Laserfiche WebLink
EVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2207 GIBSON PL Permit#: PW2201-007 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: SITE WORK FOR 1692 SF DETACHED GARAGE&ADD 1010 SF DRIVEWAY <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 ❑ New Connection, Size -0 Per Cost Estimate <br /> 0 Alteration 0 Meter Only, Size -❑ Per Cost Estimate <br /> ❑ Repair 0 Water System Development Fee Total:$ <br /> ❑ Cap-off,quantity 0 Sewer System Development Fee Total:$ <br /> ❑ Reconnection to stub 0 Water Service Line(behind meter), Size <br /> ❑ Backwater Valve ❑ Backflow Prevention(Outside Building): 0 RPBA or 0 DCVA <br /> ►NOT REQUIRED .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 0 New Connection,Size -❑ Per Cost Estimate <br /> ❑ Meter Only, Size ❑%"Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total:$ ❑ Backflow Prevention(Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): ❑ DCVA JOT REQUIRED <br /> NOT REQUIRED Explanation/Utility Permit#: <br /> Explanation!Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for>21: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): ❑ DCVA(for Domestic service) ❑ RPBA(for Domestic service) ❑ DCDA(for Fire service) <br /> AD NOT 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, 0 See Attached for calculations!credit 0 YES,Traffic Mitigation Total: $ <br /> To be added on PW 2Zo/—0a3, To be added on 0 See Attached for calculations/credit <br /> Quantity charged info SF Quantity charged SF OT REQUIRED <br /> QTY isl!a Ground only 0 all hard surfaces QTY is❑ Roof only 0 all hard surfaces <br /> $ 2-70. 49 $ <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 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 /> ❑Saved to Address Folder in Development Tech File <br /> )QNOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> IOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> YES, Permit#PW 021:1,l—0 0-7, <br /> , Stormwater NPDES Tab Completed in TRAKiT ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED G/_ / <br /> Worksheet Completed By: .16 a~- Date: O 3 t0 9 /Zo 2 Z <br /> Worksheet Checked By: Date: ���Zo 22� <br /> REVISED 11/27/2019 <br />