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1110 <br /> ILLIN EVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2318 HIGHLAND ST Permit#: PW2103-003 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: Driveway for ADU <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 /> ❑ Reconnection to stub ❑ Water Service Line(behind meter), Size <br /> ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑RPBA ❑ DCVA <br /> KNOT 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 ❑ New Connection, Size -❑ Per Cost Estimate <br /> ❑ Meter Only, Size ❑ 3/" Detect Meter Only, Service Size <br /> ❑ Water System Development Fee Total:$ ❑ Backflow Prevention (Outside Building): ❑DCDA <br />' ❑ Backflow Prevention(Outside Building): ❑DCVA NOT 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 reference. <br /> IR 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 /> xj 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, Dn See Attached for calculations/credit ❑YES,Traffic Mitigation Total: $ <br /> To be added on PW 2-io3'0 To be added on ❑See Attached for calculations/credit <br /> Quantity charged SF (64 Quantity charged SF 0 NOT REQUIRED <br /> QTY is Ground only❑all;ur faces QTY is❑ Roof only❑ all surfaces <br /> $ t1•� <br /> ❑ NOT REQUIRED 11 1 <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> V YES—TYPE: ❑ SFR ❑ DUPLEX I►': ADU ❑ INFILL DWELLING ❑ MULTI-FAMILY ❑ COMMERCIAL <br /> See Attached Letter,2 copies (Permit Techs to issue one coy to applicant with permits, scan one copy to Jeffrey Marks) <br /> 5 Digital copy attached to permit record, Permit# <br /> Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑ YES—Type <br /> 01 NOT REQUIRED <br /> ason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> g YES, Permit#PW 2.1 p3-D03 <br /> - Stormwater NPDES Tab Completed in TRAKiT 1VADA Tab Completed in TRAKiT [ }Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED ,p <br /> Worksheet Completed By: IMA44/17" Date: D v 51112/ <br /> Worksheet Completed By: Date: <br /> REVISED 12/22/2021 <br /> 1 <br />