Laserfiche WebLink
L.L.. E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> imims WASHINGTON <br /> PROJECT ADDRESS: 5001 SOUND AVE Permit#: PW2103-009 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: SUBDIVIDE LOT INTO TWO LOTS/DEMO EXISTING GARAGE AND <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 /> A-New Connection to main plus t connections to building 0 New Connection, Size 3/4 - 0 Per Cost Estimate <br /> ❑ Alteration e5 ❑ Meter Only, Size - 0 Per Cost Estimate <br /> ❑ Repair 3.24D 0 Water System Development Fee Total: $ <br /> ❑ Cap-off, quantity - 40 0 Sewer System Development Fee Total: $ <br /> ❑ Reconnection to stub b 2- -20 0 Water Service Line(behind meter), Size <br /> ❑ Backwater Valve 0 Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ NOT REQUIRED p 00 Z.- ❑ NOT REQUIRED ' e <br /> Explanation/Utility Permit#: U. D Explanation/Utility Permit#: K 7itiZ <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 3/4 Det ct Meter Only, Service Size <br /> ❑ Water Sy tem Development Fee Total: $ 0 Back ow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflo Prevention (Outside Building): 0 DCVA IT N7 REQUIRED <br /> SNOT f QUIRED Explanation/Utility Permit#: <br /> Explana on/Utility Permit#: <br /> WATER D ARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Yes, Q ntity , See attached for reference. <br /> it-NOT EQUIRED <br /> Plumbing ermits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ Backflo revention (Inside Building): 0 DCVA(for Domestic service) 0 RPBA (for Domestic service) 0 DCDA (for Fire service) <br /> IOFNOT QUIRED <br /> r'\ <br /> (building Permits (Note:Permit Technr 'ens to add all items selected below to associated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FE : TRAFFIC MITIG N FEES: <br /> ir 0-YES, 0 See Attached for calculations/credit 0 YES,Traffi itigation Total: $ <br /> To be added on PW 2403•Gd• To b added on 0 Se ttached for calculations/credit <br /> Quantity charged .C'5 SF Quan ity charged SF gNO EQUIRED <br /> QTY is$'Ground only 0 all hard surfaces QTY i 0 Roof only 0 all hard surfaces <br /> $ 4047.1 J' $ <br /> ❑ NOT REQUIRED <br /> itional Checklists: <br /> ADDRESS LETT R REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑ YES—TYP . ❑ SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> ❑ e 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 /> ❑ Saved to Address Folder in Development Tech File <br /> igt-N REQUIRED <br /> FIRE SPRI LERS REQUIRED? <br /> ❑ YES— pe <br /> rgFNOT EQUIRED <br /> Reas n: <br /> PUBLIC WORKS PERMIT - QUIRED? <br /> 4251=ES, Permit#PW 3.od X-Stormwat- PDES Tab Completed in TRAKiT RADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> • NOT REQUIREr <br /> Wo heet C' pleted By: Date: O?!1(o 'ZoZA <br /> Worksheet Checked By: / Date: <br /> REVISED 11/27/2019 <br />