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• i <br /> EVE R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> omm WASHINGTON <br /> PROJECT ADDRESS: 4617 RIVERFRONT BLVD—urr 4V1OS Permit#: C1908-003 <br /> TENANT: OVERLOOK AT RIVERFRONT k etA)I9OS-OI6 <br /> DESCRIPTION OF WORK: NEW SFR/2015 IRC-RB1811-001 <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 /> 1R/New Connection to main plus ' connections to building 0 New Connection, Size -0 Per Cost Estimate <br /> ❑Alteration 5d'Meter Only, Size 3/911 -0 Per Cost Estimate <br /> ❑ Repair st Water System Development Fee Total: $ 3 cf l <br /> ❑Cap-off, quantity aSewer System Development Fee Total: $ 4 j21,'L� <br /> ❑ Reconnection to stub 0 Water Service Line(behind meter), Size <br /> ❑ Backwater Valve ❑ 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: $ ❑ Backflow Prevention(Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA SNOT REQUIRED <br /> tii 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 /> SNOT 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) ❑ 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 /> AYES, Stormwater Total:$ 62,2,,20, ❑YES,Traffic Mitigation Total:$ <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) ❑See Attached for calculations/cre 't <br /> ❑All Hard Surface Fees to be added to Permit# QACIOK-1303 SNOT REQUIRED u <br /> ❑ See Attached Spreadsheet for calculations/credit 1,, 5„�-tZ <br /> ❑ NOT REQUIRED g� 4' i ( 613 n6 , 1�,6 ill N� tit <br /> Additional Checklists: i' <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> 'YES-TYPE: XSFR 0 DUPLEX 0 ADU ❑ INFILL DWELLING 0 MULTI-FAMILY ❑COMMERCIAL <br /> SSee 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# PW(903-0/6 <br /> KSaved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES-Type <br /> SNOT REQUIRED <br /> Reason: ft Qpvivri (,j((rI 351 OF- PI <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> E1YES, Permit#PW ft.j(908-fll6 <br /> Stormwater NPDES Tab C mpleted in TRAKiT VtADA Tab Completed in TRAKiT PeInspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: Date: <br /> Worksheet Checked By: Date: <br /> REVISED 4/24/2019 <br />