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E ERETT PUBLIC WORKS REV REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 1515 132ND ST SE Permit #: PW1903-075 <br />TENANT: [TenName] <br />DESCRIPTION OF WORK: DEMOLISH FUEL CANOPY AND CARWASH BLDG <br />Utility Permits (Note: Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) <br />SANITARY SEWER: <br />❑ New Connection to main plus connections to buildinc <br />❑ Alteration <br />❑ Repair <br />❑ Cap -off, quantity <br />❑ Reconnection to stub <br />❑ Backwater Valve <br />XNOT REQUIRED <br />Explanation/ Utility Permit #: <br />IRRIGATION SERVICE: (Not Including Cost Estimates) <br />❑ New Connection, Size <br />❑ Meter Only, Size <br />❑ Water System Development Fee Total: $ <br />❑ Backflow Prevention (Outside Building): ❑ DCVA <br />PxNOT REQUIRED <br />planation/ Utility Permit #: <br />DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) <br />❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Meter Only, Size - ❑ Per Cost Estimate <br />❑ Water System Development Fee Total: $ <br />❑ Sewer System Development Fee Total: $ <br />❑ Water Service Line (behind meter), Size <br />❑ Backflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA <br />NOT REQUIRED <br />Explanation/ Utility Permit #: <br />FIRE SERVICE: (Attach Cost Estimate / Request for Reference) <br />❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ %" Detect Meter�Only, Service Size <br />❑ Backflow Prevention (Outside Building): ❑ DCDA <br />IdNOT REQUIRED <br />xplanation/ Utility Permit #: <br />WATER DEPARTMENT COST ESTIMATE NEEDED-Qf yes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, Quantity See attached for reference. <br />KNOT 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 />P NOT REQUIRED <br />Building Permits (Note: Permit Technicians to add all items selected below to associated Building Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: <br />❑ YES, Stormwater Total: $ <br />❑ Roof Only Fee on Bldg Permit (ground hard surfaces fee on PW Permit) <br />❑ All Hard Surface Fees to be added to Permit # <br />❑ See Attached Spreadsheet for calculations / credit <br />,NOT REQUIRED <br />Additional Checklists: <br />TRAFFIC MITIGATION FEES: <br />❑ YES, Traffic Mitigation Total: $ <br />❑ See Attached for calculations / credit <br />0,NOT REQUIRED <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 />KNOT REQUIRED. <br />FIRE SPRINKLERS REQUIRED? <br />❑ YES —Type <br />KNOT REQUIRED <br />Reason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />YES, Permit # PW_ /9'03- 6.7 <br />J§.Stormwater NPDES Tab Completed in TRAKiT 1KADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />❑ NOT REQUIRED <br />Worksheet Completed By: <br />Worksheet Checked By: <br />Date: & //O l o/9 <br />Date: <br />REVISED 412412019 <br />