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_ 0 IP <br /> E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 5406 OCEAN AVE Permit#: B2110-020 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: ADD COVERED FRONT PORCH TO FRONT OF HOUSE <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 -❑ Per Cost Estimate <br /> ❑ Alteration ❑ Meter Only, Size -❑ Per Cost Estimate <br /> ❑ Repair ❑ Water System Development Fee Total: $ <br /> ❑ Cap-off,quantity ❑ Sewer System Development Fee Total: $ <br /> ❑ Recon ection to stub ❑ Wate Service Line(behind meter), Size <br /> ❑ Bac ater Valve ❑ B flow Prevention (Outside Building): ❑RPBA ❑ DCVA <br /> ® N REQUIRED ® OT REQUIRED <br /> Ex nation/Utility Permit# planation/Utility Permit# <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size ❑ New Connection, Size -❑ Per Cost Estimate <br /> ❑ Meter Only,Size ❑ 3/4" De ct Meter Only, Service Size <br /> ❑ Water stem Development Fee Total:$ ❑ Ba ow Prevention (Outside Building): ❑DCDA <br /> ❑ Bac ow Prevention (Outside Building): ❑DCVA ® T REQUIRED <br /> ® N REQUIRED Explanation/Utility Permit# <br /> xplanation/Utility Permit# <br /> WATE EPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Y , Quantity , See attached for reference. <br /> ® OT REQUIRED <br /> Plumb g Permits(Note:Permit Technicians to add all items selected below to 'lumbing Permit-for items inside building only) <br /> Backflo Prevention (Inside Building): ❑DCVA(for Domestic service) ❑RPBA(f.rpomestic service) ❑DCDA(for Fire service) <br /> ® N REQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selectee --low o associated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ® YES, ® See Attached for calculations/credit ❑YES,T :ffic Mitigation Total: $ <br /> To be added on PW To be added on B2110-020 2 See Attached for calculations/credit <br /> Quantity charged SF Quantity charged 230SF 11 OT REQUIRED <br /> QTY is❑ Ground only❑ all surfaces QTY is® Roof only❑ all s aces <br /> $ 61.59 <br /> OT 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: ❑ SFR ❑ DUPLEX ❑ADU ❑ INFILL DWELLING ❑ MULTI-FAMILY ❑ 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 /> ❑ NOT REQUIRED <br /> FIRE SP INKLERS REQUIRED? <br /> ❑ YE —Type <br /> ® T REQUIRED <br /> Re son: <br /> PUBLIC W KS PERMIT REQUIRED? <br /> ❑ YES, rmit#PW <br /> ❑ ormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br /> ® NO REQUIRED <br /> Worksheet Completed By: .:,:- Date: UCo(08/20 Z Z- <br /> Worksheet Completed By: Date: <br /> REVISED 12/22/2021 <br />