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• 4111- <br /> EVERETT <br /> ir., PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2320 RAILWAY AVE Permit#: PW2010-036 <br /> TENANT: (TenName] <br /> DESCRIPTION OF WORK: SITE IMPROVEMENTS FOR ICI CONSTRUCTION YARD <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (Note:Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and lrrigati , as selected below) <br /> SANITARY SEW R: DOMESTIC WATER SERVI : (Attach Calculation & Cost Est.) <br /> fNew Conne on to main plus , connections to building 0 New Connection, Size - 0 Per Cost Estimate <br /> ❑ Alteration +Meter Only, Size - 0 Per Cost Estimate <br /> ❑ Repair Water System De lopment Fee Total: $ 22, 332. Oe' <br /> ❑ Cap-of, quantity Sewer System evelopment Fee Total: $ 2ga Qp i.o 0 <br /> ❑ Rec• nection to stub 0 Water Servi Line (behind meter), Size <br /> ❑ Ba' water Valve -gackflow evention (Outside Building):KRPBA or 0 DCVA <br /> ❑ •T REQUIRED � M2_ <br /> ❑ R �(�Explanation/Utility Permit#: ( Explan on/ Utility Permit#: U 2 0 MCA <br /> IRRIGATION SERVICE: (Not chiding Cost Estimates) FIRE SERVIC . (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size 0 New Co ection, Size -0 Per Cost Estimate <br /> %Meter Only, Size 1 ler 0 3/4" D ct Meter Only, Service Size <br /> ot.Water System D elopment Fee Total: $ 131Q52.00 Ba low Prevention (Outside Building): 0 DCDA <br /> 1StBackflow Prey tion (Outside Building): la DCVA T REQUIRED <br /> ❑ NOT REQU ED a a nt ,,,, ( ( Ex lanation/Utility Permit#: <br /> Explanation tility Permit#: L.)10� <br /> WATE EPARTMENT COST ESTIMATE NEEDED-(lf yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Ye , Quantity , See attached for reference. <br /> T REQUIRED <br /> Plumbin. •ermits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ Backfl., Prevention (Inside Building): 0 DCVA (for Domestic service) 0 RPBA (for Domestic service) 0 DCDA (for Fire service) <br /> p,NO •EQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to ass•ciated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES 09 <br /> A YES,ASee Attached for calculations/credit E YES, Traffic Mitigation Ti . : $ • , 3 <br /> To be added on PW Z010- o3v To be added on $2-O i•- 047— 0 See Attached for •- cu :tions/credit <br /> Quantity charged 4-t Si 459 SF Quantity charged . 01 SF 0 NOT REQUIRE, <br /> QTY is WI-Ground only 0 all hard surfaces QTY is`F Roof 0 all hard surfaces <br /> $ n.0,311 .90 $ 4`i — B2O . <br /> ❑ NOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> OYES—TYPE. 0 SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 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 /> igital copy attached to permit record, Permit# ?iJ 2.e sO -03(e <br /> al-saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SP NKLERS REQUIRED? <br /> ❑o YE —Type_ <br /> tpii. T REQUIRED <br /> R son: <br /> PUBLIC WORKS P IT REQUIRED? <br /> ES, Peimit# 2_o r o • 0 3 Co <br /> C�`ST water NPDES Tab Completed in TRAKiT Qf-ABA Tab Completed in TRAKiT spections Added in TRAKiT <br /> ❑ NOT RE IRED <br /> Worksh et Completed By: Date: Oc /// )'Z4J7L <br /> Worksheet Checked By: Date: <br /> REVISED 11/27i2079 <br />