630 57TH ST SW 2023-06-23 - Laserfiche WebLink

• Zv2-0 • EVERETT PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: 57XX SEAHURST AVE Permit#: PW2006-016 TENANT: [TenName] DESCRIPTION OF WORK: SITEWORK FOR SHORT PLAT 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 3 connections to building f New Connection, Size I -0 Per Cost Estimate ❑Alteration 0 Meter Only, Size -0 Per Cost Estimate ❑ Repair 3 2`o Y 3 Ge me, 0 Water System Development Fee Total:$ • FT[- SF�tv�- ❑ Cap-off, quantity _ 4 3 0 Sewer System Development Fee Total: $ ❑ Reconnection to stub 30 j 4-"Mil-' ❑Water Service Line(behind meter), Size ❑ Backwater Valve - - ❑ Backflow Prevention (Outside Building): 0 RPBA or❑ DCVA ❑ NOT REQUIRED ❑ NOT REQUIRED t � Explanation/Utility Permit#: 0k Explanation/Utility Permit •#: �V1 � � �� 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 " Detect Meter Only, Service Size ❑Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): 0 DCDA ❑ Backflow Prevention Building): 0 DCVA NOT REQUIRED Bac o (Outsideg) � IS"NOT 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. R 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) ❑ RPBA(for Domestic service) 0 DCDA(for Fire service) R1 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: $ $!I. 20 ❑YES,Traffic Mitigation Total: $ ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calculations/credit MAII Hard Surface Fees to be added to Permit# Vv.41.064-oit. 'NOT REQUIRED ❑ See Attached Spreadsheet for calculations/credit --1:b£, ❑ NOT REQUIRED Additional Checklists: ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) ❑YES-TYPE: 0 SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL ❑ See Attached Letter,2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) ❑ Digital copy attached to permit record, Permit# ❑ Saved to Address Folder in Development Tech File 1111 NOT REQUIRED FIRE SPRINKLERS REQUIRED? ❑YES-Type SNOT REQUIRED Reason: PUBLIC WORKS PERMIT REQUIRED? pi YES, Permit#PW Looc,- o 1 4 Stormwater NPDES Tab Completed in TRAKiT )(SADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT ❑ NOT REQUIRED Worksheet Completed By: Date: /212t lZoto Worksheet Checked By: Date: REVISED 11/27/2019