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EVERET <br />WASHINGTON <br />PUBLIC WORKS REVIEW WORKSHEET <br />PROJECT ADDRESS: 9401 SHARON DR <br />Permit #: B2004-021 <br />TENANT: EXPLORER MIDDLE SCHOOL <br />DESCRIPTION OF WORK: ADA UPGRADES TO EXISTING TOILET ROOMS TO COMPLY W/ <br />Utility/ Permits (Note: Permit Technicians to Create Utility Pen -nit for Sewer, Water, Fire, and Irrigation, as selected below) <br />SANITARY SEWER: <br />❑ New Connection to main plus connections to building <br />❑ Alteration <br />❑ Repair <br />❑ Cap -off, quantity <br />❑ Reconnection to stub <br />❑ Backwater Valve <br />p6-NOT 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 />SOT REQUIRED <br />Explanation/ 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 />to -PLOT 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 />91-NOT REQUIRED <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 />91LOT 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 />RWOT 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: $ M 9& <br />❑ Roof Only Fee on Bldg Permit (ground hard surfaces fee on PW Permit) <br />IVAII Hard Surface Fees to be added to Permit # 1?5Zoo4-o2l <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 />ptWOT 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 />ANOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />❑ YES -Type <br />4 NOT REQUIRED <br />Re son: <br />PUBLIC WORKS PERMIT REQUIRED? <br />❑ YES, Permit # PW <br />❑ Stormwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />AN NOT REQUIRED <br />Worksheet Completed By, Date: 0 t6o /2,0 Z0 <br />Worksheet Checked By: Date: <br />REVISED 1112712019 <br />