10115 HOLLY DR BLDG K OLIN FIELDS APTS 2021-12-16

EVERETT WASHINGTON PUBLIC WORKS REVIEW WORKSHEET PROJECT ADDRESS: 10115 HOLLY DR #K203 Permit #: B2103-040 TENANT: OLIN FIELDS APTS-K303 DESCRIPTION OF WORK: REPAIR OF FIRE DAMAGED UNIT 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 ❑ New Connection, Size - ❑ 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 ❑ Water Service Line (behind meter), Size ❑ Packwater Valve ❑ Backflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA OT REQUIRED PINOT 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: $ ❑ aackflow Prevention (Outside Building): ❑ DCDA ❑ Backflow Prevention (Outside Building): ❑ DCVA Z NOT REQUIRED NOT REQUIRED Explanation/ Utility Permit #: Explanation/ Utility Permit #: WATER DEPARTMENT COST ESTIMATE NEEDED-(lf yes, PW Reviewer to send cost estimate request to Water Department) ❑ Yes, Quantity See attached for reference. OT REQUIRED Plumbing Permits (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) )N❑ ackflow Prevention (Inside Building): ❑ DCVA (for Domestic service) ❑ RPBA (for Domestic service) ❑ DCDA (for Fire service) OT REQUIRED Building Permits (Note: Permit Technicians to add all items selected below to associated Building Permit) STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: ,'YES, See Attached for calculations / credit ❑ YES, Traffic Mitigation Total: $ To be added on PW To be added on 13 21173 - 0q0 ❑ See Attached for calculations / credit Quantity charged SF Quantity charged K4 SF RINOT REQUIRED QTY is ❑ Ground only ❑ all hard surfaces QTY isleRoof only ❑ all hard surfaces $ $ 11,46 ❑ NOT REQUIRED Additional Checklists: ADDRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) ❑ YES — TYPE: ❑ SFR ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY ❑ COMMERCIAL ❑ See Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) ❑ Digital copy attached to permit record, Permit # ❑ Saved to Address Folder in Development Tech File J31NOT REQUIRED FIRE SPRINKLERS REQUIRED? ❑ YES —Type XNOT REQUIRED Reason: PUBLIC WORKS PERMIT REQUIRED? ❑ YES, Permit # PW ❑ Stormwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT NOT REQUIRED / Worksheet Completed By: , ` Date: 3 1 ?3 /2 Worksheet Checked By: Date: REVISED 1112712019