4612 RIVERFRONT BLVD 2020-12-23 - Laserfiche WebLink

im E V E R E T T PUBLIC WORKS REVIEW WORKSHEET mom WASHINGTON PROJECT ADDRESS: 4612 RIVERFRONT BLVD - 115 Permit#: C1907-016 TENANT: OVERLOOK AT RIVERFRONT f rt "&ICA DESCRIPTION OF WORK: NEW SFR/2015 IRC-RB1810-001 �" 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.) 'New Connection to main plus connections to building ❑ New Connection, Si 0 Per Cost Estimate ❑Alteration $'Meter Only, Size S q -0 Per Cost Estimate ❑ 'Repair F Water System Development Fee Total: $ t1 ' El Cap-off, quantity Sewer System Development Fee Total: $ Sit /,93 ❑ Reconnection to stub 0 Water Service Line(behind meter), Size ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA ❑ NOT REQUIRED 0 NOT REQUIRED Explanation/Utility Permit#: Explanation/Utility Permit#: 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 ❑3/4"Detect Meter Only, Service Size . ❑Water System Development Fee Total:$ 0 Backflow Prevention(Outside Building): 0 DCDA ❑ Backflow Prevention (Outside Building): 0 DCVA 1 'NOT REQUIRED KNOT REQUIRED Explanation/Utility Permit#: Explanation/Utility Permit#: WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) ❑Yes, Quantity , See attached for reference. KNOT 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) SNOT REQUIRED Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: EYES, Stormwater Total:$ 622.°° ❑YES,Traffic Mitigation Total:$ ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calculations/credit grAII Hard Surface Fees to be added to Permit# e,19a-016 13('NOT REQUIRED— „ , h1: ❑ See Attached Spreadsheet for calculations/credit ❑ NOT REQUIRED it is ( I5ifi P6/ /�7,1b 4 N196) Additional Checklists: ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) ISrYES-TYPE: 1'SFR 0 DUPLEX 0 ADU ❑ INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL zi See Attached Letter, 2 copies (Permit Techs to issue one co y to applicant with permits, scan one copy to Jeffrey Marks) N Digital copy attached to permit record, Permit#PLU140 '-O9y Saved to Address Folder in Development Tech File • ❑ NOT REQUIRED FIRE SPRINKLERS REQUIRED? ❑YES-Type KNOT REQUIRED Reason: SIRE me, 1W01/4 0O orrti PUBLIC WORKS PERMIT REQUIRED? W YES, Permit#PW IqO+-0�{q 'Stormwater NPDES Tab Completed in TRAKiT ItADA Tab Completed in TRAKiT $Inspections Added in TRAKiT ❑ NOT REQUIRED fa Worksheet Completed By: (- �,ldl - Date: Y1217Z81, Worksheet Checked By: Date: REVISED 4/24/2019