1701 121ST ST SE 2022-05-02 - Laserfiche WebLink

• e EVERETT PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: 1701 121ST ST SE Permit#: PW2101-024 TENANT: [TenName] DESCRIPTION OF WORK: REPLANT AND VEGETATION FROM TREE TRIMMING PROJECT 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, quantity 0 Sewer System Development Fee Total:$ ❑ Reconnection to stub 0 Water Service Line(behind meter), Size ❑ Backwater Valve ❑Backflow Prevention (Outside Building): 0 RPBA or El DCVA KNOT REQUIRED NOT REQUIRED Explanation/Utility Permit#: Explanation/Utility Permit#: IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) ❑ New Connection, Size 0 New Connection, Size -0 Per Cost Estimate ❑Meter Only, Size ❑W Detect Meter Only, Service Size ❑Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): 0 DCDA ❑ Backflow Prevention(Outside Building): 0 DCVA Et NOT REQUIRED NOT REQUIRED Explanation/Utility Permit#: Explanation/Utility Permit#: WATER DEPARTMENT COST ESTIMATE NEEDED-Of yes, PW Reviewer to send cost estimate request to Water Department) elifYes, Quantity , See attached for reference. liANOT REQUIRED Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) ❑ Backflow Prevention(Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) ❑ DCDA(for Fire service) ANOT REQUIRED Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: ❑YES, 0 See Attached for calculations/credit 0 YES,Traffic Mitigation Total: $ To be added on PW To be added on 0 See Attached for calculations/credit Quantity charged SF Quantity charged SF 194\10T REQUIRED QTY is 0 Ground only 0 all hard surfaces QTY is 0 Roof only 0 all hard surfaces $ $ KNOT REQUIRED Additional Checklists: ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) ❑YES-TYPE: 0 SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL ❑See Attached Letter,2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) ❑ Digital copy attached to permit record, Permit# ❑Saved to Address Folder in Development Tech File 'NOT REQUIRED FIRE SPRINKLERS REQUIRED? ❑ ES-Type ►i OT REQUIRED Reason: ,PUBLIC WORKS PERMIT REQUIRED? YES, Pei- it#PW 1)03l- o Lt4 *. Stormwater NPDES Tab Completed in TRAKiT ADA Tab Completed in TRAKiT inspections Added in TRAKiT ❑ NOT REQUIRED (� Worksheet Completed By: (`‘.‘ Date: � 1-612k Worksheet Checked By: Date: 3 I3 REVISED 11/27/2019