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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 B Permit #: B2207-067 <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 ® Meter Only, Size X - ❑ Per Cost Estimate <br />❑ Repair ❑ Water System Development Fee Total: $t-9' <br />❑ Cap -off, quantity ❑ Sewer System Development Fee Total: $ -9— <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 # vl�IN u - C Explanation/Utility Permit # <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, Size ❑ 1/4" Detect Meter Only, Service Size <br />❑ Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): ❑DCDA <br />❑ Backflow Prevention (Outside Building): ❑DCVA ®" NOT REQUIRED <br />NOT REQUIRED Explanation/Utility Permit # <br />Explanation/Utility Permit # <br />WATER DEPARTMENT COST ESTIMATE NEEDED -(If yes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, Quantity , See attached for reference. <br />N NOT REQUIRED <br />Plumbing Permits (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) <br />Backflow Prevention (Inside Building): ❑DCVA (for Domestic service) ❑RPBA (for Domestic service) ❑DCDA (for Fire service) <br />N NOT REQUIRED <br />Building 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 Mitigation Total: $ <br />To be added on PW To be added on <br />❑See Attached for calculations/credit <br />Quantity charged SF Quantity charged SF <br />NOT REQUIRED <br />QTY is ❑ Ground only ❑ all surfaces QTY is ❑ Roof only ❑ all surfaces <br />$ w',^,N l <br />NOT REQUIRED &`t t�Ylf�A (ALd � PirV /j I' <br />Additional Checklists: <br />ADDRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) <br />YES —TYPE: E[ SFR ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY ❑ COMMERCIAL <br />See Attached Letter, 2 copies (Permit Techs to issue one coy applicant with permits, scan one copy to Jeffrey Marks) <br />V 10 <br />® Digital copy attached to permit record, Permit # R2.20-1- <br />Saved to Address Folder in Development Tech File <br />❑ NOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />EZ YES —Type <br />❑ NOT REQUIRED <br />Reason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />® YES, Permit # PW_ _. --01 O <br />❑ Stormwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />❑ NOT REQUIRED <br />j <br />�� I�' Worksheet Completed By: , t Date: �L2— <br />� l>; <br />Worksheet Completed By: Date: <br />REVISED 12122,12021 <br />