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71 <br />7 <br />E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 2131 LAKE HEIGHTS DR SE Permit #: PW2103-043 <br />TENANT: BETHANY AT SILVER LAKE <br />DESCRIPTION OF WORK: <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 />❑ New Conn ction to main plus connections to building ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Alteratio ❑ Meter Only, Size - ❑ Per Cost Estimate <br />❑ Repair ❑ Water System)Development Fee Total: $ <br />❑ Cap- , quantity ❑ Sewer Syste Development Fee Total: $ <br />❑ Rec nnection to stub ❑ Water Se ice Line (behind meter), Size <br />,❑ Ba water Valve ❑ ackflo revention (Outside Building): ❑ RPBA or ❑ DCVA <br />�N T REQUIRED NOT QUIRED <br />Expl, nation/ Utility Permit #: Explana on/ Utility Permit #: <br />IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate /Request for Reference) <br />❑ New Connecti , Size ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Meter Only, ze ❑ %" Detect Meter Only, Service Size <br />❑ ate Syst Development Fee Total: $ ;'NOT <br />ackflow revention (Outside Building): ❑DCDA <br />❑ ackflow revention (Outside Building): ❑ DCVA R UIRED <br />NOT R UIRED Explanat' n/ Utility Permit #: <br />Explanati / Utili 'Permit #: <br />WATER DEP RTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, Qu tity See attached for reference. <br />'6NOT R UIR—FID <br />Plumbing ermits (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) <br />Backfiow revention (Inside Building): ❑ DCVA (for Domestic service) ❑ RPBA (for Domestic service) ❑ DCDA (for Fire service) <br />NOT RE UIRED <br />Buildi g Permits (Note: Permit Technicians to add all items selected below to associated Building Permit) <br />STORMW TER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br />YES, 0,See Attached for calculations / credit ❑ YES, Traffic Mitigation Total: $ <br />To be added on PW To be added on ❑ See Attached for calculations / credit <br />Quantity charged 341 SF Quantity charged SF El REQUIRED <br />QTY is PLGround only ❑ all hard surfaces QTY is ❑ Roof only ❑ all hard surfaces <br />$ '&1. 4- 5 $ <br />❑ NOT REQUIRED <br />Additional Checklists: <br />ADDRESS LETTE REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br />❑ YES - TYPE: SFR ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY ❑ COMMERCIAL <br />❑ Se Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br />❑ gital copy attached to permit record, Permit # <br />EVSaved to Address Folder in Development Tech File <br />NOT IfQUIRED <br />FIRE SPRINKLE REQUIRED? <br />YES -Type <br />NOT REQU ED <br />Reason: <br />-PUBLIC WORKS PERMIT REQUIRED? <br />YES,Zeit # PW - ®&13 <br />ormwater PDES Tab Completed in TRAKiT 0\�ADA Tab Completed in TRAKiT Del nspections Added in TRAKiT <br />❑ NOT REQUIRED AA <br />Worksheet Completed By: M Date: <br />Worksheet Checked By: Date: <br />REVISED 1112712019 <br />2./ ?- <br />