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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 6309 BEECH ST Permit#: C1904-007 <br /> TENANT: [fenName] <br /> DESCRIPTION OF WORK: NEW,2-STORY, DETACHED ADU <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 /> ❑ New Connection to main plus connections to building 0 New Connection,Size - 0 Per Cost Estimate <br /> ❑Alteration 0 Meter Only, Size -0 Per Cost Estimate <br /> 0 Repair 0 Water System Development Fee Total: $ <br /> 0 Cap-off, quantity 0 Sewer System Development Fee Total:$ <br /> 0 Reconnection to stub 0 Water Service Line(behind meter), Size <br /> 0 Backwater Valve 0 Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> OP NOT REQUIRED I 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 W Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total: $ 0 Backflow Prevention (Outside Building): ❑ DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA exNOT REQUIRED <br /> NOT REQUIRED Explanation/Utility Permit#: <br /> xplanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-Of yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> II 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 /> SNOT 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 /> YES, Stormwater Total: $ 44, y-ti ❑YES,Traffic Mitigation Total: $ <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surfacesp fee on PW Permit) 0 See Attached for calculations/credit <br /> ❑All Hard Surface Fees to be added to Permit# 41..1/9/0 —o Fe NOT REQUIRED <br /> .XSee Attached Spreadsheet for calculations/credit <br /> ❑ NOT REQUIRED <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 /> ❑See 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# <br /> ❑Saved to Address Folder in Development Tech File <br /> NII NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> [SOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> b'YES, Permit#PW (q(0—dam <br /> ❑ Stormwater NPDES Tab ompleted in TRAKiT 0 ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: , 2— /__ Date: 0J /5 <br /> Worksheet Checked By: / Date: <br /> REVISED 4242019 <br />