Laserfiche WebLink
4m- 1110 <br /> PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 215 DORN AVE UNIT A&B Permit#: C1803-004 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: NEW DUPLEX(A&B) <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 /> ITNew Connection to main plus l connections to building , New Connection, Size 3ra�' - 0 Per Cost Estimate-Ufl1'C <br /> ❑Alteration 0 Meter Only, Size - 0 Per Cost Estimate <br /> ❑ Repair I!-Water System Development Fee Total: $ 3, 1...- -.o� <br /> s Cap-off, quantity I 603 ., / ift Sewer System Development Fee Total: $ s'i /ah o0 <br /> ❑ Reconnection to stub 0 Water Service Line(behind meter),Size <br /> ❑ Backwater Valve 0 Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ NOT REQUIRED 0 NOT REQUIRED a <br /> Explanation/Utility Permit#: �.lvt ti�' O L.0 Explanation/Utility Permit#: CAPE � 3�j R,fU(� ? <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> II New Connection, Size l" ❑ New Connection, Size - 0 Per Cost Estimate <br /> ❑ Meter Only, Size 0%" Detect Meter Only, Service Size <br /> it Water System Development Fee Total: $ eS.op ❑ Backflow Prevention (Outside Building): 0 DCDA <br /> Backflow Prevention (Outside Building): RDCVA %NOT REQUIRED <br /> ❑ NOT REQUIRED Explanation/Utility Permit#: <br /> Explanation/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 /> u <br /> L�PNOT REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ Backflow Prevention (Inside Building): 0 DCVA(for Domestic service) ❑ RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> 9.NOT REQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit $ � a G�r��°`T <br /> STORMWATER SYSTEM DEVELOPMENT FEES TRAFFIC MITIGATION FEES / <br /> AA 00 <br /> ❑YES, Stormwater Total: $ 1, q 46. 33 0 YES,Traffic Mitigation Total: $ fr`j <br /> i <br /> IrSee Attached Spreadsheet for calculations lirSee Attached Spreadsheet for <br /> calculations/credit <br /> ❑ NOT REQUIRED 14. <br /> tl""�,�,�! /4/8t c,9 0 NOT REQUIRED rt. <br /> ' ( <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> [SUES-TYPE: 0 SFR 1 DUPLEX ❑ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> E See Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> fit Digital copy attached to permit record, Permit# ?IA) /g O 3 vl <br /> R(Saved to Address Folder in Development Tech File jg ol— 009 <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES-Type <br /> KNOT REQU ED „,1 p <br /> Reason: W � `� Q�1 F'11' <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> YES, Permit#PW ( ccd03- p' � <br /> I Stormwater NPDES Tab Com leted in TRAKiT I .ADA Tab Completed in TRAKiT &Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: Date: #2/SS )' <br /> Worksheet Checked By: - Date: gIQ5 7,01°‘ <br /> REVISED 2/22/2019 <br />