ST AVE SE Permit#: C1904-015 <br /> TENANT: OVERLOOK AT RIVERFRONT -tu ti otl—b6( <br /> DESCRIPTION OF WORK: NEW SFR/2015 IRC RB1810-002 "" <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 I connections to building 0 New Connection, Si 4e -0 Per Cost Estimate <br /> ❑Alteration Meter Only, Size 3M" -0 Per Cost Estimate 0 <br /> ❑ Repair tit Water System Development Fee Total: $ 3f q5�: <br /> ❑ Cap-off, quantity El Sewer System Development Fee Total: $. ,121. e f <br /> ❑ Reconnection to stub 0 Water Service Line(behind meter), Size <br /> ❑ Backwater Valve 0 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 'Qf NOT REQUIRED <br /> EL NOT 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 /> ($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 /> IA 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 /> 13 YES, Stormwater Total: $ 622.00 On Clgoq-0I$ 0 YES,Traffic Mitigation Total: $ <br /> 0 See Attached Spreadsheet for calculations 0 See AttachedASpr adsheet for calculations/credit <br /> ❑ NOT REQUIRED Z?.66. -10111 +625 NPb, 438 �� SNOT REQUIRED W� fait M Pw11o5_oLf L <br /> Additional Checklists: ! E�) T <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> '$YES-TYPE: 1%SFR 0 DUPLEX 0 ADU ❑ INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> 18'See Attached Letter, 2 copies(Permit Techs to isue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> tt Digital copy attached to permit record, Permit# 419011-060 <br /> Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> SNOT REQUIRED / <br /> Reason: FIRE GQDEi W kl 350 aF Fl4• <br /> PUBLIC WORKS PERMIT REq UIRED? <br /> Vi YES, Permit#PW 1104-061 <br /> Stormwater NPDES Tab Completed in TRAKiT 1 'ADA Tab Completed in TRAKiT ♦Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED �`''//n,, ,,Worksheet Completed By: T 4f'Z G &. Date: fi45/2.0t <br /> Worksheet Checked By: Date: <br /> REVISED 2/22/2019 <br />