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• • <br /> 41"7 PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 4935 SEAVIEW WAY Permit#: PWW1805-001 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: INSTALL RETAINING WALL, REPLACE DRIVEWAY <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: (Not Including Cost Estimates) <br /> ❑ New Connection 0 New Connection, Size <br /> ❑Alteration 0 Meter Only, Size <br /> ❑ Repair ❑ Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ Cap-off OKNOT REQUIRED <br /> ❑ Reconnect Explanation/Utility Permit#: <br /> ONOT REQUIRED <br /> Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Not Including Cost Estimates) <br /> ❑ New Connection, Size 0 New Connection, Size <br /> ❑ Meter Only, Size 0 3/" Detect Meter Only, Service Size <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA ❑ Backflow Prevention (Outside Building): 0 DCDA <br /> NOT REQUIRED XNOT REQUIRED <br /> Explanation/Utility Permit#: E lanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(lf yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> ROT REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit) <br /> ❑Water Service Line (behind meter), Size <br /> ��ackflow Prevention (Inside Building): ❑ DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> ,.❑`RIOT REQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ❑YES,Water: $ 0 YES, $ <br /> Sewer: $ 0 See Attached Spreadsheet for calculations/credit <br /> ❑See Attached Spreadsheet for calculations/credit 4 NOT REQUIRED <br /> -SNOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑YES—TYPE <br /> ❑ See 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 /> XNOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> ` [NOT REQUIRED <br /> Reason: <br /> P BLIC WORKS PERMIT REQUIRED? <br /> YES, Pe mit#PW W <br /> Stormwater NPDES Ta ompleted in TRAKiT ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiTO <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: 1 Date: <br /> a � <br /> Worksheet Checked By: Date: fo <br /> REVISED 8/6/2018 <br />