Laserfiche WebLink
EVERETT PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 1925 73RD ST <br />Permit #: B2008-002 <br />TENANT: AFH <br />DESCRIPTION OF WORK: 4 BEDROOM ADDITION / BATHROOM AND LAUNDRY ALTERATIONS/ RAMP <br />PW Reviewer to select all that apply below: <br />Utility Permits (Note: Permit Technicians to Create Utility Permit <br />for Sewer, Water, Fire, and Irrigation, as selected below) <br />SANITARY SEWER: <br />DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) <br />❑ New Connecti n to main plus connections to building <br />❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Alteration <br />❑ Meter Only, Size - ❑ Per Cost Estimate <br />❑ Repair <br />❑ Water Sy em Development Fee Total: $ <br />❑ Cap -off, q ntity <br />❑ Sewer,System Development Fee Total: $ <br />❑ Reconn tion to stub <br />❑ Wa Service Line (behind meter), Size <br />❑ Backw er Valve <br />❑ B kflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA <br />1NOT EQUIRED <br />OT REQUIRED <br />Expla ation/ Utility Permit #: <br />Explanation/ Utility Permit #: <br />IR IGATION SERVICE: (Not Including Cost Estimates) <br />FIRE SERVI E. (Attach Cost Estimate /Request for Reference) <br />❑ New Connection, Size <br />❑ New Con ection, Size - ❑ Per Cost Estimate <br />❑ Meter Only, Si e <br />❑ 3/<"iDet t Meter Only, Service Size <br />❑ Water Syste Development Fee Total: $ <br />❑ Bac ow Prevention (Outside Building): ❑ DCDA <br />❑ Backflow P evention (Outside Building): ❑ DCVA <br />IjN REQUIRED <br />KNOT R UIRED <br />Ex anation/ Utility Permit #: <br />Explanat' n/ Utility ermit #: <br />WATER DEPA ME COST ESTIMATE NEEDED -(If yes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, Quan ' y See attached for reference. <br />tilL NOT RE UIRED <br />Plumbing ermits (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) <br />❑ Backflow revention (Inside Building): ❑ DCVA (for Domestic service) ❑ RPB (for Domestic service) ❑ DCDA (for Fire service) <br />NOT R UIRED <br />uilding Permits (Note: Permit Technicians to add all items se <br />ed belo to associated Building Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: <br />TRAFFIC MITICATION FEES: <br />YES, Stormwater Total: $ ZAP <br />❑ YES, Tra Mitigation Total: $ <br />❑ Roof Only Fee on Bldg Permit (ground hard surfaces fee on PW <br />Permit ❑ Se Attached for calculations / credit <br />IXAII Hard Surface Fees to be added to Permit # $ 2-00Q - 00 <br />% I(NOT EQUIRED <br />XSee Attached Spreadsheet for calculations / credit <br />❑ NOT REQUIRED <br />"ts: <br />litional hec7QQ'U1RED? <br />ADDRESS LETTER R (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) <br />DYES —TYPE: ❑ R ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING <br />❑ MULTI -FAMILY ❑ COMMERCIAL <br />❑ See A ched Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br />❑ Digit copy attached to permit record, Permit # <br />❑ Saytd to Address Folder in Development Tech File <br />NOT REQ IRED <br />FIRE SPRINKLERS REQUIRED? <br />❑ YES —Ty e <br />YN( QUIRED <br />Reason(: <br />PUBLIC WORK PERMIT REQUIRED? <br />❑ YES, PermV PW <br />❑ Sj6rmwater NPDES Tab Completed in TRAKiT ❑ ADA Tab <br />XNOT RE UIRED <br />Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />Worksheet Completed By: �`, <br />Date: <br />Worksheet Checked By: <br />Date: 24 <br />REVISED 11/27/2019 <br />