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• • <br /> PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 3214 BROADWAY Permit#: B1710-041 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: NEW 140 UNIT MULTI-FAMILY W/PARKING <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (Note:Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Inigation, as selected below) <br /> SANITARY SEWER j- DOMESTIC WATER SERVICE: (Not Including ostEstimates) <br /> O/New Connection T f io D3[New Connection, Size —9 rnds. <br /> ❑Alteration 0 Meter Only, Size <br /> ❑ Repair 0 Backflow Prevention(Outside Building): 0 RPBA or D DCVA <br /> ❑ Cap-off QNOT REQUIRED �1 <br /> 0 Reconnect Explanation/Utility Permitt SEE' east es nl .h -For ARl�+ _ <br /> ❑ NOT REQUIRED -t-' lte0 tVO, t/l. 4 sung S+�/S dW-Y.£ • <br /> Explanation/Utility Permit It: 7 <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Not Including Cost Estimates) <br /> 1 New Connection, Sizg�_ (r A \\ of col 0 New Connection, Size <br /> it Meter nly,Size I(91f °'1 m /;'Detect Meter Only, Service Size 6 a <br /> ❑ Bac ow Prevention (Outside Building): 0 DCVA 0 Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ NO REQUIRED ff � LL 0 NOT REQUIRED <br /> Expl ation/Utility Permit#: Syc cis,/ ads( 4c.. Explanation!Utility Permit#: <br /> W ER DEPARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) <br /> es, Quantity 2 , See attached for reference. / 4 p Q� JB <br /> NOT REQUIRED 6 r1 {J!R <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit) <br /> or Water Service Line(behind meter), Size /r <br /> r�,. <br /> �(Backflow Prevention (Inside Building): . 'DCVA(for Domestic service) 0 RPBA(for Domestic service) ti DCDA(for Fire service) <br /> ❑ NOT REQUIRED <br /> • ! <br /> Building Permits (Note:Permit Technicians to add all it ms elected below to associated Building Permit) <br /> SYSTEM DEVELOPMENT FEES: 9f ao TRAFFIC MITIGATION FEES: <br /> ❑YES,Water:$__ _ J �—' DYES, $ / <br /> Sewer:$ I4 4" '0. SX a!07$7 0 See Attached Spreadsheet for calculations/credit <br /> 1A14 See Attached Spreadsheet for calculations!credit Q 0 NOT c-�i REQUIREED' <br /> O NOT REQUIRED 5Z�F» L " -'-c- �Q 62lg�� 3_9,Jr41J. 27(/ ®, 2.4Z.S?A{) <br /> Additional Checklists: / <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> IVES-TYPE <br /> It See Attached Letter, 2 copies(Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> 117 Digital copy attached to permit record, Permit# /q'OS —02� <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> DYES-Type 7 <br /> ❑ NOT REQUIRED <br /> Reason: "Fu/LL- Co Tl ita- <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> YES, Permit#PW nro - D 2- 7' <br /> �.Stormwater NPDES Tab Completed in TRAKiT S ADA Tab Completed in TRAKiT '$d.Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED ��yyyy�� """" �ny� -7� <br /> Worksheet Completed By: n y�r1 j31-5��.74/0 S Date: rp /!�7/7 <br /> Worksheet Checked By: �JI�(J7/] ( J(�V/�,�,C.�{/_ Date: 119 91 W 1 I <br /> REVISED 8/82018 t <br />