2207 GIBSON PL 2022-10-28 - Laserfiche WebLink

EVERETT PUBLIC WORKS REVIEW WORKSHEET iimmi WASHINGTON PROJECT ADDRESS: 2207 GIBSON PL Permit#: B2109-031 TENANT: [TenName] DESCRIPTION OF WORK: CONSTRUCTION OF NEW 1692SF DETACHED SINGLE STORY GARAGE 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 connections to building 0 New Connection, Size ❑ Per Cost Estimate ❑Alteration 0 Meter Only, Size -❑ Per Cost Estimate ❑ Repair 0 Water System Development Fee Total:$ ❑ Cap-off, quantity 0 Sewer System Development Fee Total:$ ❑ Reconnec' n to stub 0 Water S rvice Line(behind meter), Size ❑ Backwa Valve 0 Backfl Prevention (Outside Building): 0 RPBA or❑ DCVA NOT QUIRED NOT EQUIRED Expla ion/Utility Permit#: Expla ation/Utility Permit#: IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) ❑ New Connection, Size ❑ New Connection, Size -❑ Per Cost Estimate ❑ Meter Only, S• e ❑3/" Dete eter Only, Service Size ❑Water Syst Development Fee Total:$ 0 Back Prevention (Outside Building): 0 DCDA ❑ Backflow revention (Outside Building): 0 DCVA ,"10 EQUIRED NOT R UIRED Exp nation/Utility Permit#: Explan on/Utility Permit#: WATER DEP MENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) ❑Yes, Qua y , See attached for reference. ,NOT RE UIRED Plum ng Per its (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) ❑ Backflow Pr ention (Inside Building): 0 DCVA(for Domestic service) ❑ RPBA(for Domestic service) ❑ DCDA(for Fire service) ,NOT REQ RED Building Permits (Note:Permit Technicians to add all items selected be to associated Building Permit) /STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIG ON FEES: AYES, 0 See Attached for cal ulations redit 0 YES,Traffic itigation Total: $ To be added on PW 2-2— o To be added on 8 2 o9—O 31 0 See ched for calculations/credit Quantity charged SF Quantity charged / 6 9 Z SF '\NOT R UIRED QTY is 0 Ground only all hard surfaces QTY is 0 Roof only 0 all hard surfaces $ 2 I-e,�S $ -415 g_11,- OT REQUIRED Additional Checklists: ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Addr etter from TRAKiT Print Menu and include) ❑YES—TYPE: 0 SFR ❑ DUPLEX 0 ADU 0 INFILL DWELLING ❑ MULTI-FAMILY ❑ COMMERCIAL ❑See Attached Letter,2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) igital copy attached to permit record, Permit# Saved to Address Folder in Development Tech File )4NO EQUIRED FIRE SPRI LERS REQUIRED? ❑YES ype. NO REQUIRED AI Re on: ` T PUBLIC WORKS PERMIT REQUIRED? DYES, Permit#PW 22 in 0-00 jgStormwater NPDES Tab Completed in TRAKiT S ADA Tab Completed in TRAKi ■ spections Added in TRAKiT ❑ NOT REQUIRED ,�// Worksheet Completed By: f( / lj ./-e_ Date: 63 D9/7O22-- Worksheet Checked By: Date: 3 ize....-z-z— REVISED 11/27/2019