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- • • <br /> - EVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2901 LOWELL SNOHOMISH RD Permit#: PW2101-020 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: CONSTRUCTION OF A.85 ACRE OFF-LEASH DOG PARK <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 ❑ Meter Only, Size -0 Per Cost Estimate <br /> ❑ Repair 0 Water System evelopment Fee Total:$ <br /> ❑ Cap-off, quan ty 0 Sewer Syste Development Fee Total: $ <br /> ❑ Reconnectio to stub 0 Water Servi Line(behind meter), Size <br /> ❑ Backwater alve 0 Backflow Pr vention (Outside Building): 0 RPBA or 0 DCVA <br /> pf-RIOT REQ IRED ErITIOT RE I RED <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 0 New Conner ion, Size -0 Per Cost Estimate <br /> ❑ Meter Onl , Size 0 3/" Detect ter Only, Service Size <br /> ❑Water Sy tem Development Fee Total:$ 0 Backflow evention (Outside Building): 0 DCDA <br /> ❑ Backflo Prevention(Outside Building): 0 DCVA 1-PIOT RE UIRED <br /> F"NOT QUIRED Explanation/Utility Permit#: <br /> Explana on/Utility Permit#: <br /> WATER DEPAR MENT COST ESTIMATE NEEDED-Of yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> 4-NOT REQU ED <br /> Plumbin P rmits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ Backflow Pr vention (Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> NOT REQ IRED <br /> BuildingPermits (Note:Permit Technician to add all items selected below to associated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT F S: TRAFFIC MITIGATION FEES: <br /> S, 0 See Attached for calculations/c dit 0 YES,Traffic Mitigation Total:$ <br /> To be added on PW o -o2...o To be added on 0 See Attached for calculations/credit <br /> Quantity charged (4(c Quantity charged SF -NOT REQUIRED <br /> QTY is 0 Ground only gall hard rfaces QTY is 0 Roof only 0 all hard surfaces <br /> $ 51.cat $ <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 /> AYES-TYPE: 0 SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY COMMERCIAL <br /> See Attached Letter,2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> is <br /> Digital copy attached to permit record, Permit# 1N4,12t01-,O24.> <br /> aved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES-Type <br /> KNOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> EYES, Per it#PW Z 0%ol-02 <br /> Irr—Stormwater NPDES Tab Completed in TRAKiT , ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: Date: (5, 1 t q fr1-6-tA <br /> Worksheet Checked By: Date: <br /> REVISED 11/27/2019 <br />