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EVE R E T T <br />WASHINGTON PUBLIC WORKS REVIEW WORKSHEET <br />PROJECT ADDRESS: 2905 LEONARD DR Permit #: B2103-086 <br />TENANT: [TenName] <br />DESCRIPTION OF WORK: REMOVE EXTG FRONT PORCH & REBUILD TO MATCH; INSTALL HIP ROOF <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 Connection to main plus connections to building ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Alteration ❑ Meter Only, Size - ❑ Per Cost Estimate <br />❑ Repair ❑ Water Syste Development Fee Total: $ <br />El Cap-off' <br />qu ntity ❑Sewer Sy em Development Fee Total: $ <br />❑ Reconne ion to stub ❑ Wate�wprlrevention <br />ice Line (behind meter), Size <br />Backw'err Valve ❑ Bac (Outside Building): ❑ RPBA or ❑ DCVA <br />OT EQUIRED NOT REQUIRED <br />xpla tion/ Utility Permit #: Explanation/ Utility Permit #: <br />IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVI E: (Attach Cost Estimate / Request for Reference) <br />❑ New Conne ion, Size ❑ New Con ction, Size - ❑ Per Cost Estimate <br />❑ Meter Only Size ❑ %" Dete Meter Only, Service Size <br />❑ Water Sy em Development Fee Total: $ ❑ Backfl Prevention (Outside Building): ❑ DCDA <br />❑ Backflo revention (Outside Building): ❑ DCVA NOT EQUIRED <br />NOT R QUIRED Ex lanation/ Utility Permit #: <br />Explanation/ tility Permit #: <br />WATER DE RTMENT COST ESTIMATE NEEDED-(Ifyes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, Qua tity See attached for reference. <br />NOT RE UIRE <br />Plumbing P rmlts (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) <br />❑ Backflow P vention (Inside Building): ❑ DCVA (for Domestic service) ❑ RPBA (for Domestic service) ❑ DCDA (for Fire service) <br />NOT RE IRED <br />Building Permits (Note: Permit Technicians to add all items selected below to associated Buildi g Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFI ITIGATION FEES: <br />YES, See Attached for calculations / credit a�103 _ b� ❑ YE Traffic Mitigation Total: $ <br />To be added on PW To be added on See Attached for calculations / credit <br />Quantity charged SF Quantity charged 5 SF N T REQUIRED <br />$QTY is ❑ Ground only ❑ all hard surfaces $QTY isAR-To` f0o'ny ❑ all hard surfaces <br />❑ NOT REQUIRED 91 <br />O <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: ❑ SFR ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY ❑ COMMERCIAL <br />YQUSaved <br />e 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 />to Address Folder in Development Tech File <br />NOTIRED <br />FIRE SPRINK ERS REQUIRED? <br />❑w,�ES —Typ <br />Re NOT RE UIRED <br />son: <br />PUBLIC WORKS PERMIT REQUIRED? <br />❑ YES, Permit PW <br />9 ❑ St -water NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />NOT REQ RED p� <br />Worksheet Completed By: Date: it figl gul <br />Worksheet Checked By: Date: <br />REVISED 1112712019 <br />