600 54TH ST SW 2022-05-11 - Laserfiche WebLink

• E V E R E T T PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: 600 54TH ST SW Permit#: PW2001-017 TENANT: [TenName] DESCRIPTION OF WORK: PARALLEL CUT/BORE IN PAVEMENT FOR SEWER EXTENSION ALONG 54TH 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 I connections to building 0 New Connection,Size -0 Per Cost Estimate ❑Alteration rr 0 Meter Only, Size - 0 Per Cost Estimate ❑ Repair $U?' S QV1 ❑Water System Development Fee Total:$ ❑ Cap-off, quantity ❑ Sewer System Development Fee Total:: $ ❑ Reconnection to stub 45I2N-ose—°- ❑Water Service Line(behind meter), Size ❑ Backwater Valve 603 5�SSW• �CI(Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA ❑ NOT REQUIRED _J-'' yb y NOT REQUIRED Explanation/Utility Permit#: (4 LIMoA $e Explanation/Utility Permit#: IRRIGATION SERVICE: (Not Includingllff Cost Estimate 1 FIRE SERVICE: (Attach Cost Estimate/Request for Reference) ❑ New Connection, Size ❑ New Connection, Size -❑ Per Cost Estimate ❑ Meter Only, Size 0 3/4" Detect Meter Only, Service Size ❑Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): ❑ DCDA ❑ Backflow Prevention (Outside Building): ❑ DCVA Er NOT REQUIRED ZEINOT REQUIRED Explanation/Utility Permit#: Explanation/Utility Permit#: WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) ❑Yes, Quantity , See attached for reference. KNOT REQUIRED Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) ❑ Backflow Prevention (Inside Building): ❑ DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) %NOT REQUIRED Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: ❑YES, Stormwater Total: $ 0 YES,Traffic Mitigation Total: $ ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calculations/credit ❑All Hard Surface Fees to be added to Permit# KNOT REQUIRED ❑ See Attached Spreadsheet for calculations/credit ,NOT 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 ❑ADU 0 INFILL DWELLING ❑ 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 KNOT REQUIRED FIRE SPRINKLERS REQUIRED? ❑YES—Type la NOT REQUIRED Reason: PUBLIC WORKS PERMIT REQUIRED? EYES, Permit#PWgp01"011- IkStormwater NPDES Tab Completed in TRAKiT IatADA Tab Completed in TRAKiT filnspections Added in TRAKiT ❑ NOT REQUIRED t, Worksheet Completed By: AI --16- Date: 10 131 2oSo Worksheet Checked By: Date: REVISED 11/27/2019