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• • <br /> EVERETT IZ <br /> WASHINGTON PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 10721 19TH AVE SE UNIT C Permit#: C1802-021 <br /> TENANT: ZERZURA TOWNHOMES U f90/_�J,6Fo 7 <br /> DESCRIPTION OF WORK: NEW TOWNHOUSE BLDG 2 UNIT 6 <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: V ✓ DOMESTIC WATER SERVICE: (Attach Calculation& Cost Est.) <br /> lid New Connection to main plus I connections to building 0 New Connection, Size -0 Per Cost Estimate <br /> ❑Alteration lEt Meter Only, SizeI"Dpn ingc 0 Per Cost Estimate <br /> ❑ Repair 1$Water System Development Fee Total: $ 51951: <br /> ❑ Cap-off, quantity tit Sewer System Development Fee Total: $5 )2), pO <br /> ❑ Reconnection to stub ❑Water Service Line(behind meter), Size <br /> ❑ Backwater Valve 0 Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ❑ NOT REQUIRED 0 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 3/4" Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total: $ 0 Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA 'a NOT REQUIRED <br /> 1K NOT REQUIRED Explanation/Utility Permit#: <br /> Explanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewe to Iv <br /> s''en cost estimate re guest to Water gepart a t) <br /> EYes, Quantity v. , See attached for reference. (2) C�onr)cc I MO B 0*1 l9 flitSE; Srnt tn ((WIN <br /> ❑ 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 /> 'ANOT 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 /> 74 YES, Stormwater Total:$ .83 $(YES,Traffic Mitigation Total: $ 2460. <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calculations/credit <br /> 113,All Hard Surface Fees to be added to Permit# PIi11$02-030 0 NOT REQUIRED -Th t{pm6 <br /> ❑ See Attached Spreadsheet for calculations/credit <br /> ❑ NOT REQUIRED <br /> Additional Checklists: one <br /> ADDRESS LETTER RE ED? ( (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> 'EYES-TYPE: E' 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> 13(See Attached Letter,2 copies(Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> g Digital copy attached to permit record, Permit# <br /> fil Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> ✓FIRE SPRINKLERS REQUIRED? <br /> 's'YES-Type 13 p <br /> ❑ NOT REQUIRED <br /> Reason: FIRE X)t <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> OYES, Permit#PW Ig02-030 <br /> 'Stormwater NPDES Tab Completed in TRAKiT 'ADA Tab Completed in TRAKiT Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: Date: 5/ 2 /2-0/1 <br /> Worksheet Checked By: Date: <br /> REVISED 4/24/2019 <br />