9204 EVERGREEN WAY 2022-04-01 - Laserfiche WebLink

• ! RE EVERETT PUBLIC WORKS REVIEW WORKSHEET iii WASHINGTON PROJECT ADDRESS: 9205 HOLLY DR Permit#: B2104-078 TENANT: LABELLA NAILS LASH HAIR SPA DESCRIPTION OF WORK: REMOVE EXISTING INTERIOR IMPROVEMENTS/DIVIDE BLDG INTO(2) 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 0 New Connection, Size -0 Per Cost Estimate ❑Alteration 0 Meter Only, Size -0 Per Cost Estimate ❑ Repair 0 Water System Development Fee Total:$ ❑ Cap-off,qu tity 0 Sewer Syst m Development Fee Total:$ ❑ Reconnec'on to stub 0 Water Se ice Line(behind meter),Size ❑ Backwat Valve 0 Backflow revention (Outside Building): 0 RPBA or 0 DCVA j�NOT R QUIRED ffi NOT QUIRED Explanaf n/Utility Permit#: Explan on/Utility Permit#: IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) ❑ New Conn tion, Size 0 New Connection, Size -0 Per Cost Estimate ❑ Meter Only, Size ❑'/<"D ect Meter Only, Service Size ❑Water Sy tem Development Fee Total:$ 0 Bac ow Prevention (Outside Building): ❑ DCDA ❑ Backflo Prevention (Outside Building): 0 DCVA 03(N REQUIRED I�NOT QUIRED Exp nation/Utility Permit#: Explana on/Uti ty Permit#: WATER DE ARTMENT COST ESTIMATE NEEDED-(lf yes, PW Reviewer to send cost estimate request to Water Department) ❑Yes, Qu ntity , See attached for reference. NtNOT QUIRED Plumbing P rmits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) ❑ Backflow P evention (Inside Building): 0 DCVA(for Domestic service) ❑ RPBA(for Domestic service) 0 DCDA(for Fire service) K NOT RE IRED Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) STORMWATER SYS EM DEVELOPMENT FEES: TRAFFIC MITIGATI• FEES ❑YES, 0 See Att hed for calculations/credit ❑YES,Traffic Mi'•ation Total: $ To be added o PW To be added on 0 See Atta •ed for calculations/credit Quantity cha ed SF Quantity charged SF 'NOT REQ RED QTY is 0 ound only 0 all hard surfaces QTY is 0 Roof only❑all hard surfaces ' ; . Gat,ak h e4 $ $ P Ed usE, N nr - duo, .NOT RE UIRED No Jh n To. as , I 1n q�6l ,,mlh ' • dditional Checklists: J DRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) YES—TYPE: 0 SFR ❑ DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY (COMMERCIAL PrSee Attached Letter,2 copies (Permit Techs to issue one copy tQ applicant with permits, scan one copy to Jeffrey Marks) taDigital copy attached to permit record, Permit# PbJ210S—014 I Saved to Address Folder in Development Tech File iAl 4 f / �� , ,./ (KNOT REQUIRED _�'��•-=-, _ _ -.{�71 !�l�.} !(Jyj'�tg �?�y E SPRINKLE- REQUIRED? ° EtircilritAlt t rE f u ,J ❑ —Type Ri NOT REQ RED Reason: PUBLIC WORKS PERMIT REQUIRED? ' YES, Permit#PW2I0S—0y 1 ,�,/ 1 � QFStormwater NPDES Tab Completed in TRAKiT ' ADA Tab Completed in TRAKiT Id Inspections Added in TRAKiT ❑ NOT REQUIRED Worksheet Completed By: c Date: c7/ l f inn i j Worksheet Checked By:ojAwjetAt 1A1( I1v Date: 5(21 t Za2 REVISED 11/27/2019