1601 FLORIDA DR 2020-12-21 - Laserfiche WebLink

_ • E EVERETT PUBLIC WORKS REVIEW WORKSHEET mom WASHINGTON PROJECT ADDRESS: !cot Ftegi Di4 pg. Permit#:C l°I06' O12 TENANT: NI p��1o�06-O41- DESCRIPTION OF WORK: srr-e WOiZK rag, N ej SFR. (tar io f W PW Reviewer to select all that apply below: Utility Permits (Note:Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) SANITARY SEWER: DOMESTIC WATER SERVICE:(Attach Calculation&Cost Est.) At New Connection to main plus I connections to building p New Connection,Size -0 Per Cost Estimate 0 Alteration Meter Only,Size J''DornIARE 0 Per Cost Estimate ❑ Repair Ali: Water System Development Fee Total:$ $i 951.s-• 0 Cap-off,quantity IAN Sewer System Development Fee Total:$ 5, 12.1.O° ❑ Reconnection to stub ii i Water Service Line(behind meter),Size I ' 0 Backwater Valve 0 Backflow Prevention(Outside Building):CI RPBA or 0 DCVA ❑ NOT REQUIRED ❑ NOT REQUIRED Explanation/Utility Permit#: U l i 11'BOA ✓'explanation/Utility Permit#: l,,C l'11'tJO V IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE (Attach Cost Estimate/Request for Reference) ❑ New Connection,Size 0 New Connection,Size -0 Per Cost Estimate ❑Meter Only,Size 0 W Detect Meter Only, Service Size ❑Water System Development Fee Total:$ 0 Backflow Prevention(Outside Building): ❑DCDA ❑ Backflow Prevention(Outside Building): CI DCVA %/)KNOT REQUIRED ,2NOT REQUIRED Explanation/Utility Permit#: Explanation/Utility Permit#: WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) ❑Yes,Quantity ,See attached for reference. ✓�NOT REQUIRED Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) ❑ Backflow Prevention(Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) a/li NOT REQUIRED Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: 01YES,Stormwater Total:$ 6Z.°—� ;yi'YES,Traffic Mitigation Total:$ 2100, 0 Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Perm ) 0 See Attached for calculations/credit ❑All Hard Surface Fees to be added to Permit# CI906-012. 0 NOT REQUIRED ❑See Attached Spreadsheet for calculations/credit Nv.,) SPA, NO CREDIT 0 NOT REQUIRED 39 3 NQ6 Additional Checklists: ADDRESS LETTER REQUIRED? (If yes(new assigned address),print out Address Letter from TRAKiT Print Menu and include) GATYES—TYPE: 0 SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL a See Attached Letter,2 copies(Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) VAR' copy attached to permit record, Permit# PW I1O6—0414 la Saved to Address Folder in Development Tech File ❑ NOT REQUIRED F E SPRINKLERS REQUIRED? YES—Type IS D 0 NOT REQUIRED Reason:FiR6 CADE PEIC Stieg% POW REQUliter ENTS PUBLIC WORKS PERMIT RE UIRED? YES,Permit#PW igo6-oda. at Stormwater NPDES Tab Completed in TRAKiT ADA Tab Completed in TRAKiT iI3(Inspections Added in TRAKiT 0 NOT REQUIRED Worksheet Completed By: ,,!z4 Date: 9112I2019 Worksheet Checked By: Date: REVISED 4/24/2019