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• • <br /> EVERETT <br /> WASHINGTON PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 320 S CABOT RD Permit#: PW1908-051 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: SITE WORK FOR NEW SFR AND DETACHED GARAGE <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (No :Permit Technicians to Create Utility Permit for Sewer Water, Fire, and Irrigation, as selected below) <br /> SANITARY SEWER: DOME IC WATER SERVICE: (Attach Calculation& Cost Est.) <br /> ❑ New Connection to ain plus connections to building ❑ Ne Connection, Size -❑ Per Cost Estimate <br /> ❑Alteration ❑ M er Only, Size -❑ Per Cost Estimate <br /> ❑ Repair ❑ ter System Development Fee Total: $ <br /> ❑ Cap-off, quanti ewer System Development Fee Total: $ <br /> Reconnection to b ater Service Line(behind meter), Size 3!f'' <br /> ❑ Backwater Valve 0Backflow Prevention (Outside Building): ❑ RPBA or❑ DCVA <br /> ❑ NOT REQUIRED ❑ NOT REQUIRED <br /> Explanation/Utility Permit#: Explanation/Utility Permit#: <br /> IRRIGATION SERVI : (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connectio►, Size ❑ New Connectio•, Size - ❑ Per Cost Estimate <br /> ❑ Meter Only, e ❑3/4" Detect er Only, Service Size <br /> ❑Water Sys m Development Fee Total: $ ❑ Backfl• 'revention (Outside Building): ❑ DCDA <br /> ❑ Backflow revention (Outside Building): ❑ DCVA .NO 'EQUIRED <br /> NOT "QUIRED Ex• .nation/Utility Permit#: <br /> Explan. ion/Utility Permit#: <br /> WATER DEPAR NT COST ESTIMATE NEEDED-(lf yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Qua y , See attached for reference. <br /> hIOT R UIRED <br /> Plumbing Pe its (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ Backflow P vention (Inside Building): ❑ DCVA(for Domestic service) ❑ RPBA(for Domestic service) ❑ DCDA(for Fire service) <br /> NOT RE UIRED <br /> Building Permits (Note:P rmit Technicians to add all items selected below to associated Building P it) <br /> STORMWATER SYSTEM VELOPMENT FEES: TRAFFIC MI ATION FEES: <br /> A YES, Stormwater To : $ i1�4`l 7. ( i ❑YES, ffic Mitigation Total: $ <br /> ❑ Roof Only F on Bldg Permit(ground hard surfaces fee on PW Permit) ee Attached for calculations/credit <br /> ,All Hard rface Fees to be added to Permit# P i'to 3 c51 T REQUIRED <br /> I-See ched Spreadsheet for calculations/credit <br /> ❑ NOT R UIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUI- D? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> YES—TYPE: SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> 0-See Attac -d Letter,2 copies (Permit Techs to isspe one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> IlrDigital c••y attached to permit record, Permit#P,t'?c'3—e 5c <br /> Saves o Address Folder in Development Tech File <br /> ❑ NOT REQUI'ED <br /> FIRE SPRINKL S REQUIRED? <br /> ❑YES—Typ <br /> fLNOT RE UIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> e•YES, Permit#PW O - US <br /> .Stormwater NPDES Tab Completed in TRAKiT C ADA Tab Completed in TRAKiT RC-Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED A4PPES <br /> Worksheet Completed By. Date: /1/2 0 /ZvI q <br /> Worksheet Checked By: Date: 1 (70 lielt <br /> REVISED 4/24/2019 <br />