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r-1 <br />EVE R E T T <br />WASHINGTON PUBLIC WORKS REVIEW WORKSHEET <br />PROJECT ADDRESS: 6815 COLBY AVE Permit #: B2005-038 <br />TENANT: KEVIN & STACEY COLE <br />DESCRIPTION OF WORK: ACCESSORY BUILDING 548 SF <br />PW Reviewer to select all that app/v below: <br />Utility Permits (Note: Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) <br />SANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) <br />❑ New Connection to main plus connections to building ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Alteration ❑ Meter Only, Size ❑ Per Cost Estimate <br />❑ Repair ❑ Water System Development Fee Total: $ <br />❑ Cap -off, quantity ❑ Sewer System Development Fee Total: $ <br />❑ Reconnection to stub ❑ Water Service Line (behind meter), Size <br />❑ ackwater Valve ❑ Backflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA <br />OT REQUIRED ZrNOT REQUIRED <br />Explanation/ Utility Permit #: Explanation/ Utility Permit #: <br />IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate /Request for Reference) <br />❑ New Connection, Size ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Meter Only, Size ❑'/" Detect Meter Only, Service Size <br />❑ Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): ❑ DCDA <br />❑ Backflow Prevention (Outside Building): ❑DCVA OCNOT REQUIRED <br />U�NOT REQUIRED Explanation/ Utility Permit #: <br />Explanation/ Utility Permit #: <br />WATER DEPARTMENT COST ESTIMATE NEEDED -(If yes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, Quantity See attached for reference. <br />NOT 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 />f&WT REQUIRED <br />Building Permits (Note: Permit Technicians to add all items selected below to associated Building Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br />YES, Stormwater Total: $ Zla3-S ❑ YES, Traffic Mitigation Total: $ <br />❑ Roof Only Fee on Bldg Permit (ground hard surfaces fee on PW Permit) ❑ See Attached for calculations / credit <br />PkII Hard Surface Fees to be added to Permit # VvvJ7,00-7- o t & KNOT REQUIRED <br />Or -See Attached Spreadsheet for calculations / credit <br />❑ NOT REQUIRED <br />Additional Checklists; <br />ADDRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) <br />DYES -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 />V WOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />❑ YES -Type <br />I&NOT REQUIRED <br />Reason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />W r`ES, Permit # PW Z-oo-7 01 PJ ,// <br />OSto.rmwater NPDES Tab Completed in TRAKiT H46A Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />❑ NOT REQUIRED <br />Worksheet Completed Date: D 7 Ltv /to-ZcZ <br />Worksheet Checked By: Date: <br />REVISED 1112712019 <br />