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110 • <br /> EVERETT w RK HEET <br /> PUBLIC WORKS REVIEW O S <br /> WASHINGTON <br /> PROJECT ADDRESS: 2405 MAPLE ST Permit#: CW2002-001 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: REMODEL EXISTING HOUSE AND ADD AN/ADDITION <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 0 New Connection, Size -0 Per Cost Estimate <br /> ❑Alteration ❑ Meter Only, Size -0 Per Cost Estimate <br /> ❑ Repair 0 Water System Development Fee Total: $ <br /> ❑ Cap-off,quantity 0 Sewer System Development Fee Total: $ <br /> ❑ Reconnection to stub ❑Water Service Line(behind meter),Size <br /> ❑ Backwater Valve 0 Backflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> ' KNOT REQUIRED K NOT REQUIRED <br /> Explanation/Utility Permit#: 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 -❑ 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 , •K NOT REQUIRED <br /> K NOT REQUIRED Explanation/Utility Permit#: <br /> Explanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> :.. <br /> KNOT 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): ❑ DCVA(for Domestic service) ❑ RPBA(for Domestic service) ❑ DCDA(for Fire service) <br /> K NOT 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 /> )8(YES, Stormwater Total: $ 158.15 ❑YES,Traffic Mitigation Total: $ <br /> K Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calculations/credit <br /> ❑All Hard Surface Fees to be added to Permit# a- K NOT REQUIRED <br /> KSee Attached Spreadsheet for calculations/credit <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 /> 0 YES—TYPE: 0 SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING ❑ MULTI-FAMILY 0 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 /> ❑ Saved to Address Folder in Development Tech File <br /> K NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> K NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ❑YES, Permit#PW <br /> 0 Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> .d X NOT REQUIRED <br /> Worksheet Completed By: 74 / Date: 09114/2020 <br /> Worksheet Checked By: Date: <br /> REVISED 11/27/2019 <br />