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E VE R E T T <br />WASHINGTON PUBLIC WORKS REVIEW WORKSHEET <br />PROJECT ADDRESS: 2725 15TH ST Permit #: C2007-005 <br />TENANT: BAKER HEIGHTS LEGACY <br />DESCRIPTION OF WORK: BAKER HEIGHTS LEGACY - BLDG B <br />PW Reviewer to select all that a 1 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 />Bj New Connection to main plus'l--connections to building tl New Connection, Size - ❑ Per Cost Estimal <br />❑ Alteration IM Meter Only, Size 9'r - ❑ Per Cost Estimate <br />❑ Repair �� Water System Development Fee Total: $ 11) <br />❑ Cap -off, quantity 9Sewer System Develo rfient Fee Total: $ <br />❑ Reconnection to s ❑Water Service Lin ehind meter), Size <br />❑ Backwater FE1 <br />❑Backflow Preve on (Outsidel�di ): [7 or ❑DCVA <br />❑ NOT REQU❑ NOT REQUID �Llt '' 11 �rExplanation/ Uermit #: �J O"l Explanation/ ility Permit #: ► ' tt� �1 deNt 7 <br />ilnsi &e <br />IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Alta Cost Estimate /Request for Reference) <br />❑ New Connection Size p New Connectio ,Size - ❑Per Cost Estimat <br />❑ Meter Only, Si J� 3/<" Detect er Only, Service Size '� ' _ <br />❑ Water Syste Development Fee Total: $ ❑Backflow revention (Outside Building : ❑ DCL)H , <br />❑ Backflow P vention (Outside Building): ❑ DCVA ❑ NOT QUIRED u2\O�-0L- <br />%NOT RE IRED Expla tion/ Utility Permit #: • 2' m MS <br />Explanatio / Utility Permit #:(qpt� h, /71 <br />WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate reauest to Water Department) <br />D'Yes, Quantity See attached for reference <br />0 NOT REQUIRED <br />Plumbing Permits (Note: P it Technicians to add all items selected below to Plumbing Permit -for items inside building only) <br />Backflow Prevention (Inside Ilding): ❑ DCVA (for Domestic service) RPBA (for Domestic service) J11 DCDA (for Fire service) <br />❑ NOT REQUIRED n , 0 <br />3 I( <br />Building Permits (Note: Permit Technicians to add all items se cted below to associated Building Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: t' TRAFFIC MITIGA N FEES: <br />g(YES, �. See Attached for calculations / credit�(,�h M9 1KYES, Traffic itigation Total: $ <br />To be added on PW 3QQ '( OBI To be added 0 —005 ❑ See Affiched for calculatjons { credit <br />Quantity charged 61129-t SF Quantity ch ged SF ❑ NOT R UIRED tzyWA Old q A �Cr <br />QTY is IN Ground only ❑ all hard surfaces QTY is oof only ❑ all hard surfaces <br />❑ NOT REQUIRED <br />Additional Checklists: <br />ADDRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) <br />RYES —TYPE: ❑ SFR ❑ PLEX ❑ ADU ❑ INFILL DWELLING 19MULTI-FAMILY ❑ COMMERCIAL <br />IR See Attached Le r, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br />IR Digital copy a ched to permit record, Permit <br />CKSaved to A ress Folder in Development Tech File <br />❑ NOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />9( YES —Type Ilk <br />❑ NOT REQUIRED <br />Reason: RW 0,0DE <br />PUBLIC WORKS PERMIT REQUIRED? <br />YES, Permit # P 0 <br />t(Stormwater NPDES Tab Completed in TRAKiT DADA Tab Completed in TRAKiT 14 Inspections Added in TRAKiT <br />❑ NOT REQUIRED <br />Worksheet Completed By: o Date: 3 —26— 20,Q I <br />Worksheet Checked By: Date: <br />REVISED 11/27/2019 <br />