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

IIIIAMP E V E R E T T PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: 9612 19TH AVE SE UNIT F Permit M B2207-063 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) New Connection to main plus 1 connections to building Alteration ❑ Repair ❑ Cap -off, quantity ❑ Reconnection to stub ❑ Backwater Valve ❑ NOT REQUIRED � Explanation/Utility Permit # 1�1v �' C j IRRIGATION SERVICE: (Not Including Cost Estimates) ❑ New Connection, Size ❑ Meter Only, Size ❑ Water System Development Fee Total. $ ❑ Backflow Prevention (Outside Building): ❑DCVA 9j NOT REQUIRED Explanation/Utility Permit # DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) ❑ New Connection, Size - ❑ Per Cost Estimate S Meter Only, Size _V - ❑ Per Cost Estimate Water System Development Fee Total: $ 3.°O Sewer System Development Fee Total $_V0Q2.00 Water Service Line (behind meter), Size ❑ Backflow Prevention (Outside Building): ❑RPBA ❑ DCVA ❑ NOT REQUIRED Explanation/Utility Permit # Z� C 3 1 FIRE SERVICE: (Attach Cost Estimate /Request for Reference) ❑ New Connection, Size - ❑ Per Cost Estimate ❑ '/4" Detect Meter Only, Service Size ❑ Backflow Prevention (Outside Building): ❑DCDA EA NOT REQUIRED Explanation/Utility Permit # WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) ❑ Yes, Quantity , See attached for reference 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) jo 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 aNOT REQUIRED QTY is ❑ Ground only ❑ all surfaces QTY is ❑ Roof only ❑ all surfaces NOT REQUIRED A II AAA" � ) wtA� Al,lii�Vl,l i� Additional Checklists: a 1 ADDRESS LETTER EQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) YES — TYPE' SFR ❑ 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 # Z21V1`D(v3 Saved to Address Folder in Development Tech File ❑ NOT REQUIRED FIRE SPRINKLERS REQUIRED? YES —Type L?_?D ❑ NOT REQUIRED Reason: PUBLIC WORKS PERMIT REQUIRED? YES, Permit # PWZ—Q D ❑ Stormwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT I-1 NOT REQUIRED Worksheet Completed By'W"A IWT wymil Date:1_ �2, ' 12ZZ,� Worksheet Completed By: REVISED 12/22/2021 Date: