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• 0 <br /> E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 1920 MERRILL CREEK PKWY Permit#: B2205-071 <br /> TENANT: UMC INC <br /> DESCRIPTION OF WORK: CONSTRUCT 3292SF OUTDOOR RACK, 8350SF FENCED AREA <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, qua ity ❑ Sewer Syst m Development Fee Total: $ <br /> ❑ Reconnec' n to stub ❑ Water S ice Line(behind meter), Size <br /> ❑ Backw r Valve ❑ Bac w Prevention(Outside Building): ❑RPBA ❑ DCVA <br /> ® NOT QUIRED ® N REQUIRED <br /> Explan ion/Utility Permit# Expl ation/Utility Permit# <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size ❑ New Con -ction, Size -❑ Per Cost Estimate <br /> ❑ Meter nly, Size ❑ %" Dete' Meter Only,Service Size <br /> ❑ Wate System Development Fee Total:$ ❑ Back 0.w Prevention(Outside Building): ❑DCDA <br /> ❑ Ba flow Prevention(Outside Building): ❑DCVA ❑ NOV' REQUIRED <br /> ® N T REQUIRED E .lanation/Utility Permit# <br /> Explanati. /Utility Permit# <br /> WATER PARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Ye ,Quantity , See attached for reference. <br /> ® aT REQU ED <br /> Plumbin Permits(Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> Backflow revention (Inside Building): ❑DCVA(for Domestic service) ❑RPBA(for Domestic service) ❑DCDA(for Fire service) <br /> ® NO REQUIRED <br /> uilding Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIG TION FEES: <br /> ® YES, ® See Attached for calculations/credit ❑YES,Tra Mitigation Total: $ <br /> To be added on PW To be added on B2205-071 e Attached for calculations/credit <br /> Quantity charged SF Quantity ch rged 1590SF ® NO REQUIRED <br /> QTY is❑ Ground only❑ all surfaces QTY is oof only® all surfaces <br /> $ 425.80 <br /> OT REQUIRED <br /> Additi al 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 /> ❑ Save to Address Folder in Development Tech File <br /> ® NOT R QUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑ YES—Type <br /> ® NOT RE'UIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ❑ YES, Permit#PW <br /> ❑ Stor water NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br /> ® NOT RE.UIRED <br /> Worksheet Completed By Date: 6tb/o4/'Ld ZZ <br /> Worksheet Completed By: Date: <br /> REVISED 12/22/2021 <br />