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_ • 0 <br /> E E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 11921 SILVER LAKE DR Permit#: C2008-004 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: REMODEL AND ADDITIONS OF LIVING SPACE AND ATTACHED GARAGE <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 0 New Con ction, Size -0 Per Cost Estimate <br /> ❑Alteration 0 Meter O y, Size -0 Per Cost Estimate <br /> ❑ Repair 0 Water ystem Development Fee Total: $ <br /> ❑ Cap-off, uantity 0 Sew System Development Fee Total: $ <br /> ❑ Recon ection to stub 0 Wa r Service Line(behind meter),Size <br /> ❑ Back ater Valve 0 B kflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> JZ(NO REQUIRED 0( T REQUIRED <br /> Expl ation/Utility Permit#: Ex lanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVI E: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size 0 New Co ection, Size -0 Per Cost Estimate <br /> ❑ Meter Only,Size 0 3/4"Det t Meter Only, Service Size <br /> ❑Water S stem Development Fee Total: $ 0 Back ow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflo Prevention(Outside Building): 0 DCVA �'NO REQUIRED <br /> 14 NOT QUIRED Exp nation/Utility Permit#: <br /> Expla tion/ tility Permit#: <br /> WATER PARTMENT COST ESTIMATE NEEDED-Of yes, PW Reviewer to send cost estimate request to Water Department) <br /> Yes, antity , See attached for reference. <br /> ik NOT EQUI ED <br /> PIu bin Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) - <br /> El Backflo Prevention(Inside Build : for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> ¢ NOT QUIRED <br /> Building Permits (No e:Permit Technicians to add:' :: <br /> l it s ::d <br /> below to associated Building P rmit) <br /> ORMWATER SYSTEM EVELOPMENT FEES: TRAFFIC MIT ATION FEES: <br /> YES,Stormwater Total: $ 312.4.5 ❑YES,Tr c Mitigation Total: $ <br /> ❑ Roof Only Fee on Bld Permit(ground hard surfac PW it) ❑ S Attached for calculations/credit <br /> *All Hard Surface Fees be added to Permit# 10 200$-00 if 'NO EQUIRED <br /> ,See Attached Spreadsh t for calculations/credit <br /> ❑ NOT REQUIRED <br /> Additional C -cklists: <br /> ADDRESS LE R REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑YES-TYP.. 0 SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> ❑ S-e Attached Letter,2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> ❑ bigital copy attached to permit record, Permit# <br /> • Saved to Address Folder in Development Tech File <br /> KNOT - QUI D <br /> FIRE SPRIN LERS RE UIRED? <br /> ❑YES-Ty e <br /> 1 NOT R QUIRED <br /> Reason: <br /> PUBLIC WOR PERMIT REQUIRED? <br /> ❑YES, Permi #PW <br /> 0 ormwater NPDES Tab Completed in TRAKiT 0 ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> fNOT RE UIRED <br /> Workshe t Completed By: Date: \1/01120 <br /> Worksheet Checked By: c:G - Date:. 1I 114PD <br /> REVISED 11/27/2019 <br />