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r <br />EVERETT V ----W <br />WASHINGTON PUBLIC WORKS REVIEW WORKSHEET <br />PROJECT ADDRESS: 431 ALVERSON BLVD Permit #: B2108-011 <br />TENANT: [TenName] <br />DESCRIPTION OF WORK: HOME ADDITION - ENLARGE LIVING ROOM, ADD PORCH, READING ROOM <br />PW Reviewer to select all that ano/y 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 ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Alteration ❑ Meter Only, Size - ❑ Per Cost Estimate <br />❑ Repair ❑ Water System Development Fee Total: $ <br />❑ Cap -off, quantity ❑ 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 />ANOT REQUIRED XNOT REQUIRED <br />Explanation/ Utility Permit #: Explanation/ Utility Permit #: <br />IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate /Request for Reference) <br />❑ New Connection, Size ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Meter Only, Size ❑ 1/4" Detect Meter Only, Service Size <br />❑ Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): ❑ DCDA <br />❑ Backflow Prevention (Outside Building): ❑ DCVA >kNOT REQUIRED <br />)(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 />❑ 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): ❑ DCVA (for Domestic service) ❑ RPBA (for Domestic service) ❑ DCDA (for Fire service) <br />,,KNOT 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 />A YES,j1j See Attached for calculations / credit ❑ YES, Traffic Mitigation Total: $ <br />To be added on PW To be added on R 2-1 Q 8 — O 11 ❑ See Attached for calculations / credit <br />Quantity charged SF Quantity charged S /9 SF It NOT REQUIRED <br />QTY is ❑ Ground only ❑ all hard surfaces QTY is ❑ Roof only )4 all hard surfaces <br />$ $ <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: ❑ SFR ❑ DUPLEX ❑ ADU ❑ 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 Marls) <br />❑ Digital copy attached to permit record, Permit # <br />❑ Saved to Address Folder in Development Tech File G sF = <br />NOT REQUIRED -- N 1.1 E U C Fr 0 ETp- Al -T I N <br />FIRE SPRINKLERS REQUIRED? 411 g & • 6 <br />❑ YES —Type TO be. <br />JANOT REQUIRED <br />Reason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />❑ YES, Permit # PW <br />❑ Stormwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />NOT REQUIRED / <br />Worksheet Completed By: r Date: ('' S/ 3 b 12 o Z f <br />Worksheet Checked By: Date: nLV.A �Zv ZI <br />REVISED 11/27/2019 <br />