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_ • • <br /> im E VE R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 7909 EVERGREEN WAY Permit#: B1907-027 <br /> TENANT: MOD PIZZA <br /> DESCRIPTION OF WORK: TI-CHANGE TO FAST CASUAL DINING PIZZA INCL INT REMODEL AND <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 /> ❑ New Connection to main plus connections to building 0 New Connection, Size -0 Per Cost Estimate <br /> ❑Alteration ❑ Meter Only, Size -0 Per Cost Estimate <br /> ❑ Repair ❑Water Sys m Development Fee Total: $ <br /> ❑ Cap-off, uantity 0 Sewer S tem Development Fee Total: $ <br /> ❑ Recon ction to stub ❑Water ervice Line(behind meter), Size <br /> ❑ Back ater Valve 0 Back ow Prevention (Outside Building): 0 RPBA or❑ DCVA <br /> ei-NO REQUIRED 140 REQUIRED <br /> Expl nation/Utility Permit#: Expl nation/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 CI'A"Detec eter Only, Service Size <br /> ❑Water System Development Fee Total: $ ❑iBackflo Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow revention (Outside Building): 0 DCVA T QUIRED <br /> RIOT R UIRED Expla tion/Utility Permit#: <br /> Explanati n/Utility Permit#: <br /> WATER DE ARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br /> CI Yes, Q ntity , See attached for reference. <br /> 4.fIOT QUIRED <br /> Plu Bing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ Backflo Prevention (Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> SOT F€QUIRED <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 /> -YES, Stormwater Total: $ 2.0?- '1 0 YES,Traffi itigation Total: $ <br /> 0 Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) ,�,(��0 See ttached for calculations/credit <br /> A2,A Hard Surface Fees to be added to Permit# J teliO- 02( th[OT QUIRED <br /> 2See Attached Spreadsheet for calculations/credit <br /> ❑ NOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑YES—TYPE: ❑ SFR 0 DUPLEX ❑ADU ❑ INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> ❑ See 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# <br /> ❑ Saved to Address Folder in Development Tech File <br /> PJ4N.GT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> eYES, PO:PW /9 l 'O 2J <br /> water NPDES Tab Completed in TRAKiTA_ Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: .— Date: l0 /LI <br /> Worksheet Checked By: / ' Date: (01 I i (r <br /> eif <br /> REVISED 4/24/2019 <br />