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• <br /> 41477 PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 7710 EVERGREEN WAY Permit#: B1808-004 <br /> TENANT: FELLOWSHIP CHRISTIAN SCHOOL <br /> DESCRIPTION OF WORK: CHANGE OF USE FROM OFFICE TO EDUCATION <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: (Not Including Cost Estimates) <br /> ❑ New Connection 0 New Connection, Size <br /> ❑Alteration 0 Meter Only,Size <br /> ❑ Repair 0 Backflow Prevention (Outside Building): ❑ RPBA or 0 DCVA <br /> ❑ Cap-off 'IBI NOT REQUIRED <br /> ❑ Reconnect Explanation/Utility Permit#: <br /> KNOT REQUIRED <br /> Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Not Including Cost Estimates) <br /> ❑ New Connection, Size 0 New Connection, Size 6,� <br /> ❑ Meter Only, Size IR'/<"Detect Meter Only, Service Size <br /> ❑ Backflow Prevention (Outside Building): ❑ DCVA ❑ Backflow Prevention (Outside Building): 0 DCDA <br /> 12(NOT REQUIRED 0 NOT REQUIRED <br /> Explanation/Utility Permit#: Explanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer o send cost estimate request to Water prtmen <br /> %Yes, Quantity I , See attached for reference,. .fei n g'I . - sc of t 9?iq7zoi <br /> ❑ NOT REQUIRED „"�" <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit) <br /> ❑Water Service Line(behind meter), Size <br /> $Backflow Prevention (Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) DCDA(for Fire service) <br /> ❑ NOT REQUIRED -16d(( 015 <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> SYSTEM DEVELOPMENT FEES: , TRAFFIC MITIGATION FEES: <br /> YES,Water: $ 0, (n0 �4,LdL1C XYES,$ IQ) I00.11 <br /> G. <br /> S wer: $ ©+, ftSee Attached€pgAtetfor c Iculations/cre it dy <br /> ASee Attached Spreadsheet for�lculations/credit CI NOT a NOT REQUIRED fereV(4 1 a Pe S' . <br /> ❑ NOT REQUIRED l' <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑YES—TYPE <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 /> KNOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> E YES—Type <br /> ❑ NOT REQUIRED <br /> Reason:_rjv RIZ,S C,tk WrIAJ Rr t, <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ❑YES, Permit#PW <br /> ❑Stormwater NPDES Tab Completed in TRAKiT 0 ADA Tab Completed in TRAKiT1 CInspections Added in TRAKiT <br /> NOT REQUIRED-o �. work IS sil 3�{ll n`�(`J�,be l'E eve axta,41 pLtri <br /> Worksheet Completed By: 4),6.9300.- c. 111�r1( Date: 1 i . 1 <br /> 1 <br /> Worksheet Checked By: Date: <br /> REVISED 8/6/2018 <br />