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- 0 • <br /> EVE R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> mom WASHINGTON <br /> PROJECT ADDRESS: 1925 60TH ST SE Permit#: B1912-022 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: NEW ADU <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 /> jAlteration 0 Meter Only, Size - 0 Per Cost Estimate <br /> ❑ Repair 0 Water System Development Fee Total: $ <br /> ❑ Cap-off, quantity 0 Sewer System Development Fee Total: $ <br /> ❑ Reconnection to stub Water Service Line(behind meter), Size 5/4 " <br /> ❑ Backwater Valve 0 Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ NOT REQUIRED C� 0 NOT REQUIRED <br /> Explanation/Utility Permit#: 01 232, 0Z_\ Explanation/Utility Permit#: U 2.002. 0 <br /> IRRIGATION RVICE: (Not Including Cost Estimates) FIRE SERVICE: (Att Cost Estimate/Request for Reference) <br /> ❑ New Con -ction, Size 0 New Connecti , Size -0 Per Cost Estimate <br /> ❑ Meter 0 'y, Size 0 3/4' Detect eter Only, Service Size <br /> ❑Water ystem Development Fee Total: $ ❑ Backfl Prevention (Outside Building): 0 DCDA <br /> ❑ Bac,<`ow Prevention (Outside Building): 0 DCVA .NO EQUIRED <br /> 041'i REQUIRED E anation/Utility Permit#: <br /> Ex.anation/Utility Permit#: <br /> WATER D ARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, antity , See attached for reference. <br /> ONO EQUIRED <br /> Plumbin ermits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ Backfl Prevention (Inside Building): ❑DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> tg,NOT EQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated BuildinPermit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC 1TIGATION FEES: <br /> EYES, Stormwater Total:$ 384.24 0 YES, affic Mitigation Total: $ <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) ee Attached for calculations/credit <br /> ,III Hard Surface Fees to be added to Permit# -PM120o2-132(o fit T REQUIRED <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 /> {AYES—TYPE: 0 SFR 0 DUPLEX I'ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> )71,See Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> IN Digital copy attached to permit record, Permit# 7%0.1200 2-02(o <br /> IgSaved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SP KLERS REQUIRED? <br /> ❑YES Type <br /> EiN REQUIRED <br /> Re son: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ,AYES, Permit#PW 20o2-o 2 to <br /> .Stormwater NPDES Tab Completed in TRAKiT I]ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed B Date: ®2 Zd 2.o2a <br /> Worksheet Checked By: Date: Za ZoZO <br /> REVISED 11/27/2019 <br />