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,. EVERETT •PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 1705 WETMORE AVE Permit#: CW1911-001 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: REMODEL AND ADD 2ND STORY AND NEW 380SF 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 Connection, Size -0 Per Cost Estimate <br /> Alteration Writ �01Q. �,mmT: SLOE 0 Meter Only, Size -0 Per Cost Estimate <br /> CI Repair 0 Water System Development Fee Total: $ <br /> ❑ Cap-off, quantity ssefik. IZEaJltLED`{D BE ❑ Sewer System Development Fee Total: $ <br /> ❑ Reconnection to stub gg—ggitylVP 1 egtU1•ri) Wigliet6 0 Water Service Line(behind meter), Size <br /> ❑ Backwater Valve stze ieD-D 5 r 6060D ffitAC16 ❑ Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ NOT REQUIRED Mot'To erst4srizoNlaw or Pgonswigt NOT REQUIRED <br /> Explanation/Utility Permit#: Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size ❑ New Connection, Size -❑ Per Cost Estimate <br /> ❑ Meter Only, Size 0 3/4' Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total:$ 0 Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA SNOT REQUIRED <br /> 1l NOT REQUIRED Explanation/Utility Permit#: <br /> Explanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-Of yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> ❑ NOT REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ Backflow Prevention (Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> 'SNOT REQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> YES, Stormwater Total: $ ao't 42. 0 YES,Traffic Mitigation Total: $ <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surface§fee on PW Permit) 0 See Attached for calculations/credit <br /> EAII Hard Surface Fees to be added to Permit# 191.2—MS (NOT REQUIRED <br /> ❑ See Attached Spreadsheet for calculations/credit <br /> ❑ NOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑YES—TYPE: 0 SFR 0 DUPLEX 0 ADU ❑ INFILL DWELLING ❑ MULTI-FAMILY 0 COMMERCIAL <br /> ❑ See Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> ❑ Digital copy attached to permit record, Permit# <br /> ❑ Saved to Address Folder in Development Tech File <br /> SNOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> SNOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> KYES, Permit#PW 1912-02$ <br /> KStormwater NPDES Tab Completed in TRAKiT t<ADA Tab Completed in TRAKiT F Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: - Date: (1.1 t'3/�lq <br /> Worksheet Checked By: Date: <br /> REVISED 11/27/2019 <br />