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• <br /> RE E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 901 W CASINO RD Permit#: PW2012-001 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: ADA UPGRADES, REPAVING/RESTRIPING ACCESSIBLE PARKING <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 -❑ Per Cost Estimate <br /> ❑ Repair 0 Water System Development Fee Total:$ <br /> ❑ Cap-off,quantity ❑Sewer System Development Fee Total: $ <br /> ❑ Reconnection to stub ❑Water Service Line(behind meter),Size <br /> ❑ Backwater Valve 0 Backflow Prevention (Outside Building): 0 RPBA or❑ DCVA <br /> kl NOT REQUIRED ¢1 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 ❑ New Connection, Size -0 Per Cost Estimate <br /> ❑ Meter Only, Size 0%"Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total:$ ❑ Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA t4 NOT REQUIRED <br /> 21 NOT REQUIRED Explanation/Utility Permit#: <br /> Explanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> ISI 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) 0 RPBA(for Domestic service) ❑ DCDA(for Fire service) <br /> NI NOT 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 /> PI YES,Stormwater Total: $ 159.94 0 YES,Traffic Mitigation Total:$ <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calculations/credit <br /> [2]All Hard Surface Fees to be added to Permit# 2012-001 NOT REQUIRED <br /> See 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: 0 SFR 0 DUPLEX 0 ADU ❑ INFILL DWELLING 0 MULTI-FAMILY ❑ 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 /> NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> Ills NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> YES, Permit#PW 2012-001 <br /> ❑Stormwater NPDES Tab Completed in TRAKiT Oil ADA Tab Completed in TRAKiT Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: AH Date: 12/15/20 <br /> Worksheet Checked By: TN Date: 12/15/20 <br /> REVISED 11/27/2019 <br />