812 35TH ST 2022-03-07 - Laserfiche WebLink

EVERETT PUBLIC WORKS REVIEW WORKSHEET Nom WASHINGTON PROJECT ADDRESS: 812 35TH ST Permit#: PW1805-063 3 Waffir seivre.e ? TENANT: [TenName] I•1g12 35 at Mit-I-S)S ` d DESCRIPTION OF WORK: SITE IMPROVEMENTS TO CREATE A 3-LOT SHO T SUBDIVISIOr V1906^01� q-ppi PW Reviewer to select all that apply below: 3)RIo 356 . 3lH +sys d� u1s elecrs o bid Utility Permits (Note:Permit Technicians to Create Utility Permi for Sewer, Water, Fire, and Irrigation, as selected below) SANITARY SEWER: DOMESTIC WATER SERA CE: (Attach Calculation& Cost kstr� KNew Connection to main plus connections to building New Connection, Size /4" x 3 - 0 Per Cost Estimate ❑Alteration \ 0 Meter Only, Size -0 Per Cost Estimate ❑ Repair 31 C � MES: gWater System Development Fee Total: $ 51:°= CAQ ❑ Cap-off, quantity 1 gi1Z 361344410 Imo emytwachrit IBrSewer System Development Fee Total: $51('L� °° ❑ Reconnection to stub 'l 0 Water Service Line(behind meter), Size Cg ►ZO ❑ Backwater Valve `1 808 35`69460 c°nn sar«ru' 0 Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA ❑ NOT REQUIRED W� S`F�b ❑ NOT REQUIRED Explanation/Utility Permit $10 - 60 ^ Sturtr Explanation/Utility Permit#: 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/" Detect Meter Only, Service Size ❑Water System Development Fee Total: $ 0 Backflow Prevention (Outside Building): 0 DCDA ❑ Backflow Prevention (Outside Building): 0 DCVA NOT REQUIRED IZt NOT REQUIRED Explanation/Utility Permit#: Explanation/Utility Permit#: WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) ❑Yes, Quantity , See attached for reference. SNOT 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) `Ef NOT REQUIRED Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: XYES, Stormwater Total: $ /J176, $3 ❑YES,Traffic Mitigation Total: $ 0 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# P1JI805-063 *NOT REQUIRED T Be. paid N See Attached Spreadsheet for calculations/credit ❑ NOT REQUIRED J Nam 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 0 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 ip DevelopmentTech File XNOT REQUIRED—Tp&, issued ai/th Ba/idby tiri/x NonF. FIRE SPRINKLERS REQUIRED? ❑YES—Type K NOT R Q J pier' Shari-Phi Reason:�J��UIRED 35�0' of ('1YE,� 13Ati}• � T�LU/1A71 �idh1111� -Mr �/ PUBLIC WORKS PERMIT REQUIRED? fiAtill&WM% EYES, Permit#PWISOS— ErStornnwater NPDES Tab Completed in TRAKiT 13'ADA Tab Completed in TRAKiT Id Inspections Added in TRAKiT ❑ NOT REQUIRED Worksheet Completed By: I O' Date: 5/Gil/?Olq Worksheet Checked By: Date: REVISED 4/24/2019