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r--j <br />EVE RETT PUBLIC WORKS REVIEW WORKSHEET <br />0 WASHINGTON <br />PROJECT ADDRESS: 920 MILLWRIGHT LOOP S Permit M PW2107-071 <br />TENANT: [TenName] <br />DESCRIPTION OF WORK: SITEWORK FOR CONSTRUCTION OF NEW COM BLDG & PUBLIC PLAZA <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 ❑ 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 E Water Service Line (behind meter), Size 2" <br />❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑RPBA ❑ DCVA <br />❑ NOT REQUIRED ❑ NOT REQUIRED AA <br />Explanation/Utility Permit # z�2� 0 b 3 Explanation/Utility Permit # 07Zo Z-Od3 <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 ❑ %" Detect Meter Only, Service Size <br />❑ Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): ❑DCDA <br />❑ Backflow Prevention (Outside Building): ❑DCVA ® NOT REQUIRED <br />® NOT REQUIRED Explanation/Utility Permit # <br />Explanation/Utility Permit # <br />WATER DEPARTMENT COST ESTIMATE NEEDED-(Ifyes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, Quantity , See attached for reference. <br />E 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 />❑ NOT REQUIRED - pQ <br />Building Permits (Note: Permit Technicians to add all items selected below to associated <br />Building Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: <br />TRAFFIC MITIGATION FEES: <br />E YES, EA See Attached for calculations / credit <br />® YES, Traffic Mitigation Total: $�Cj, <br />To be added/PW07-071 To be added on B2107-073 <br />9See Attached for calculations/credit <br />Quantity cha9 SF Quantity charged 2640 SF <br />❑ NOT REQUIRED <br />QTY is E G❑ all surfaces QTY is E Roof only ❑ all surfaces <br />�oZI -�• 4 13, 5 V9 <br />$2840.74 695.11NOT REQUI <br />20 Z Z -> 9 5 <br />Additional Checklists: <br />ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br />E YES -TYPE: ❑ SFR El DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY E COMMERCIAL <br />E See Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br />E Digital copy attached to permit record, Permit # PW2107-071 <br />E Saved to Address Folder in Development Tech File <br />❑ NOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? `O�C) <br />❑ YES -Type - - <br />® NOT REQUIRED <br />Reason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />o` � ti1�oti2 <br />® YES, Permit # PW PW2107-071 ► y6� <br />E Stormwater NPDES Tab Completed in TRAKiT E ADA Tab Completed in TRAKiT E Inspections Added in TRAKiT <br />❑ NOT REQUIRED <br />Worksheet Completed By: Date: j 2- Z Z ?o z 1 <br />Worksheet Completed By: Date: <br />REVISED 1212212021 <br />