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• <br /> EVERET ?Ira <br /> WASHINGTON PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 2114 HOYT AVE Permit#: C2002-005 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: NEW ADU OVER DOUBLE GARAGE TO REPL EXTG GARAGE <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 -0 Per Cost Estimate <br /> Alteration 0 Meter Only, Size -0 Per Cost Estimate <br /> ❑ Repair 0 Water System Development Fee Total: $ <br /> ❑ Cap-off, quantity 0 Sewer System Development Fee Total: $ <br /> ❑ Reconnection to stub OCLVVater Service Line(behind meter), Size 3 4 '' <br /> ❑ Backwater Valve 0 Backflow Prevention (Outside Building): 0 RP A or 0 DCVA <br /> ❑ NOT REQUIRED I t-r [ I� 0 NOT REQUIRED I <br /> Explanation/UtilityPermit#: lJ 1 LI Explanation/Utility Permit#: V Z 061- `D <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size 0 New Connection, Size -0 Per Cost Estimate <br /> ❑ Meter Only, Size 0 3/4" Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total: $ 0 Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA F,t,NOT REQUIRED <br /> L' OT REQUIRED Explanation/Utility Permit#: <br /> zxplanation/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(lf yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity _ , See attached for reference. <br /> piadOT 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 /> LOT 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 /> �XES, Stormwater Total: $ 223. 14 0 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 /> ❑All Hard Surface Fees to be added to Permit# ,NOT REQUIRED <br /> 'bee Attached Spreadsheet for calculations/credit <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 /> I\YES— PE: ❑ SFR 0 DUPLEX IS-ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> See Attached Letter,2 copies(Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> igital copy attached to permit record, Permit# C 2.o vZ c'05. <br /> GS-Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> RIOT REQUIRED <br /> Reason: `$irr.d.4 350 b F G-H <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ❑YES, Permit#PW <br /> 0 Stormwater NPDES Tab Completed in TRAKiT 0 ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> 041IOT REQUIRED <br /> Worksheet Completed By, % Date: 02.r1Z6 /'Z..b Z <br /> 6 o <br /> Worksheet Checked By: Date: OE/2 (ZDZ0 <br /> REVISED 11/27/2019 <br />