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• i <br /> E E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2031 RAINIER AVE Permit#: B2106-035 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: NEW 560SF DETACHED 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 SEW R: DOMESTIC WATER SERVICE: (Attach Calculation& Cost Est) <br /> ❑ New Connect an to main plus connections to building 0 New Connecti. , Size -0 Per Cost Estimate <br /> ❑Alteration 0 Meter Only„size 0 Per Cost Estimate <br /> ❑ Repair 0 Water Sy em Development Fee Total: $ <br /> ❑ Cap-off, ,uantity ❑ Sewer ystem Development Fee Total: $ <br /> ❑ con -ction to stub 0 Wat-'Service Line(behind meter), Size <br /> ❑ ack ;'ater Valve ❑ a• flow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> NOT 'EQUIRED l,IT REQUIRED <br /> Expla:`ation/Utility P-rmit#: Ex.lanation/Utility Per 'it#: <br /> IRRIGATION S VICE: (Not Including Cost Estimates) FIRE SERVICE: (A ach Cost Estimate/Request for Reference) <br /> ❑ New Conner ion, Size 0 New Connec in, Size -0 Per Cost Estimate <br /> ❑ Meter Onl, Size 0 3/4" Detect r-ter Only, Service Size <br /> ❑Water S -tern De elopment Fee Total: $ ❑packflow;"revention (Outside Building): 0 DCDA <br /> CI gackflo;' Preve ion (Outside Building): 0 DCVA VNOT R-•UIRED <br /> NONOT • QUIR'D Explanaf•n/Utility Permit#: <br /> Explan. ion/Ut ity Permit#: <br /> WATER DE-ARTM NT COST ESTIMATE NEEDED-(lf yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Y s, Qu. tity , See attached for reference. <br /> IOT R7QUIR'D <br /> Plum•ing;'ermits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> N❑ ac low;`•revention (Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> OT R 'WIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> STRMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ghES, 0 See Attached for c_alcuJ�ti., s I credit a 0 YES,Traffic Mitigation Total: $ <br /> To be added on PW 6 -t) Ai To be added on ►. U d —(11 ❑ See Attached for calculations/credit <br /> Quantity charged ' i SF Quantity cparged 7�tf SF I 'JOT REQUIRED <br /> QTY is 0 Ground onl • QTY is Roof on,- • a ha surfaces <br /> $ _ al :r. surfaces $ EI/1, Lis <br /> DNOT R • IRED <br /> Additional Che, lists: <br /> ADDRESS LETT REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑YES—TYPE: ■ SFR ❑ •UPLEX ❑ADU 0 INFILL DWELLING ❑ MULTI-FAMILY 0 COMMERCIAL <br /> ❑ Se: Attached Le er,2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> ❑ D';eital copy at ached to permit record, Permit# <br /> ❑ `aved to Ad ess Folder in Development Tech File <br /> ISINOT R .AUIRED <br /> FIRE SPRINKLER REQUIRED? <br /> ❑yEs—Type <br /> I,MOT RE UIR D Reason: i /'� M <br /> pliBLIC WORKS PERMIT REQUIRE? <br /> ES, Per it#PW` ea..ow <br /> Stormwater NPDES Tab Completed in TRAKiT IN'ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED /O7/2OZ <br /> Worksheet Completed By: IJ. Date: t <br /> Worksheet Checked By: ✓ 1 Date: i t /Z-401,f <br /> REVISED 11/27/2019 <br />