4503 RUCKER AVE 2023-06-22 - Laserfiche WebLink

• • Ls E VE R E T T PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: 4501 RUCKER AVE Permit#: B1904-020 TENANT: [TenName] DESCRIPTION OF WORK: REMODEL REAR SFR PW Reviewer to select all that apply below: Utility Permits (Note:Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) SANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) ❑ New Connection to main plus connections to building 0 New Connection, Size - 0 Per Cost Estimate ❑Alteration 0 Meter Only, Size -0 Per Cost Estimate ❑ Repair 0 Water System Development Fee Total: $ ❑ Cap-off, quantity ❑Sewer System Development Fee Total:$ ❑ Reconnection to stub 0 Water Service Line (behind meter),Size ❑ Backwater Valve 0 Backflow Prevention (Outside Building): ❑ RPBA or 0 DCVA NOT REQUIRED -NOT REQUIRED Explanation/Utility Permit#: Explanation/Utility Permit#: IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) ❑ New Connection, Size 0 New Connection, Size -0 Per Cost Estimate ❑ Meter Only, Size 0 3/4" Detect Meter Only, Service Size ❑Water System Development Fee Total: $ 0 Backflow Prevention (Outside Building): 0 DCDA ❑ Backflow Prevention (Outside Building): 0 DCVA .NOT REQUIRED $LOT REQUIRED Explanation/Utility Permit#: Explanation/Utility Permit#: WATER DEPARTMENT COST ESTIMATE NEEDED-(lf yes, PW Reviewer to send cost estimate request to Water Department) ❑Yes, Quantity , See attached for reference. NOT REQUIRED Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) ❑ Backflow Prevention(Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) -NOT REQUIRED Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: %YES, Stormwater Total: $ 114• o l A YES,Traffic Mitigation Total:$2.400.o0 0 Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit 0 See Attached for calculations/credit l II Hard Surface Fees to be added to Permit# 'P� I''0'7- p25 0 NOT REQUIRED Iii-See Attached Spreadsheet for calculations/credit ❑ NOT REQUIRED Additional Checklists: ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) AYES—TYPE: 0 SFR 0 DUPLEX ❑ADU r% INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL ISee Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) 4@ Digital copy attached to permit record, Permit# 'Pvy 6 2 S -Saved to Address Folder in Development Tech File ❑ NOT REQUIRED FIRE SPRINKLERS REQUIRED? ❑YES—Type [VOT REQUIRED Reason: PUBLIC WORKS PERMIT REQUIRED? AYES, Permit#PW i907- 625" ie.Stormwater NPDES Tab Completed in TRAKiT 0-ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT ❑ NOT REQUIRED Worksheet Completed By: Date: '7/17 120 l 5 Worksheet Checked By: Date: 11/3 2,tJ REVISED 4/24/2019