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• <br /> I_ EVERETT <br /> WASHINGTON PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 10725 19TH AVE SE UNIT N8 Permit#: C1803-022 <br /> TENANT: ZERZURA TOWNHOMES Q <br /> DESCRIPTION OF WORK: NEW TOWNHOUSE BLDG 4 UNIT'8 (CQ I O( _ 01 0 <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 /> ANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation& Cost Est.) <br /> New Connection to main plus I connections to building 0 New Connection, -0 Per Cost Estimate <br /> ❑Alteration Er Meter Only, Sizel oom(ARE-0 Per Cost Estimate <br /> ❑ Repair si XWater System Development Fee Total: $3/9 ',to• <br /> ❑ Cap-off, quantity VErSewer System Development Fee Total: $5/12.1.a <br /> ❑ Reconnection to stub 0 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/" 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 j'NOT REQUIRED <br /> (NOT REQUIRED Explanation/Utility Permit#: <br /> Explanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(lf yes, PW Reviewer to se d cost estimate request to Water Departm nt) <br /> EYes, Quantity _ , See attached for reference. (i) ConntatrAS ID Ill i t! 56/ S o /f7s/ZY <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 /> 'KNOT 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 /> RYES, Stormwater Total: $ 3 ]4I,33 YES,Traffic Mitigation Total: $ a4W 1 <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calculations/credit <br /> L(AII Hard Surface Fees to be added to Permit#Pie/SMR-030 ❑ NOT REQUIRED INN,[OME, <br /> ❑ See Attached Spreadsheet for calculations/credit /T <br /> ❑ NOT REQUIRED <br /> Additional Checklists: itteNdolyie <br /> A9DRESS LETTER REQU ED? (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 /> 1ErSee Attached Letter, 2 copies(Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> Er Digital copy attached to permit record, Permit# <br /> aSaved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> /IRE SPRINKLERS REQUIRED? <br /> 12(YES—Type 1st' <br /> ❑ NOT REQUIRED <br /> Reason: f E DG <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> 'AYES, Permit#PW (1302-030 <br /> Stormwater NPDES Tab Completed in TRAKiT IIADA Tab Completed in TRAKiT Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: 1ITTJY'& V Date: S 2/ <br /> /213/9 <br /> Worksheet Checked By: Date: <br /> REVISED 4/24/2019 <br />