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LI EVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 4624 RIVERFRONT BLVD_.[ '# Permit#: C1908-006 <br /> TENANT: OVERLOOK AT RIVERFRONT 4P10108-62 <br /> DESCRIPTION OF WORK: NEW SFR 2015 IRC-RB1810-002 <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 /> 11 New Connection to main plus connections to building 0 New Connection, Size -❑ Per Cost Estimate <br /> ❑Alteration Et'Meter Only, Size g/H tI -0 Per Cost Estimate <br /> ❑ Repair Hi Water System Development Fee Total:$ ://5 •❑Cap-off,quantity Sewer System Development Fee Total: $ ,I2-L t9 <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: $ 0 Backflow Prevention (Outside Building): ❑ DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA 1ZNOT REQUIRED <br /> KNOT REQUIRED Explanation/Utility Permit#: <br /> Explanation/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 /> lit 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) CIRPBA(for Domestic service) 0 DCDA(for Fire service) <br /> KNOT 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 /> DYES, Stormwater Total:$ 6 ❑YES,Traffic Mitigation Total:$ <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for c-Iculafons/cre•it <br /> )'AII Hard Surface Fees to be added to Permit# GI908-006 RI NOT REQUIRED • • At <br /> El See Attached Spreadsheet for calculations/credit ,r+ '�O'l2 <br /> ❑ NOT REQUIRED 22161111 65/ PU /428 ��iV 7 <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> EYES-TYPE: VI SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING ❑ MULTI-FAMILY ❑ COMMERCIAL <br /> ICSee Attached Letter,2 copies(Permit Techs to i sue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> Pi Digital copy attached to permit record, Permit#ru)IQO$-02o <br /> IiSaved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES-Type <br /> 1NOT REQUIRED <br /> Reason: F(IZE CWDE, G)'/nl 350' QF`F1 <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> la/YES, Permit#PW HO '-O2- <br /> SrStormwater NPDES Tab Completed in TRAKiT 'ADA Tab Completed in TRAKiT (Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED p <br /> Worksheet Completed By: hu'h& Date: g/`p/o!1 <br /> Worksheet Checked By: Date: <br /> REVISED 4/24/2019 <br />