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imi EVE R E TT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 5130 51ST PL SW Permit#: B2102-060 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: NEW CONSTRUCTION OF SFR BUILD ON VACANT LOT <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 /> OVA NITARY SEWER: .9.9MESTIC WATER SERVICE: (Attach Calculation & Cost Est.) <br /> tjiNew Connection to main plus t connections to building SONew Connection, Size 3 i f "' - 0 Per Cost Estimate <br /> ❑ Alteration 0 Meter Only, Size - 0 Per Cost Estimate <br /> ❑ Repair [Water System Development Fee Total: $ 4.( 4o, 0o <br /> ❑ Cap-off, quantity ii Sewer System Development Fee Total: $ 5, 4 2 2.0t <br /> ❑ Reconnection to stub 0 Water Service Line(behind meter), Size <br /> ❑ Backwater Valve 0 Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ NOT REQUIRED ❑ NOT REQUIRED <br /> Explanation/Utility Permit#: U2io 3. O f(, Explanation/Utility Permit#: U ZS 63 .o i v <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size 0 New Connection, Size -0 Per Cost Estimate <br /> ❑ Meter Only, Size ❑ 'A" Detect Meter Only, Service Size <br /> ❑ Water System Development Fee Total: $ 0 Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA JNOT REQUIRED <br /> W-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 reference. <br /> IOT 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): 0 DCVA (for Domestic service) 0 RPBA(for Domestic service) 0 DCDA (for Fire service) <br /> [SNOT 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 /> fd-YES/ -See Attached for calculations/credit ,litYES,Traffic Mitigation Total: $ 3, ill.oD <br /> To be added on PW 2/04-431 To be added on 0 See Attached for calculations/credit <br /> Quantity charged 2-?,...4-1 SF Quantity charged SF 0 NOT REQUIRED <br /> QTY is 0 Ground pnly ball hard surfaces QTY is 0 Roof only 0 all hard surfaces <br /> $ -7'1 4.oV $ <br /> ❑ NOT REQUIRED <br /> Additional Checklists: <br /> 014 DRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ES-TYPE: KSFR 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 /> IC-Digital copy attached to permit record, Permit# "Pvv 21a 4 037 <br /> Ur-Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑ YES-Type <br /> 13=NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> Qi--YES, Permit#PW 210 4,031 <br /> [ktormwater NPDES Tab Completed in TRAKiT OKADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED / <br /> Worksheet Completed By: Date: v`l-1 r2-( 'Lis' L( <br /> Worksheet Checked By: Date: <br /> REVISED 11/27/2019 <br />