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• <br /> • I <br /> EEVE R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2408 RAVENNA ST Permit#: C1909-010 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: CONVERT FINISHED BASEMENT TO AN ADU <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 t main plus connections to building 0 New Connection, Size -0 Per Cost Estimate <br /> ❑Alteration 0 Meter Only, Size -0 Per Cost Estimate <br /> ❑ Repair 0 Water System velopment Fee Total: $ <br /> ❑ Cap-off, q ntity 0 Sewer Syste evelopment Fee Total: $ <br /> ❑ Reconne ion to stub 0 Water Se ' e Line(behind meter), Size <br /> ❑ Backw er Valve ❑ Backflo revention (Outside Building): 0 RPBA or 0 DCVA <br /> III-NOT EQUIRED SNOT QUIRED <br /> Explanation/Utility Permit#: Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Conne tion, Size 0 New Conne ion, Size - ❑ Per Cost Estimate <br /> ❑ Meter On , Size ❑'/<" Detec eter Only, Service Size <br /> ❑Water stem Development Fee Total: $ 0 Backflo Prevention (Outside Building): 0 DCDA <br /> ❑ Back w Prevention (Outside Building): ❑ DCVA ,SNOT EQUIRED <br /> 0-NO REQUIRED Explanation/Utility Permit#: <br /> Explanation/Utili Permit#: <br /> WATER DEP RTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Qu tity , See attached for reference. <br /> IEZ.NOT QUIRE% <br /> Plumbing .ermits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ Backflow evention (Inside Building): 0 DC\A(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> �PJOT REQUIRED <br /> Building Permits ( ote:Permit Technician to add all items selected below to associated Building Pe' it) <br /> STORMWATER SYSTE DEVELOPMENT FEE : TRAFFIC MITI r•ATION FEES: <br /> 'YES, Stormwater Tota: $ 2 9, 7 9 ❑YES,Tra p`c Mitigation Total: $ <br /> 0 Roof Only Fee on Bldg Permit(ground rd surfaces fee on PW Permit) 0 Se;Attached for calculations/credit <br /> a-All Hard Surface ees to be added to rmit# �W tg It—o 4c� i IOT '' QUIRED <br /> ..See Attached Spr adsheet for calcul ions/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 /> 4ES—TYPE: 0 SFR 0 DUPLEX eiCADU 0 INFILL DWELLING 0 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 /> g$aved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> IOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> *YES, Permit#PW j' i I p o 4O <br /> $$tormwater NPDES Tab Completed in TRAKiT DADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> i/ r1 <br /> Worksheet Completed By: Date: �� (/ ��� <br /> \A/nrkchaat r.harkarl Rv data• <br />