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• <br /> EVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> Imo WASHINGTON <br /> PROJECT ADDRESS: 1622 E MARINE VIEW DR BLDG F Permit#: B1812-031 <br /> TENANT: RIVERVIEW APTS <br /> DESCRIPTION OF WORK: NEW APT BLDG,4 STORY,24 UNIT(#F, 6 OF 9) <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (Note:Permit Technicians to Create Utility Permit f er5Water�Fire, and Irrigation, as selected below) <br /> /SANITARY SEWER: OMESTIC WA ER SERVICE: (Attach Calculation&Cost Est.) <br /> ❑ New Connection to main plus connections to building ❑ New Connection, Size - 0 Per Cost Estimate <br /> ❑Alteration Meter Only, Size a" -❑ Per Cost Estimate <br /> ❑ Repair ❑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 ❑ Backflow Prevention (Outside Building): 0 RPBA or❑ DCVA <br /> 'S[NOT REQUIRED '1 p� pp�� 0 NOT REQUIRED sys dpy Are wlle$t a <br /> Explanation/Utility Permit#: 0; On da9 S U�W�'b?� Explanation/Utility Permit#:tiafhwitici, sewer rein'IF. <br /> t/ IRRIGATION SERVICE: (Not Including Cost Estimates) A,GKRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size ❑ New Connection, Size -❑ Per Cost Estimate <br /> ❑ Meter Only, Size 3/" Detect Meter Only, Service Size an <br /> ❑Water System Development Fee Total: $ 0 Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA 0 NOT REQUIRED <br /> lii(NOT REQUIRED Explanation/Utility Permit#: (A('11? O(q <br /> Explanation/Utility Permit#: <br /> V4ATER DEPARTMENT COST ESTIMATE NEEDED-Of yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> 1K NOT REQUIRED ed art S <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): 'aDCVA(for Domestic service) 0 RPBA(for Domestic service) $(DCDA(for Fire service) <br /> ❑ NOT REQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> VITORMWATER SYSTEM DEVELOPMENT FEES: �RAFFIC MITIGATION FEES: ,f <br /> 1tt YES, Stormwater Total: $ a a 33.55 . . $,gSOsi' of ftrdF � �(YES,Traffic Mitigation Total:$2 ,968, <br /> 'Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calculations/credit <br /> ❑All Hard Surface Fees to be added to Permit# 0 NOT REQUIRED ctli offEttil. art gtj 3 <br /> ❑See Attached Spreadsheet for calculations/credit JJ <br /> ❑ NOT REQUIRED BIg12-o3I 61S1i-O31 <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: 0 SFR ❑ DUPLEX 0 ADU 0 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 Ad ress Folder in Development Tech File <br /> *NOT REQUIRED . % , T-tin Kolwl-oi'i <br /> tl FIRE SPRINKLERS REQUIRED? <br /> (YES-Type (3(1- <br /> ❑ NOT REQUIRED <br /> Reason: frtRg COlpt✓ <br /> /PUBLIC WORKS PERMIT REQUIRED? <br /> 'EYES, Permit#PWIgp . 1a <br /> $�Stormwater NPDES Tab Completed in TRAKiT '$rADA Tab Completed in TRAKiT 'Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: j+ Date: 6, <br /> P5-1(ierl <br /> Worksheet Checked By: Date: <br /> REVISED 4/24/2019 <br />