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• 0 <br /> - E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 5001 SOUND AVE Permit#: B1912-021 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: ADDITION OF NEW 2 CAR ATTACHED GARAGE &ELEVATED DECK ON <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: (Attach Calculation&Cost Est.) <br /> ❑ New Connection to main plus connections to building 0 New Connection, Size -0 Per Cost Estimate <br /> ❑Alteration 0 Meter Only, Size -0 Per Cost Estimate <br /> ❑ Repair 0 Water System Development Fee Total: $ <br /> ❑ Cap-off, quantity ❑Sewer System Development Fee Total: $ <br /> ❑ Reconnect' n to stub 0 Water Se ice Line(behind meter), Size <br /> ❑ Backwat Valve 0 Backflo Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> IONOT R UIRED [S,YJ'IOT QUIRED <br /> Explanati n/Utility Permit#: Explan tion/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size 0 New Connection, Size -0 Per Cost Estimate <br /> ❑ Meter Only, Size 0%" Detec Meter Only, Service Size <br /> ❑Water System Development Fee Total:$ 0 Backfl Prevention (Outside Building): 0 DCDA <br /> ❑ Backflo Prevention (Outside Building): 0 DCVA 'CILNOT EQUIRED <br /> 6 NOT QUIRED Explanation/Utility Permit#: <br /> Explan ion/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 /> ❑ NOT REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ Backflow 76 revention (Inside Building): ElDCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> la NOT R UIRED <br /> Building Permits (Note:Permit Technicians to add all ms selected below to associated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: 1�'' .0(q1 TRAFFIC MITIGATION FEES: <br /> EtrYES, Stormwater Total:$ 2-40•it$ _ ❑YES,Traffic Mitigation Total:$ <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) ❑ S e Attached for calculations/credit <br /> ❑All Hard Surface Fees to be added to Permit# I1NO EQUIRED <br /> ❑ See Attached Spreadsheet for calculations/credit <br /> ❑ NOT REQUIRED <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: 0 SFR 0 DUPLEX ❑ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> ❑See Attached Letter,2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> ❑ Digi I copy attached to permit record, Permit# <br /> yt <br /> ❑ S ed to Address Folder in Development Tech File <br /> IFI NOT RE IRED <br /> FIRE E SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> VINOT RE UIRED <br /> eason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> IN YES, Permit#PW Z.-0c92 0/4 <br /> I1•Stormwater NPDES Tom.Completed in TRAKiT 0 DA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED Atab, <br /> Worksheet Completed By: _� Date: e ' '7-Ar/ '7' <br /> w <br /> i Worksheet Checked By: �� Date: /o (If70 <br /> REVISED 11/27/2019 <br />