10617 ROSEWOOD AVE 2022-01-25 - Laserfiche WebLink

• RE E V E R E T T PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: 10617 ROSEWOOD AVE Permit#: PW2010-027 TENANT: [TenName] DESCRIPTION OF WORK: CLEARING,GRADING, DRIVEWAY,ETC FOR NEW DUPLEX 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 Kew Connection, Size 3/if' -0 Per Cost Estimate ❑Alteration El Meter Only, Size -0 Per Cost Estimate ❑ Repair SEweti Water System Development Fee Total: $ �0 ❑ Cap-off, quantity `�❑Sewer System Development Fee Total: $ ❑ Reconnection to stub SINt.e rAtMt-Its3 0 Water Service Line(behind meter), Size ❑ Backwater Valve Ce$ ❑ Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA ,ti.NOT REQUIRED 0 NOT REQUIRED Explanation/Utility Permit#: Explanation/Utility Permit#: 1.42 1O3"O3(0 IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) ❑ New Connection, Size 0 New Connection, Size -0 Per Cost Estimate ❑ Meter Only, Size 0 3/4" Detect Meter Only, Service Size ❑Water System Development Fee Total:$ ❑ Backflow Prevention (Outside Building): ❑ DCDA 0 Backflow Prevention (Outside Building): ❑ DCVA KNOT REQUIRED NOT REQUIRED Explanation/Utility Permit#: Explanation/Utility Permit#: WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes, PWReviewerto 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) ttNOT REQUIRED Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) .D2btfl-bat STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: VI YES, Stormwater Total: $ 0 r* 6 .1-4 EYES,Traffic Mitigation Total:$ ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calculations/credit All Hard Surface Fees to be added to Permit# "W2.010-024 0 NOT REQUIRED See Attached Spreadsheet for calculations/credit El NOT NOT REQUIRED S '-kOOe. 4 MPA4.7- 411— Additional Checklists: -- �+ ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and in e) YES-TYPE: 0 SFR XDUPLEX ❑ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL ►a.See Attached Letter,2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) igital copy attached to permit record, Permit# ?W dd -01' \Saved to Address Folder in Development Tech File ❑ NOT REQUIRED FIRE SPRINKLERS REQUIRED? ❑YES-Type KNOT REQUIRED Reason: PUBLIC WORKS PERMIT REQUIRED? YES, P rmit#PW 20d 0 -Oa Stormwater NPDES Tab Completed in TRAKiT ,A ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT ❑ NOT REQUIRED Worksheet Completed By: \ Date: 3123 21 Worksheet Checked By: Date: REVISED 11/27/2019