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E V E R E T T <br />PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 9612 19TH AVE SE UNIT A Permit #: B2207-068 <br />TENANT: GRAYSON SQUARE TOWNHOMES BLDG L <br />DESCRIPTION OF WORK: NEW TOWNHOUSE - GRAYSON SQUARE BLDG L <br />PW Reviewer to select all that apply 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 />New Connection to main plus connections to building ❑ New Connection, Size - ❑ Per Cost Estimate <br />Alteration ' <br />[9 Meter Only, Size V _- ❑ Per Co a <br />❑ Repair ❑ Water System Development Fee T al $ e' <br />❑ Cap -off, quantity ❑ Sewer System Development Fee Tot 1 $$ <br />❑ Reconnection to stub ❑ Water Service Line (behind meter), Sze <br />❑ Backwater Valve ❑ Backflow Prevention (Outside Buildin BA ❑ DCVA <br />❑ NOT REQUIRED u2Z1G� _l��L.(c ❑ NOT REQUIRED <br />Explanation/Utility Permit # Explanation/Utility Permit # U ZZ I C? Zoo <br />IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate / Request for Reference) <br />❑ New Connection, Size ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Meter Only ize 03 4" D ect Meter Only, Service Size <br />ttem Development Fee Total: $ ❑ ckflow Prevention (Outside Building): ❑DCDA <br />❑ W/Bacow <br />❑ Prevention (Outside Building): ❑DCVA OT REQUIRED <br />QUIRED Explanation/Utility Permit # <br />on/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 />[] NO EQUIRED <br />Plumbing ermits (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) <br />Backflow P vention (Inside Building): ❑DCVA (for Domestic service) ❑RPBA (for Domestic service) ❑DCDA (for Fire service) <br />NOT EQUIRED <br />Buil ing Permits (Note- Permit Technicians to add all items selected below to associated <br />Building Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: <br />TRAFFIC MITIGATION FEES: <br />❑ YES, ❑ See Attached for calculations / credit <br />❑ YES, Traffic Mi 6 ation Total- $ <br />To be added on PW To be added on <br />❑See ached for calculations/credit <br />Quantity charged SF Quantity charged SF <br />NOT RE IRED <br />QTY is ❑ Grouncj-6nly ❑ all surfaces QTY is ❑ Roof only ❑ all surfaces <br />Dd NOT REQ ED rYALT <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: R SFR ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY ❑ COMMERCIAL <br />W 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 # '$�'�-DI-D(ogj <br />Saved to Address Folder in Development Tech File <br />❑ NOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />YES-TypeA�_b <br />NOT REQUIRED <br />Reason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />[� YES, Permit # PW 22D -010 <br />❑ Stormwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />❑ NOT REQUIRED <br />Worksheet Completed By, I 'XQ~4V jDate: 0n Im 6y <br />, <br />Worksheet Completed By Date: <br />REVISED 1212212021 <br />