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• • <br /> im E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2511 WALNUT ST Permit#: B2108-056 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: NEW COVERED FRONT DECK&NEW BACK PATIO ROOF <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 0 Meter Only, Size -0 Per Cost Estimate <br /> ❑ Repair 0 Water System Development Fee Total:$ <br /> ❑ Cap-o ,quantity 0 Sewer System Development Fee Total: $ <br /> ❑ Reco nection to stub 0 Wate Service Line(behind meter), Size <br /> ❑ Ba ater Valve 0 B flow Prevention(Outside Building): 0 RPBA or 0 DCVA <br /> X N T REQUIRED X T REQUIRED <br /> Ex anation/Utility Permit#: planation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New C nnection, Size 0 New Connection, Size -0 Per Cost Estimate <br /> ❑ Meter nly, Size 0 3/<" etect Meter Only, Service Size <br /> ❑Wat System Development Fee Total:$ 0 B kflow Prevention (Outside Building): 0 DCDA <br /> ❑ Bac flow Prevention(Outside Building): 0 DCVA j� T REQUIRED <br /> XN REQUIRED Explanation/Utility Permit#: <br /> E anatio /Utility Permit#: <br /> WATER EPARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, uantity , See attached for reference. <br /> XN REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to PI bing Permit-for items inside building only) <br /> ❑ Backfl Prevention(Inside Building): 0 DCVA(for Domestic service) ❑ RPBA(f r Domestic service) 0 DCDA(for Fire service) <br /> KNOT EQUIRED <br /> Buil ing Permits (Note:Permit Technicians to add all items selected below o associated Buildi g Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC ITIGATION FEES: <br /> ❑YES, 0 See Attached for calculations/credit 0 YES, raffic Mitigation Total: $ <br /> To be added on PW To be added on B2108-056 ❑ ee Attached for calculations/credit <br /> Quantity charged SF Quantity charged 94 SF X T REQUIRED <br /> QTY is 0 Ground only 0 all hard surfaces QTY is DKRoof only 0 all har su aces <br /> $ $ 24.75 <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 /> ❑YES—TYPE: 0 SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> ❑ ee 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 /> KNOT EQUIRED <br /> FIRE SP INKLERS REQUIRED? 0 <br /> ❑YES Type 11/ <br /> XNO REQUIR D <br /> Rea n: <br /> PUBLIC W RKS PERMIT REQUIRED? <br /> ❑YES, P rmit#PW <br /> Stormwater NPDES Tab Completed in TRAKiT 0 ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> XNO REQUIRED <br /> Worksheet Completed By: ,'h;r !Se l/,jo. e Date: 6 g/3 0 /2 0Z 9 <br /> Worksheet Checked By: /� cJ !! Date: 6 f!o /Zaz t <br /> REVISED 11/27/2019 <br />