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`EVERETT PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 2701 ROCKEFELLER AVE Permit #: PM005-013 <br />TENANT: (TenNanni <br />DESCRIPTION OF WORK: 6 FEET TEMP CONST/SECURITY - CLEARINGIGRADINGIEXC <br />PW Reviewer to select all Mat apply below: <br />Utility Permits (Nate: Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Inavellon, as selected below) <br />SANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation d Cost Est) <br />❑ New Connection to main plus connections to building ❑ New Connection, Size -O Per Cost Estimate <br />D Attention O Meter Only, Size - D Per Cost Estimate <br />❑ Repair D Water System Development Fee Total: $ <br />❑ Cap -off, quantity ❑ Sower System Development Fee Total: $ <br />❑ Reconnection to stub ❑ Water Service Line (behind meter), Size <br />❑ Backwater Valve O Backgew Prevention (Outside Building): D RPBA or D DCVA <br />)I(NOT REQUIRED A(NOT REQUIRED <br />Explanation/ Utility Permit #: Explanation/ Utility Permit C <br />IRRIGATION SERVICE:(NO lncluarg Cost Estimates) FIRE SERVICE.(Atiach Cost Estimate/ Request for Reference) <br />O New Connection, Size O New Connection, Size - O Per Cost Estimate <br />D Meter Only, Size O'G Detect Meter Only, Service Size <br />D Water System Development Fee Total: $ VD Backgow Prevention (Outside Building): D DCDA <br />wO/ Bac"m Prevention (Outside Building): O DCVA ONOTREQUIRED <br />q NOT REQUIRED Explanation/ Utility Permit #: <br />Explanation/ Utility Permit #: <br />WATER DEPARTMENT COST ESTIMATE NEEDED-(ffoe PW Reviewer to send test estimate request to Water Department) <br />O Yes, Quaptlry See attached for reference. <br />NOT REQUIRED <br />Plumbing Perm%tS (Note: Permit Technicians to addall items selected below to Plumbing Perri items made building only) <br />O Backfim Prevention (Inside Building) ODCVA(tor Domesticservice) ORPBA(tor Domesticiaoce) ODCDA(/or Fireservice) <br />)I(NOT REQUIRED <br />Building Permlts Mote: Permit Technician to adda#trems selected balowto associated Building Farm#) <br />STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MRIGATION FEES: <br />O YES, Starmwater Total: $ O YES, TreRc Mitigation Total: $ <br />D Roof Only Fee on Bldg Permit (ground ham surfaces fee on PW Permit) D See Attached for calculations / credit <br />O At Had Surface Fees to be added to Permit # )a( NOT REQUIRED <br />O See Attached Spreadsheet for calculations I crock <br />) NOT REQUIRED <br />Addlgonal Checklists: <br />ADDRESS LETTER REQUIRED? (if yes (new assigned address), printout Address Letter from TRANT Print Menu and include) <br />OYES -TYPE: OSFR ❑DUPLEX ❑ADU ❑INFILLDWELLING OMULTI-FAMILY ❑COMMERCIAL <br />O See Attached Labor, ] copies (Permit Techs M issue one copy to applicant wind permits, scan one copy to Jeffrey Marks) <br />O Digital copy attached to permit record, Permit # <br />O Saved to Address Folder in Development Tech File <br />11 NOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />O YES -Type <br />X NOT REQUIRED <br />Reason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />17 YES, Permit # Fly 2001 <br />$(Stormwater NPDES Tab Completed in TRAKT )(ADATab Completedin TRAKiT 0 Inspections Added in TRANT <br />O NOT REQUIRED <br />Workshnst Completed By. Date: I2/1 <br />Worksmet Checked By: Data: <br />