Laserfiche WebLink
LT. E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 3308 ROCKEFELLER AVE Permit#: B2005-035 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: CONVERSION OF EXTG BASEMENT INTO SEPARATE DWELLING <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 -❑ Per Cost Estimate <br /> ❑Alteration 0 Meter Only, Size -❑ Per Cost Estimate <br /> ❑ Repair ❑Water System Development Fee Total:$ <br /> ❑ Cap-off,quantity 0 Sewer System Development Fee Total: $ <br /> ❑ Reconnection to stub ❑Water Service Line(behind meter), Size <br /> ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑ RPBA or❑ DCVA <br /> A.NOT REQUIRED JFNOT REQUIRED <br /> =xplanation/Utility Permit#: Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size 0 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): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA Ilf-NOT REQUIRED <br /> RI-NOT REQUIRED Explanation/Utility Permit#: <br /> Explanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity ,See attached for reference. <br /> -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): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 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 SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> DOLYES, Stormwater Total: $ 3 F'• 500 ❑YES,Traffic Mitigation Total:$ <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calculations/credit <br /> Ii All Hard Surface Fees to be added to Permit# Vv.!tot I- pArt. ligNOT REQUIRED <br /> I0-See Attached Spreadsheet for calculation /credit <br /> ❑ NOT REQUIRED 14 -S <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: ❑SFR 0 DUPLEX CI-ADU ° INFILL DWELLING ❑ MULTI-FAMILY 0 COMMERCIAL <br /> IiitSee 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 /> iSaved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED VNII T - <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> ❑ NOT REQUIRED <br /> Reason: <br /> $-P BLIC WORKS PERMIT REQUIRED? <br /> EES, Permit#PW Ze•l t —0 4li <br /> Fir-Stormwater NPDES Tab Completed in TRAKiT 11ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: i ' Date: 00/36 /iv LZ <br /> Worksheet Checked By: Date: <br /> REVISED 11/27/2019 <br />