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• • <br /> E EVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> mom WASHINGTON <br /> PROJECT ADDRESS: 601 LAUREL DR Permit#: B1910-032 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: NEW COVERED DECK TO REPLACE EXISTING SMALLER DECK <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 SE VICE: (Attach Calculation& Cost Est.) <br /> ❑ New Connection to m n plus connections to building 0 New Connection, S' e - 0 Per Cost Estimate <br /> ❑Alteration 0 Meter Only, Size -0 Per Cost Estimate <br /> ❑ Repair 0 Water System evelopment Fee Total: $ <br /> ❑ Cap-off,quantit ❑ Sewer Syste Development Fee Total: $ <br /> ❑ Reconnection stub 0 Water Se ' e Line(behind meter), Size <br /> ❑ Backwater V ve 0 Backflow revention (Outside Building): 0 RPBA or 0 DCVA <br /> , QT REQ RED KNOT REQUIRED <br /> Explanation Utility Permit#: Exp�anation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size ❑ New Connecti , Size -0 Per Cost Estimate <br /> ❑ Meter Only, Siz ❑3/4" Detect M er Only, Service Size <br /> ❑Water Syste evelopment Fee Total:$ 0 Backflow P evention (Outside Building): 0 DCDA <br /> ❑ Backflow Pr ention (Outside Building): 0 DCVA A-NOT RE IRED <br /> lit-NeT REQ IRED Explanation/Utility Permit#: <br /> Explanatio Utilit ermit#: <br /> WATER DEPA TMENT COST ESTIMATE NEEDED-Of yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quan 'y , See attached for reference. <br /> .&OT RE IRED <br /> Plumbing P mits (Note: It Tec nicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ Backflow Pr vention (In ' e Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> 9..N.OT REQ IRED <br /> Building ermits (Note:Permit Technicians to add all items selected below to associated Building Pe mit) <br /> STORMWA ER SYSTEM DEVELOPMENT FEES: TRAFFIC MITI TION FEES: <br /> )(YES, Sto mwater Total:$ 72.!2 0 YES,Traffi itigation Total: $ <br /> aRoo Only Fee on Bldg Permit(ground hard urfaces fee on PW Permit) ❑ See ttached for calculations/credit <br /> ❑,All H rd Surface Fees to be added to Perm' # %NOT R QUIRED <br /> See ttached Spreadsheet for calculation /credit <br /> ❑ NOT REQ IRED <br /> Additional C kl ts: <br /> ADDRESS LETTER - ' QUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑YES—TYPE: ❑ FR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> ❑ See • ached Letter, 2 copies(Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> ❑ Di.'al copy attached to permit record, Permit# <br /> ❑ S-ved to Address Folder in Development Tech File <br /> KNOT R ',WIRED <br /> FIRE SPRINKL S REQUIRED? <br /> ❑YES—Type <br /> ❑ NOT RE IRED <br /> Reason: <br /> PUBLIC WORKS ERMIT REQUIRED? <br /> ❑YES, Permit PW <br /> ❑ S rmwater NPDES Tab Completed in TRAKiT 0 ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ittNOT RE IRED <br /> Worksheet Completed By: _ E--- <br /> -- __,,, Date: Of /2? 1 2O f 9 <br /> \A/nrkchaat r.harkarl Rv• AT* data• /d IZ747.0lq <br />