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• <br /> E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> mum WASHINGTON <br /> PROJECT ADDRESS: 1528 GRAND AVE Permit#: PW2203-014 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: SOLDIER PILE WALL TO BE INSTALL AT THE TOP OF THE SLOPE TO <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 -❑ Per Cost Estimate <br /> ❑Alteration 0 Meter Only, Size -0 Per Cost Estimate <br /> ❑ Repair 0 Water System Development Fee Total: $ <br /> ❑ Cap-off,quantity ❑ 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 /> p-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 -0 Per Cost Estimate <br /> ❑ Meter Only, Size 0 9/4" Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total:$ ❑ Backflow Prevention(Outside Building): CIDCDA <br /> ❑ Backflow Prevention(Outside Building): 0 DCVA %NOT REQUIRED <br /> KNOT 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 /> 0-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): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> Ilgl-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 To be added on 0 See Attached for calculations/credit <br /> Quantity charged SF Quantity charged SF OT REQUIRED <br /> QTY is 0 Ground only 0 all hard surfaces QTY is 0 Roof only❑all hard surfaces <br /> $ $ <br /> iOT 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 ❑ 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 /> i'NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> )RIOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> p-YES, Permit#PW 22o 3- O t 4 <br /> ❑ Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: O' Date: 4 I t l I zo 2 z <br /> Worksheet Checked By: Date: <br /> REVISED 11/27/2019 <br />