2324 100TH ST SE 2021-12-13 - Laserfiche WebLink

A906 r1 E E R E T T W 1W WASHINGTON PUBLIC WORKS REVIEW WORKSHEET PROJECT ADDRESS: 2324 100TH ST SE Permit #: B2001-038 TENANT: [TenName] DESCRIPTION OF WORK: CONVERSION OF EXTG FAMILY ROOM TO AN ADDITIONAL BEDROOM 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.) ❑ New 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 ❑ Water Service Line (behind meter), Size ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA gNOT REQUIRED RiNOT REQUIRED Explanation/ Utility Permit #: 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 ❑ 3/" Detect Meter Only, Service Size ❑ Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): ❑ DCDA ❑ Backflow Prevention (Outside Building): ❑ DCVA I:CNOT REQUIRED I$NOT 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. 11 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) ENNOT 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 calculations / credit ❑ All Hard Surface Fees to be added to Permit # ❑ NOT REQUIRED ❑ See Attached Spreadsheet for calculations / credit "OT REQUIRED Additional Checklists: ADDRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) OYES —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 NOT REQUIRED FIRE SPRINKLERS REQUIRED? ❑ YES —Type IkNOT REQUIRED Reason: PUBLIC WORKS PERMIT REQUIRED? ❑ YES, Permit # PW z O ®,5-- ®Z`Z— ❑ Stormwater NPDES Tab mpleted in TRAKiT ❑ AD Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT 9NNOT REQUIRED Worksheet Completed By: Date: Worksheet Checked By: Date: REVISED 1112712019