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0 E V E R E T T 4UBLIC WORKS REVI& WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 902 HOYT Permit #: C1906-018 <br />TENANT: [TenName] <br />DESCRIPTION OF WORK: 1ST LEVEL 24X24 GARAGE,2ND LEVEL 24X24 RECREATION ROOM <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 ❑ New Connection, Size - ❑ Per Cost Estimate <br />Iteration ❑ Meter Only, Size - ❑ Per Cost Estimate <br />Repair ❑ Water System Development Fee Total: $ <br />❑ Cap -off, quantity ❑ Sewer System Development Fee Total: $ <br />Reconnection to stub 7Water Service Line (behind meter), Size 3 f " <br />❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA <br />❑ NOT REQUIRED ❑ 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 - ❑ Per Cost Estimate <br />❑ Meter Only, Size ❑ %" Detect Meter Only, Service Size <br />❑ Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): ❑ DCDA <br />❑ Backflow Prevention (Outside Building): ❑ DCVA ,,NOT REQUIRED <br />W,NOT REQUIRED Explanation/ Utility Permit #: <br />Explanation/ Utility Permit #: <br />WATER DEPARTMENT COST ESTIMATE NEEDED-(/fyes, PW Reviewerto send cost estimate request to Water Department) <br />❑ Yes, Quantity See attached for reference. <br />RIOT 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): ❑ DCVA (for Domestic service) ❑ 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 />STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br />YES, Stormwater Total: $ t f8 , 2 t ❑ YES, Traffic Mitigation Total: $ <br />❑ Roof Only Fee on Bldg Permit (ground hard surfaces fee on PW Permit) ❑ See Attached for calculations / credit <br />04AII Hard Surface Fees to be added to Permit # PWt4 t2- oeaS , 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: ❑ SFR ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ 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 />&NOT REQUIRED <br />eason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />ES, Pe mit # PW 1 ? 12 •oaS' <br />,LStormwater NPDES Tab Completed in TRAKiT )!(ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />❑ NOT REQUIRED // <br />Worksheet Completed B Date: 12 G03 12.0 14 <br />Worksheet Checked By: Date: _ 6711 d3 mil <br />REVISED 1112712019 <br />