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• • <br /> EVE RETT <br /> LI <br /> WASHINGTON PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: (p2.D t11.4 Cr. C c et*lb Permit#: W2 302--c1 <br /> DESCRIPTION OF WORK: "ilt1 I NA) MiikAill7f. i-1014., j n Tv tot lir emit <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 /> El New Connection to main plus connections to building ❑ New Connection,Size - ❑Per Cost Estimate <br /> El Alteration ❑ Meter Only,Size -El Per Cost Estimate <br /> ❑ Repair El Water System Development Fee Total:$ <br /> Cap-off,quantity ❑ Sewer System Development Fee Total:$ <br /> Reconnection to stub ® Water Service Line(behind meter),Size 5/1-1 II <br /> El Backwater Valve ❑ Backflow Prevention(Outside Building):❑RPBA ❑DCVA <br /> ❑ NOT REQUIRED El NOT REQUIRED , f <br /> Explanation/Utility Permit#U1'3o5 0 25 Explanation/Utility Permit# U Z'3 �0 - <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Request for Reference) <br /> El New Connection,Size El New Connection,Size -❑Per Cost Estimate <br /> ❑ Meter Only,Size ❑ %"Detect Meter Only,Service Size <br /> ❑ Water System Development Fee Total:$ ❑ Backflow Prevention(Outside Building):❑DCDA <br /> ❑ Backflow Prevention(Outside Building):❑DCVA El NOT REQUIRED <br /> J NOT REQUIRED Explanation/Utility Permit# <br /> Explanation/Utility Permit# <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes,PW Reviewer to send cost estimate request to Water Department) <br /> El Yes,Quantity ,See attached for reference. <br /> 14 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): El DCVA(for Domestic service) El RPBA(for Domestic service) ❑DCDA(for Fire service) <br /> NOT REQUIRED <br /> Building Permits(Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> STORMWATER SYSTE EVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> YES, See Atta ed for calculations/credit ❑YES,Traffic Mitigation Total:$ <br /> To be a d on W To be a ed on'2 D 2.'�3 ❑See Attached for calculations/credit <br /> Quantity cha d SF Quantity c ed SF �t� IA NOT REQUIRED <br /> QTY is❑G un ly El all surfaces QTY is Wl Roo ❑all surf c V <br /> 40 <br /> $ $ 19)1.0 <br /> INOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address),print out Address Letter from TRAKiT Print Menu and include) <br /> VI YES—TYPE:'SFR ❑DUPLEX ❑ADU El INFILL DWELLING ❑MULTI-FAMILY ❑COMMERCIAL <br /> See 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# 2002'0i3 <br /> Saved to Address Folder in Development Tech File <br /> El NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑ YES—Type <br /> 4q NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> 0 YES,Permit#PW <br /> ❑Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT ❑Inspections Added in TRAKiT <br /> 2 NOT REQUIRED <br /> Worksheet Completed By: /aG t9a qeZ0144t Date: 0 51 I b 12,01 <br /> Worksheet Reviewed By: Date: 5 0O 23 <br />