1412 HOYT AVE 2022-02-16 - Laserfiche WebLink

E VE R E T T PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: 1412 HOYT AVE Permit #: C1804-005 TENANT: [TenName] I S 5;� DESCRIPTION OF WORK: NEW SFR PW Reviewer to select all that apply below: If out ` 0 0/0 Utility Permits (Note: Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) SANITARY SEWER: DOMESTIC WATER SERVI E: (Attach Calculation & Cost Est.) New Connection to main plus _connections to building ew Connection, Size- - ❑ Per Cost Estimate ❑ Alteration Meter Only, Size - ❑ Per Cost Estimate ❑ Repair Water System Development Fee Total: $115t" ,. ❑ Cap -off, quantity #rSewer System Development Fee Total: ❑ Reconnection to stub JVWater Service Line (behind meter), Size ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA ❑ NOT REQUIRED ❑ NOT REQUIRED Explanation/ Utility Permit #: —cISsop'a ►I Explanation/ Utility Permit #: " nw DFi►'Yn� —U 05-031 IRRIGATION SERVICE: (Not InchYding C b t Estima tes) ates) FIRE SERVICE: (Attach Cost Estimate /Request for Reference) ❑ New Connection, Size ❑ New Connection, Size - ❑ Per Cost Estimate ❑ Meter Only, Size ❑'/" Detect Meter Only, Service Size ❑ Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): ❑ DCDA ❑ Backflow Prevention (Outside Building): ❑ DCVA ONOT REQUIRED (NOT REQUIRED Explanation/ Utility Permit #: Explanation/ Utility Permit #: WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) ❑ Yes, Quantity See attached for reference. NOT REQUIRED Plumbing Permits (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) ❑ Backflow Prevention (Inside Building): ❑ DCVA (for Domestic service) ❑ RPBA (for Domestic service) ❑ DCDA (for Fire service) 1S NOT REQUIRED Building Permits (Note: Permit Technicians to add all items selected below to associated Building Permit) STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: ❑ YES, Stormwater Total $ ❑ YES, Traffic Mitigation Total: $ ❑ Roof Only Fee on Bldg Permit (ground hard surfaces fee on PW Permit) ❑ See Attached for calculat)ops / credit ❑ All Hard Surface Fees to be added to Permit # )d NOT REQUIRED 'tom.—}ih`nJ Lot ❑ See Attached Spreadsheet for calculations / credit NOT REQUIRED Additional Checklists: ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) YES — TYPE: IN SFR ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY ❑ COMMERCIAL 19 See Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with pennits, scan one copy to Jeffrey Marks) 9 Digital copy attached to permit record, Permit # ® Saved to Add re s Fol er in DevelopmentTech File �,ryp NOT REQUIRED � FIRE SPRINKLERS REQUIRED? ❑ YES —Type ONOT REQUIRED Reason: PUBLIC WORKS PERMIT REQUIRED? El YES, Permit # PW WStormwater NPDES Tab Completed in TRAKiT 19(ADA Tab Completed in TRAKiT Irl nspections Added in TRAKiT ❑ NOT REQUIRED /�►)' !/j �/7, '//J/J�� Worksheet Completed By: Date: Worksheet Checked By: Date: 119 REVISED 412412019