1515 132ND ST SE 2022-01-20 - Laserfiche WebLink

r i E R E T T WAS PUBLIC WORKS REVIEW WORKSHEET HINGTON PROJECT ADDRESS: 1515132ND ST SE Permit #: B1910-038 TENANT: JACK IN THE BOX DESCRIPTION OF WORK: TI- DEMO PORTION OF BUILDING/ ROOF AND RELATED ACCESSORIES PW Reviewer to select all that apply below. Utility Permits (Note: Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) SANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) )YNew Connection to main plus _connections to building ❑ New Connection, Size - ❑ Per Cost Estimate ❑ Alteration ❑ Meter Only, Size - ❑ Per Cost Estimate ❑ Repair ❑ Water System Development Fee Total: $ ❑ Cap -off, quantity ❑ Sewer System Development Fee Total: $ ❑ Reconnection to stub WWater Service Line (behind meter), Size ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA ❑ NOT REQUIRED �(� oiy, J O ❑ NOT REQUIRED Explanation/ Utility Permit #: J-`U ✓✓ Explanation/ Utility Permit #: IRRIGATION SERVICE: (Not Including Cost Estimates) 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 fLNOT REQUIRED RIOT REQUIRED Explanation/ Utility Permit #: Explanation/ Utility Permit #: WATER DEPARTMENT COST ESTIMATE NEEDED-(ifyes, PW Reviewer to send cost estimate request to Water Department) ❑ Yes, Quantity See attached for reference. OT 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) X-NOT REQUIRED Building Permits (Note: Permit Technicians to add all items selected below to associated Building Permit) STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: 10 YES, Stormwater Total: $ taZ0 . vZ ❑ YES, Traffic Mitigation Total: $ Roof Only Fee on Bldg Permit (ground hard surfaces fee on PW Permit) ❑ See Attached for calculations / credit WAIT Hard Surface Fees to be added to Permit # v5 i PNOT REQUIRED $ 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: ❑ SFR ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY ❑ COMMERCIAL ❑ See Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) ❑ Digital copy attached to permit record, Permit # ❑ Saved to Address Folder in Development Tech File PNOT REQUIRED FIRE SPRINKLERS REQUIRED? ❑ YES —Type W-NOT REQUIRED Reason: PUBLIC WORKS PERMIT REQUIRED? YES, Permit# PW Ty4t9tb - eS-1 ZStormwater NPDES Tab Completed in TRAKiT *(ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT ❑ NOT REQUIRED Worksheet Completed Date: CG 2-Zc / 2.1r 2.6 Worksheet Checked By: Date: 3 7 u � I tou Kt VIJtU 4IZ41ZU7y