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EVERETT <br />WASHINGTON <br />PROJECT ADDRESS: <br />TENANT: <br />DESCRIPTION OF WORK: <br />PUBLIC WORKS REVIEW WORKSHEET <br />1710 W MARINE VIEW DR <br />Permit #: PW2204-004 <br />[TenName] <br />NEW COMM BLDGS (2) TO BE CONSTRUCTED. ADDITIONAL SITE WORK. <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: <br />® New Connection to main plus 2 connections to building <br />❑ Alteration <br />❑ Repair <br />❑ Cap -off, quantity <br />❑ Reconnection to stub <br />❑ Backwater Valve <br />❑ NOT REQUIRED <br />planation/Utility Permit # <br />IRRIGATION SERVICE: (Not Including Cost Estimates) <br />❑ New Connection, Size <br />® Meter Only, Size 1" <br />® Water System Development Fee Total: $7200.00 <br />® Backflow Prevention (Outside Building): ®DCVA <br />❑ NOT REQUIRED <br />Explanation/Utility Permit # ,. <br />DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) <br />® New Connection, Size 2" - ❑ Per Cost Estimate <br />❑ Meter Only, Size - ❑ Per Cost Estimate <br />® Water System Development Fee Total: $ 22979.00 <br />® Sewer System Development Fee Total: $ 29739.00 <br />❑ Water Service Line (behind meter), Size <br />❑ Backflow Prevention (Outside Building): ❑RPBA ❑ DCVA <br />❑ NOT REQUIRED <br />Explanation/Utility Permit #21 r de <br />FIRE SERVICE: (Attach Cost Estimate / Request for Reference) <br />❑ New Connection, Size - ❑ Per Cost Estimate <br />® %" Detect Meter Only, Service Size <br />® Backflow Prevention (Outside Building): ®DCDA <br />❑ NOT REQUIRED <br />Explanation/Utility Permit 11_22C(o <br />WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br />® Yes, Quantity 1 , See attached for reference. �jpt ivmt, wrw/�-M . �"� Gad <br />❑ NOT REQUIRED <br />Plumbing ermits (Note: Permit Technicians to add all items selected below to Plumbing Pe►mit-for items inside building only) <br />Backflow P ention (Inside Building): ❑DCVA (for Domestic service) ❑RPBA (for Domestic service) ❑DCDA (for Fire service) <br />1RI N REQUIRED <br />Building Permits (Note: Permit Technicians to add all items <br />STORMWATER SYSTEM DEVELOPMENT FEES: <br />® YES, ❑ See Attached for calculations / credit <br />To be added on PW2204-004 To be added on <br />Quantity charged 2-72W F 24c so Quantity charg d <br />QTY is ® Ground only ❑ all urfaces QTY is ❑ R f only <br />� A to Livi s . (02- <br />I-1 NOT REQUIRED <br />below to associated Building Permit) <br />TRAFFIC MITIGATION FEES: <br />❑ YES, Tra c Mitigation Total: $ <br />❑ ee Attached for calculations/credit <br />SF IX NO�EQUIRED <br />El all surfaces / <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 Marks) <br />❑ Digital copy attached to permit record, Permit # <br />❑ Saved to Address Folder in Development Tech File <br />® NOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />❑ YES —Type <br />® NOT REQUIRED <br />Reason: will be on buildings <br />PUBLIC WORKS PERMIT REQUIRED? <br />® YES, Permit # PW2204-004 <br />® Stormwater NPDES Tab Completed in TRAKiT ® ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />❑ NOT REQUIRED <br />Worksheet Completed By. 6Date: d ( (o <br />Worksheet Completed By: Date: <br />REVISED 12/22/2021 <br />