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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> MINIM WASHINGTON <br /> PROJECT ADDRESS: 9502 18TH AVE W UNIT N Permit#: B2310-025 <br /> DESCRIPTION OF WORK: NEW SFR-REF RB2306-001 UNIT N <br /> PW Reviewer to select all that apply below: <br /> tility Permits (Note:Permit Technicians to Create Utility rmit 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 1 connections to building ❑ New Connection,Size - 0 Per Cost Estimate <br /> ❑ Alteration ® Meter Only,Size 3/4-INCH-❑Per Cost Estimate <br /> ❑ Repair ® Water System Development Fee Total:$4,311.00 <br /> ❑ Cap-off,quantity ® Sewer System Development Fee Total:$5,580.00 <br /> ❑ Reconnection to stub ❑ Water Service Line(behind meter),Size <br /> ❑ Backwater Valve ❑ Backflow Prevention(Outside Building):❑ RPBA ❑ DCVA <br /> ❑ NOT REQUIRED ❑ NOT REQUIRED <br /> Explanation/Utility Permit# Explanation/Utility Permit# <br /> RRIGATION SERVICE:(Not Including Cost Estimates) SERVICE:(Attach Cost Estimate/Request for Reference) <br /> New Connection,Size ❑ New Connection,Size -0 Per Cost Estimate <br /> ❑ Meter Only,Siz ❑ %"Detect M er Only,Service Size <br /> ❑ Water Syste Development Fee Total:$ ❑ Backflo revention(Outside Building):❑ DCDA <br /> ❑ Backflo revention(Outside Building):❑DCVA ® N EQUIRED <br /> ® NOT QUIRED xplanation/Utility Permit# <br /> E anation/Utility Permit# <br /> WATER DEPART T COST ESTIMATE NEEDED-(If yes,PW Reviewer to send cost estimate request to Water Department) <br /> ® Yes,Quan ' ,See attached for reference. o —D� <br /> NOT UIRED 23t L <br /> Plumbing Permits( te:Permit Technicians to add all items selected below to Plumbing Permit for items inside building only) <br /> Backflow Preve on(Inside Building): ❑ DCVA(for Domestic service) ❑RPBA(for Domestic service) ❑DCDA(for Fire service) <br /> ® NOT R IRED <br /> Building Permits(Note:Permit Technicians to add all items selected below to associated Buildi Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ❑ YES,❑See Attached for calculations/credit ®YES,Traffic Mitigation Total:$4,993.00 <br /> To be added on PW To be added on ❑See Attached for calculations/credit <br /> Quantity charged SF Quantity charged SF ❑ NOT REQUIRED <br /> QTY is❑Ground only❑all surfaces QTY is❑Roof only❑all surfaces <br /> $ $ 5623c0—0)25 <br /> ® NOT REQUIRED C.av£.0...�o o 4 'P‘,4 22L 1- 021 <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#B2310-025 <br /> ®Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑ YES—Type <br /> ® NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ❑ YES,Permit#PW <br /> ❑Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT ❑Inspections Added in TRAKiT <br /> ® NOT REQUIRED <br /> Worksheet Completed By: ! ileG!ept Date:10/1O/2023 <br /> ,AVIWorksheet Reviewed By: �e: N.o 1 10 i 2023 <br />