9612 19TH AVE SE D 2023-12-18 - Laserfiche WebLink

E V E R E T T PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: 9612 19TH AVE SE UNIT D Permit #: B2207-065 TENANT: GRAYSON SQUARE TOWNHOMES BLDG L DESCRIPTION OF WORK: NEW TOWNHOUSE - GRAYSON SQUARE BLDG L PW Reviewer to select all that apply below: Utility Permits (Note. Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) SANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) New Connection to main plus connections to building ❑ New Connection, Size - ❑ Per Cost Estimate Alteration Meter Only, Size 1 „ - ❑ Per Cost Estimate _ ❑ Repair ❑ Water System Development Fee Total: $ -119 ❑ Cap -off, quantity ❑ Sewer System Development Fee Total: $ ❑ Reconnection to stub ❑ Water Service Line (behind meter), Size ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑RPBA ❑ DCVA ❑ NOT REQUIRED ❑ NOT REQUIRED Explanation/Utility Permit # Explanation/Utility Permit # IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate / Request for Reference) ❑ New Connection, Size ❑ New Connection, Size - ❑ Per Cost Estimate ❑ Meter Only, Size ❑ '/4' Detect Meter Only, Service Size ❑ Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building) ❑DCDA ❑ Backflow Prevention (Outside Building) ❑DCVA tL NOT REQUIRED ® NOT REQUIRED Explanation/Utility Permit # Explanation/Utility Permit # WATER DEPARTMENT COST ESTIMATE NEEDED-(Ifyes, PW Reviewer to send cost estimate request to Water Department) ❑ Yes, Quantity , See attached for reference. W NOT REQUIRED Plumbing Permits (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) Backflow Prevention (Inside Building) ❑DCVA (for Domestic service) ❑RPBA (for Domestic service) ❑DCDA (for Fire service) NOT REQUIRED Building Permits (Note: Permit Technicians to add all items selected below to associated Building Permit) STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: ❑ YES, ❑ See Attached for calculations / credit ❑ YES, Traffic Mitigation Total: $ To be added on PW To be added on ❑See Attached for calculations/credit Quantity charged SF Quantity charged SF NOT REQUIRED QTY is ❑ Ground only ❑ all surfaces QTY is ❑ Roof only ❑ all surfaces $ �WNOT REQUIRED A l -j W Additional Checklists: ADDRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) YES —TYPE. MSFR [:]DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY [:]COMMERCIAL See Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) Digital copy attached to permit record, Permit # 1�22,01— D(vS Saved to Address Folder in Development Tech File ❑ NOT REQUIRED FIRE SPRINKLERS REQUIRED? YES —Type 1 ❑ NOT REQUIRED Reason. PUBLIC WORKS PERMIT REQUIRED? YES, Permit # PW_,_2.1 OS- Q 10 ❑ Stormwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT ❑ NOT REQUIRED 1,,,'� r' ^ �n �1 a Worksheet Completed By ' R"A 1 �YX `14 jS--�I(M � Date 0111 IZ 0 12t2,2, :6 Worksheet Completed By: Date: REVISED 12/22/2021