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E V E R E T T <br />PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 950218TH AVE W UNIT L Permit #: B2310-029 <br />DESCRIPTION OF WORK: NEW SFR - REF RB2306-003 UNIT L <br />PW Reviewer to select all that apply below: <br />Utility Permits (Note: Permit Technicians to Create Ut ' Permit for Sewer, W ter, 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 - ❑ 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 />IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate /RequestforReference) <br />❑ New Connection, Size ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Meter Onl , Size ❑ %" Detect Meter Only, Service Size <br />❑ Water tem Development Fee Total: $ ❑ Backflo revention (Outside Building): ❑ DCDA <br />❑ Back w Prevention (Outside Building): ❑ DCVA ® NO QUIRED <br />® N REQUIRED planation/Utility Permit# <br />planation/Utility Permit# <br />WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, antity . See attached for reference. <br />® N0,71REQUIRED <br />Plum ing Permits (Note: Permit Technicians to add all items selected below to Plumbing Permit for items inside building only) <br />Backflow Pr ention (Inside Building): ❑DCVA (for Domestic service) ❑RPBA (for Do esticservice) ❑ <br />=rvice) <br />® NOT UZQUIRED <br />Building Permits (Note: Permit Technicians to add all items selected below to associated Bull di Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: <br />TRAFFIC MITIGATION FEES: <br />❑ YES, ❑See Attached fo�calculat' /credit <br />®YES, Traffic Mitigation Total: $4993.00 <br />To be added on PWTo be added on <br />El See Attached for calculations/cr it <br />Quantity charged Quantity charged SF <br />❑ NOT REQUIRED <br />QTY is ❑ GrZD❑ all surfaces CITY is ❑ Roof only ❑ all surfaces <br />$ <br />® NOT REQUIRC, O V &rc 6 ln! — �. <br />��t0 -0 <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 #2_IL_' 10 - Ozq <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: ?enJ Date:10/12/2023 <br />n <br />Worksheet Reviewed By: 71f4d a� Date:10/12/2023 <br />