5003 OCEAN AVE 2023-11-01 - Laserfiche WebLink

i r EVERETT WASHINGTON PUBLIC WORKS REVIEW WORKSHEET PROJECT ADDRESS: 5003 OCEAN AVE Permit M B2112-015 TENANT: [TenName] DESCRIPTION OF WORK: NEW SFR WITH DRIVEWAY PW Reviewer to select all that aaoly below: LTL-2-2C(a-o0-7 Utility Permits (Note: Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) SANITARY SEWER: DOMESTIC WATER SERVICE: Wtach Calculation & Cost Est.) 'New Connection to main plus connections to building KNew Connection, Size 3 11 - ❑ Per Cost Estimate ❑ Alteration ❑ Meter Only, Size - ❑ Per Cost Estimate ❑ Repair [Water System Development Fee Total: $ 4 , 3 0 - o a ❑ Cap -off, quantity [Sewer System Development Fee Total: $�, SBO.yy ❑ Reconnection to stub ❑ Water Service Line (behind meter), Size ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA ❑ NOT REQUIRED ❑ NOT REQUIRED Explanation/ Utility Permit #: Explanation/ Utility Permit #: IRRIGATION SER E: (Not Including Cost Estimates) FIRE7Detectter ch Cost Estimate /Request for Reference) ❑ New Conne�ize ,Size ❑Ne,Size - ❑Per Cost Estimate ❑ Meter Only, ❑ 3/a" Only, Service Size ❑ Water Sy m Development Fee Total: $ ation (Outside Building): ❑ DCDA ❑ Backflo Prevention (Outside Building): ❑ DCVAWOD9.NOT R QUIRED Expla Permit #: Explanation/ Utility Permit #: WATER D/EPfTMENT COST ESTIMATE NEEDED -(If yes, PW Reviewer to send cost estimate request to Water Department) ❑ Yes, Qy , See attached for reference. NOT RRED Plumbing Permits (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) ackflow Prevention (Inside Building): ❑ DCVA (for Domestic service) ❑ RPBA (for Domestic service) ❑ DCDA (for Fire service) ❑KNOT EQUIRED tIORMWATER ding Permits (Note: Permit Technicians to add all items selected below to ass ciated Building Permit) SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: YES, ee Attached for calculations / credit YES, Traffic Mitigation Total: $ 31 Ti To be added on PW 1 2.o.3 -0 L (o To be added on ❑ See Attached for calculations / credit Quantity charged ,118 SF Quantity charged SF ❑ NOT REQUIR QTY is ❑ Ground only O all hard surfaces QTY is ❑ Roof only ❑ all hard surfaces $ 1,34ta-`LP $ r 2-l� 2— ❑ NOT REQUIREDI-A dditional Checklists: ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) JKYES — TYPE: FR ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY ❑ COMMERCIAL See Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marrs) igital copy attached to permit record, Permit # S -L 112 - o S Saved to Address Folder in Development Tech File ❑ N REQUIRE FIRE SPRINK RS REQUIRED? ❑ YES —Typ KNOT RE UIRED Reason: PUBLIC WORKS PERMIT REQUIRED? %YES, Pmit # PW D -O7.(o eWStormwater NPDES Tab Completed in TRAKiT RADA Tab Completed in TRAKiT Inspections Added in TRAKiT ❑ NOT REQUIRED Worksheet Completed By: Date: O Y! O 9 17-0 Z 2 Worksheet Checked By: r Date: 4 /g1 UZ Z REVISED 1112712019