21 76TH ST SW 2023-08-02 - Laserfiche WebLink

E V E R E T T PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: 21 76TH ST SW Permit#: B2203-033 TENANT: [TenName] DESCRIPTION OF WORK: ADD 10X23 TO FRONT OF HOUSE FOR LIVING AND DINING AREA, 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 ❑ New Connection, Size -❑ Per Cost Estimate ❑ Alteration ❑ Meter Only,Size -❑ Per Cost Estimate ❑ Repair ❑ Water System Development Fee Total: $ ❑ Cap-off,quantity ❑ Sewer System Development Fee Total:$ ❑ Reconnection to stub ❑ Water Service Line(behind meter), Size ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑RPBA ❑ 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 ❑ New Connection, Size -❑ Per Cost Estimate ❑ Meter Only,Size ❑ 3/" Detect Meter Only, Service Size ❑ Water System Development Fee Total:$ ❑ Backflow Prevention (Outside Building): ❑DCDA ❑ Backflow Prevention(Outside Building): ❑DCVA ® NOT REQUIRED ® NOT REQUIRED Explanation/Utility Permit# Explanation/Utility Permit# WATER DEPARTMENT COST ESTIMATE NEEDED-(If 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): ❑DCVA(for Domestic service) ❑RPBA(for Domestic service) ❑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, ® See Attached for calculations/credit ❑YES,Traffic Mitigation Total:$ To be added on PW To be added on B2203-033 ❑See Attached for calculations/credit Quantity charged SF Quantity charged 571 SF ® NOT REQUIRED QTY is❑ Ground only❑ all surfaces QTY is❑ Roof only❑ all surfaces $ $152.91 ❑ NOT REQUIRED Additional Checklists: ADDRESS LETTER REQUIRED? (If yes(new assigned address), print out Address Letter from TRAKiT Print Menu and include) OYES—TYPE: ❑ SFR ❑ DUPLEX ❑ADU ❑ INFILL DWELLING ❑ MULTI-FAMILY ❑ 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 ® NOT REQUIRED FIRE SPRINKLERS REQUIRED? ❑YES—Type ® NOT REQUIRED Reason: PUBLIC WORKS PERMIT REQUIRED? ❑ YES, Permit#PW ❑ Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT ® NOT REQUIRED / �^ Worksheet Completed By: /44 / .`. Date: 0 1— 2! - 2c Worksheet Completed By: Date: REVISED 12/22/2021