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EVERETT <br />WASHINGTON <br />PROJECT ADDRESS: <br />TENANT: <br />DESCRIPTION OF WORK: <br />PUBLIC WORKS REVIEW WORKSHEET <br />3706 WETMORE AVE <br />Permit #: B2101-058 <br />[TenName] <br />BUILD GARAGE BEHIND HOUSE, FACING ALLEY-24' X 24' <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 building <br />❑ Alteration <br />❑ Repair <br />❑ Cap -off, qua tity <br />❑ ReconnectI to stub <br />❑ ackwat Valve <br />NOT PXQUIRED <br />Explan ion/ Utility Permit #: <br />IRRIGATION SERVICE: (Not Including Cost Estimates) <br />❑ New Connection, Size <br />❑ Meter Only, Size <br />❑ Water Sy tem Development Fee Total: $ <br />❑ Backflo Prevention (Outside Building): ❑ DCVA <br />XNOT EQUIRED <br />Expla tion/ Utilyty Permit #: <br />WATER DEP <br />❑ es, Qua ti <br />OT R50U <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 Sys m Development Fee Total: $ <br />❑ Water S,afvice Line (behind meter), Size <br />❑ ack Prevention (Outside Building): ❑ RPBA or ❑ DCVA <br />O EQUIRED <br />Explanation/ Utility Permit #: <br />FIRE SERVICE: (Attach Cost Estimate /Request for Reference) <br />❑ New Con ction, Size - ❑ Per Cost Estimate <br />❑ %" Dete Meter Only, Service Size <br />❑ Backfl Prevention (Outside Building): ❑DCDA <br />KNOT EQUIRED <br />Explanation/ Utility Permit #: <br />RTM ENT COST ESTIMATE N E EDE D-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br />ty See attached for reference. <br />IRED <br />Plumbin/Preentioln <br />its (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) <br />\EyBackflow (Inside Building): ❑ DCVA (for Domestic service) ❑R A (for Domestic service) ❑ DCDA (for Fire service) <br />,RNOT RE <br />B /I(>f%tfg Permits (Note: Permit Technicians to add all items se/ec d be to associated Building7ATION <br />it) <br />ORM TER SYSTEM DEVELOPMENT FEES: TRAFFIC MIT FEES: <br />YES, See Attached for calculations / credit ❑ YES, Tra c Mitigation Total: $ <br />To be added on PW To be added on 2-10(� Q r% ❑ Se Attached for calculations / credit <br />Quantity charged SF Quantitycharg 5� 6 SF NOT EQUIRED <br />QTY is ❑ Ground only ❑ all hard surfaces QTY isRo only ❑ all hard surfac <br />$ <br />NOT REQUIRED <br />Checklists: <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 />❑ Se Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br />❑ Di ital copy attached to permit record, Permit # <br />❑ ved to Address Folder in Development Tech File <br />NOT R UIRED <br />❑ YES —Ty e <br />rAOT R UIRED <br />eason' <br />PUBLIC WORK E <br />❑ YES, Permitfi PW <br />/etCompleted <br />rmwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑Inspections Added in TRAKiT <br />VNOTRED <br />Worksh By: Date: <br />Worksheet Checked By: Date: <br />REVISED 1112712019 <br />