2107 122ND PL SE 2021-12-23 - Laserfiche WebLink

• E V E R E T T PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: 2107 122ND PL SE Permit#: B1912-016 TENANT: [TenName] DESCRIPTION OF WORK: NEW DETACHED 26'x32' POLE FRAME GARAGE/SHOP 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 0 New Connection, Size -0 Per Cost Estimate ❑Alteration 0 Meter Only, Size -0 Per Cost Estimate ❑ Repair 0 Water System Development Fee Total:$ ❑ Cap-off, quantity 0 Sewer System Development Fee Total: $ ❑ Reconnection to stub 0 Water Service Line(behind meter), Size C Backwater Valve ❑ Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA p-NOT REQUIRED 131\10T 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 0 3 " Detect Meter Only, Service Size ❑Water System Development Fee Total: $ 0 Backflow Prevention (Outside Building): 0 DCDA ❑ Backflow Prevention (Outside Building): 0 DCVA OrclOT REQUIRED 0-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. -NOT REQUIRED Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) ❑ Backflow Prevention(Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) iaNOT REQUIRED Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: LYES, Stormwater Total:$ 2010.9 2 o w 131-v c+ 'PE •--r" 0 YES,Traffic Mitigation Total: $ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calculations/credit 0 All Hard Surface Fees to be added to Permit# .NOT REQUIRED See Attached Spreadsheet for calculations/credit ❑ NOT REQUIRED Additional Checklists: ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) ❑YES—TYPE: 0 SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING ❑ MULTI-FAMILY 0 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 KNOT REQUIRED FIRE SPRINKLERS REQUIRED? ❑YES—Type KNOT REQUIRED Reason: PBBLIC WORKS PERMIT REQUIRED? YES, Permit#PW (mot 12.- 037 ,�,/ $ M tormwater NPDES Tab Completed in TRAKiT ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT ❑ NOT REQUIRED Worksheet Completed By: Date: 12��2v�9 Worksheet Checked By: Date: '21 1'8 tiO1°� REVISED 11/27/2019