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• <br /> EVE RETT <br /> Ira PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 620 10TH ST Permit#: PW2105-028 <br /> TENANT: JETTY LANDING RESTROOM REPLACEMENT <br /> DESCRIPTION OF WORK: SITE WORK FOR JETTY LANDING RESTROOM REPLACEMENT <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 /> E Alteration 0 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 /> ❑NOT REQUIRED E NOT REQUIRED <br /> Explanation/Utility Permit#: \/1.22D�J' 0 I"1 Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑New Connection,Size ❑ 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 /> E Backflow Prevention(Outside Building): E DCVA E NOT REQUIRED <br /> ❑NOT REQUIRED Explanation/Utility Permit#: <br /> Explanation/Utility Permit#: V2203- 011 <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-Of yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes,Quantity , See attached for reference. <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) ❑DCDA(for Fire service) <br /> �S(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 /> EYES, See Attached for calculations/credit 0 YES,Traffic Mitigation Total:$ <br /> To be added on PW 2105-028 To be added on 0 See Attached for calculations/credit <br /> Quantity charged 6,447 SF Quantity charged SF E NOT REQUIRED <br /> QTY is 0 Ground only E all hard surfaces QTY is 0 Roof only 0 all hard surfaces <br /> $ 1,726.51 $ <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 /> EYES-TYPE: ❑SFR 0 DUPLEX ❑ADU ❑INFILL DWELLING 0 MULTI-FAMILY E COMMERCIAL <br /> E See Attached Letter,2 copies(Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> E Digital copy attached to permit record, Permit# PW2105-028 <br /> E Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES-Type <br /> E NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> EYES, Permit#PW 2105-028 <br /> E Stormwater NPDES Tab Completed in TRAKiT E ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑NOT REQUIRED <br /> Worksheet Completed B : � � Date: 03 OS 2022 <br /> p y � / / <br /> Worksheet Checked By: Date: <br /> REVISED 11/27/2019 <br />