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`EVERETT PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 615 MILLWRIGHT LOOP N Permit a: B2208-105 <br />OESCRIPTIONOFWORK: TI TO EXISTING 2-STORY BLDG. WHISKEY BAR/COFFEE BAR <br />PW Remewer to select all that apply below: <br />Utility Permits (Note: Permit Technicians to Creole Utility Permit for Server, Water, Fire, and lrriBorm, as stanched added <br />SANRARYSEWER: DOMESTIC WATER SERVICE: (Attach Calculation N Cost Est.) <br />[-1 New Connection to ma in plus connections to trial III ® New Connection, Size 2-Inch-Q Per Cost Fiscal <br />❑Alteration ❑ Meter Only, She -E] Per Cost Estimate <br />❑Repair ® Water System Development Fee Total:$1<35T.0D <br />❑ Capaff, quantlry, ® Sewer System Development Fee Total: $18,$¢0.00 <br />❑ metrication to rtua ❑ Water Service Line (behind meter), Size <br />❑ Backwater Valve ❑ Badllow Prevention (Outside Building): Q RPBA Q DCVA <br />® NOT REQUIRED ❑ NOT REQUIRED <br />Explanations ility Permit p_ Explanation/Utility Permit p 01301— 0% <br />IRRIGATION SERVICE. (Not Cost Estimates) FIRE SERVICE, tzoorch Cost Estimatellequesfor Reference) <br />® New Connection, Size 314-Inah ® New Connection, Size 6-Inch-® Per Cost Estimate <br />❑ MMer Only, Size_ ® %e Better Meter Only, Service Size 6inch <br />® Water System Development Fee Total:$631LOD ® Backhow Prevention( Outside Building):® UCLA <br />®Backflow Prevention(Outside Building):®RPM NOT REQUIRED <br />❑ NOT REQUIRED Explanatlon/Utlllty Permit #0-,309- 0+9 <br />Explanation/Utility Permit#J-7309— 04-1t <br />WATER DEPARTMENT COST ESTIMATE NEEDEO-(I)ye; PW ReWewer to send cost estimate request to Water Deportment) <br />® Yes, Quantity l-fire service connection, See attached for reference. <br />❑ NOT REQUIRED <br />Plumbing Permits(Nate:Permit Technicians to acid all Items related below to Plumbing Permit -for Items inside bWlding only) <br />lardlow Prevention (inside Building): ❑ DCVA(fer Domestic servlre) ® RPBA( far Bomesdcarryl ❑ DOM(for HreservlreJ <br />❑ NOT REQUIRED <br />Building Permits(Note: Permg Technicians to acid allitems seloondbelow to associated Building Pis <br />IN <br />TORMWATER SYSTEM DEVELOPMENT FE <br />AI MNIGATIONFEES' <br />❑YES, Q See ANachedfor calculation/ credit <br />YES,Tre M1.gaLlon Total:$_ <br />To be added on PW_ To be added on <br />❑ See Attached for calculations/credit <br />Quantitycharged_SF Quandtpcharged_$F <br />NOT REQUIRED <br />QTY is❑Created only ❑all surfaces QTYU❑Roof only ❑all surfaces <br />$_ S <br />® NOT REQUIRED <br />ddklaml Cbealzlarts: <br />ADDRESS LETTER REQUIRED? (If Sea (new assigned address), prim out Address letter bream TRAKIT Print Menu and Include) <br />❑YES —TYPE: Q BOB ❑DUPLE% ❑ADO ❑INFILL DWELLING QMULTI-FAMILY [I COMMERCIAL <br />❑ See Attached Letter, 2 copies (Permit Tabs to Issue we ropy to apPllmnt with Permit; scan one ropy to Jeffrey Marks) <br />❑ Digital copy attached to permit record, Permit g_ <br />❑ Saved to Address Folder in Development Tech File <br />® NOT REQUIRED <br />IRE SPRINKLERS REQUIRED <br />® YES —Type NFPA13 <br />❑ NOT REQUIRED <br />Reason: building <br />PUBLIC WORKS PERMIT REQUIRED? <br />®YES, Permit N PW 212 LROM <br />® Sternewaler NPDES Tab Completed In TRAKIT ® ADA Tab Completed In TWIT ® Institutions Added In TRAKIT <br />❑ NOT REQUIRED <br />ms/ <br />Workaheet Completed By: e/4d 7&wAJ.OQZ Dale: <br />Worksmet Reviewed By:JfP# 741 Date: 9-f8-`NiQ.wi <br />