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EVE R E T T PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 7037 MORGAN RD Permit #: PW2004-023 <br />TENANT: [TenName] <br />DESCRIPTION OF WORK: ADDITION OF (3) BEDROOMS FOR AFH/ RECONFIGURE BATHROOM FOR <br />PW Reviewer to select all that apply 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 ❑ Se er System Development Fee Total: $ <br />❑ Recon ection to stub ❑ ater Service Line (behind meter), Size <br />❑ Bac ater Valve ackflow Prevention (Outside Building): ❑ RPBA or ❑DCVA <br />X N9T REQUIRED IZICNOT REQUIRED <br />Ex anation/ Utility Permit #: xplanation/ 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 />❑ Wat/ion/ <br />tem Development Fee Total: $ ❑ Ba flow Prevention (Outside Building): ❑ DCDA <br />❑ BacPrevention (Outside Building): ❑DCVA T REQUIRED <br />KNOTUIRED E planation/ Utility Permit #: <br />planUtility Permit #: <br />WATER D PARTMENT COST ESTIMATE NEEDED-(Ifyes, PW Reviewerto send cost estimate request to Water Department) <br />❑ Yes, antity See attached for reference. <br />NOT EQUIRED <br />Plumbing ermits (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) <br />❑ Backflo revention (Inside Building): ❑ DCVA (for Domestic service) ❑ RPBA (for Domestic service) ❑ DCDA (for Fire service) <br />[NOT QUIRED <br />Buil ing Permits (Note: Permit Technicians to ad items selected below to associated Building Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br />IQ YES, Stormwater Total: $ / . S 48 ❑ YES, Traffic igation Total: $ <br />❑ Roof Only Fee on Bldg Permit (ground hard surfaces fee on P Permit) ❑ SeSfftached for calculations / credit <br />IP All Hard Surface Fees to be added to Permit # 23 IN EQUIRED <br />❑ 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 />❑ 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 />NOTAQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />❑ YES —�T e <br />1NOTiREQUIRED <br />Reason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />❑ YES, Permit # PW n — 0 V3 <br />Stormwater NPDES Tab pleted in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />❑ NOT YEQUIRED <br />Worksheet Completed By: Date: <br />Worksheet Checked By: Date: <br />REVISED 1112712019 <br />