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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> MEM WASHINGTON <br /> PROJECT ADDRESS: 1622 E MARINE VIEW DR BLDG G Permit#: B1812-032 <br /> TENANT: RIVERVIEW APTS <br /> DESCRIPTION OF WORK: NEW APT BLDG 3 STORY,4 UNIT, 12 BAY GARAGE(#G, 7 OF 9) <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (Note:Permit Technicians to Create Utility Permit for <br /> ,��Seyy r Waatter,r,�Fire, and Irrigation, as selected below) <br /> "'SANITARY SEWER: D 4AEgfiC 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 LAItT Meter Only, Size In -0 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): ❑ RP Corr 0D CVA <br /> NOT REQUIRED " ` -t^ 0 NOT REQUIRED S s deli -for Mete, <br /> Explanation/Utility Permit#: att� cm '6\Qq 3 a 14O74g0 Explanation/Utility Permit#: caetutek oft S 1 r K(mi� <br /> /IRRIGATION SERVICE: (Not Including Cost Estimates) SIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size 0 New Connection, Size - Ccot Estimate <br /> ❑ Meter Only, Size s 3/4" Detect Meter Only, Service Size ` I <br /> ❑Water System Development Fee Total:$ ❑ Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA j] NOT REQUIRED <br /> W NOT REQUIRED Explanation/Utility Permit#: <br /> Explanation/Utility Permit#: <br /> B/VNATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> ,' .NOT REQUIRED am \ 5 <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): E DCVA(for Domestic service) 0 RPBA(for Domestic service) DCDA(for Fire service) <br /> ❑ NOT REQUIRED ?Rog <br /> ,0l i <br /> llding Permits6(Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> VSTORMWATER SYSTEM DEVELOPMENT FEES: vTRAFFIC MITIGATION FEES: <br /> idYES, Stormwater Total:$ $11. -Ar 263sr t Yrof EYES,Traffic Mitigation Total: $ `i �f►/, D <br /> /A Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calcul tions/cr,edit <br /> ❑All Hard Surface Fees to be added to Permit# 0 NOT REQUIRED ail if' an 814 T <br /> ❑ See Attached Spreadsheet for calculations/credit <br /> ❑ NOT REQUIRED Bi$12-032 81$12-032 <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 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 Address Folder in Development Tech File <br /> X NOT REQUIRED Wj 131d9 1=pn FUUI809--011 <br /> y'FIRE SPRINKLERS REQUIRED? <br /> ii(YES-Type 13 <br /> ❑ NOT REQUIRED <br /> Reason: ri/ZE ape <br /> C43UBLIC WORKS PERMIT REQUIRED? <br /> EYES, Permit#PWIS09-01'� <br /> lErStormwater NPDES Tab Completed in TRAKiT ISf ADA Tab Completed in TRAKiT Er Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: Date: b/ <br /> 12g 20/1 <br /> Worksheet Checked By: Date: <br /> REVISED 4/24/2019 <br />