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EVERETT W R PUBLIC WORKS REVIEW O KSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 8831 CORBIN DR Permit#: BW2012-001 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: NEW DETACHED ADU &RAMP <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 b w) <br /> SANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation& t Est.) <br /> O ew Connection to main plus connections to building 0 New Connection, Size -0 Per Cost Estimat <br /> AIl <br /> lteration 0 Meter Only, Size -0 Per Cost Estimate <br /> Repair 0 Water System Development Fee Total: $ <br /> ❑Cap-off,quantity ❑ Sewer System Development Fee Total: $ <br /> O Reconnection to stub Ilif Water Service Line(behind meter), Size <br /> O Backwater Valve 0 Backflow Prevention (Outside Building): 0 RPBA or 0 D A <br /> NOT REQUIRED ` �c 6S ❑ NOT REQUIRED <br /> Ex tion/Utility Permit#: 2 �'�'" Explanation/Utility Per #: 7.1 r• 0 <br /> IRRIGATION SERVIC : (Not Including Cost Estimates) FIRE SERVICE: ach Cost Estimate/Request for Reference) <br /> ❑ New Connection, :ize 0 New Conn ion, Size -0 Per Cost Estimate <br /> ❑ Meter Only, Si - 0 3/4" Det Meter Only, Service Size <br /> ❑Water Syste• Development Fee Total:$ ❑pac w Prevention (Outside Building): 0 DCDA <br /> o gackflow ' evention (Outside Building): 0 DCVA NtN REQUIRED <br /> EliONOT R •UIRE Explanation/Utility Permit#: <br /> Explana'•n/Uti' Permit#: <br /> WATER DE ARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑ es, Q ntity , See attached for reference. <br /> WNOT QUIRED <br /> Plumbin Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ackflo Prevention (Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> V NOT QUIRED <br /> Plumb <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> STORMWATER SYST DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ❑YES, 0 See Atta ed for calculations/credit 0 YES,Traffic Mitigation Total: $ <br /> To be added o► 'W To be added on 0 See Attached for calculations/credit <br /> Quantity ch.-•ed SF Quantity charged SF 4 <br /> NOT REQUIRED <br /> QTY is 0 '.round only 0 all hard surfaces QTY is❑ Roof only 0 all hard surfaces <br /> OT -' QUIRED <br /> Addi ional Checklists: <br /> A DRESS LETTER REQUIRED? (If yes 4,w assigned address), print out Address Letter from TRAKiT Print Menu and includ <br /> YES—TYPE: ❑ SFR ❑ DUPLEXDU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> 1 'See Attached Letter,2 copies (Permit Techs to is ue o e copy to applicant with permits, scan one copy to Jeffrey Ma ) <br /> VDigital copy attached to permit record, Permit# w 2-00 <br /> Saved to Address Folder in Development Tech File <br /> ❑ T REQ ED <br /> FIRE SP KLERS REQUIRED? <br /> ❑YES ype <br /> VN REQUIRED <br /> e on: <br /> PUBLIC WOR PERMIT REQUIRED? <br /> ❑YES, Per ' #PW <br /> 0 tormwater NPDES Tab Completed in TRAKiT 0 ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> No NOT QUIRED <br /> Worksheet Completed By: Date: VZZ zi <br /> Worksheet Checked By: - Date: <br /> lJ 4 <br /> REVISED 11/27/2019 <br />