10105 1ST DR SE 2021-12-14 - Laserfiche WebLink

E VE R E T T *PUBLIC WORKS REW WORKSHEET WASHINGTON PROJECT ADDRESS: 10103 1ST DR SE Permit #: C1910-017 TENANT: [TenName] DESCRIPTION OF WORK: NEW SFR WITH DRIVEWAY AND DRAINAGE 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 OL New Connection, Size jb 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 IgWater Service Line (behind meter), Size ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA ❑ NOT REQUIRED ❑ NOT 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 ❑ %" Detect Meter Only, Service Size ❑ Water System Development Fee Total: $ ackflow Prevention (Outside Building): ❑ DCDA ❑ Backflow Prevention (Outside Building): ❑ DCVA NOT REQUIRED ;RWOT REQUIRED Explanation/ Utility Permit #: Explanation/ Utility Permit #: ATER DEPARTMEN COST ESTIMATE EDED-(If yes, PW Revie er to s nd cost estimate request to Water Department) Yes, Quantity i ee a ached for reference. q - ❑ NOT REQUIRED 1 u 1 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) A -NOT REQUIRED W/ a - 1 Building Permits (Note: Permit Technicians to add all items selected below to associated Building Permit) STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: ,LXES, Stormwater Total: $ 1,2 2.4. 8 Z ❑ YES, Traffic Mitigation Total: $ ❑ Roof Only Fee on Bldg Permit (ground hard surfaces fee on PW Permit) ❑ See Attached for calculations / credit ARVII Hard Surface Fees to be added to Permit # -P44 1112- 039 KNOT REQUIRED ffSee Attached Spreadsheet for calculations / credit ❑ NOT REQUIRED Additional Checklists: ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) IIKYES - TYPE: MLSFR ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY ❑ COMMERCIAL 6—See Attached Letter, 2 copies (Permit Techs to issue one copy to ap licant with permits, scan one copy to Jeffrey Marks) (.Digital copy attached to permit record, Permit # '7a1.1 tq 12- 03 Kaved to Address Folder in Development Tech File ❑ NOT REQUIRED FIRE SPRINKLERS REQUIRED? YES -Type IS-D NOT REQUIRED Reason: M 0jZ4C_ -7-*44,,4 350, r='M n_c PUBLIC WORKS PERMIT REQUIRED? I5YES, Permit # PW IR 12 - 53 `i - �ItStormwater NPDES Tab Completed in TRAKiT t!�ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT ❑ NOT REQUIRED /? Worksheet Completed By: sue' Date: 2019 Worksheet Checked By: Date: lsluu — I REVISED 1112712019