9632 19TH AVE SE A 2023-12-22 - Laserfiche WebLink

E V E R E T T PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: 0 U( 2, 19TH AVE SE UNITA Permit #: T)-2-08- Ill TENANT: GRAYSON SQUARE TOWNHOMES BLDGJ DESCRIPTION OF WORK: NEW TOWNHOUSE - GRAYSON SQUARE BLDG 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 -I— connections to building Alteration Repair Cap -off, quantity Reconnection to stub Backwater Valve NOT REQUIRED ilanation/Utility Permit # IRRIGATION SERVICE: (Not Including Cost Estimates) ❑ New Connection, Size ❑ Meter Only, Size ❑ Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): ❑DCVA �] NOT REQUIRED Explanation/Utility Permit # DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) ❑ New Connection, Size - ❑ Per Cost Estimate © Meter Only, Size 1 " - ❑ Per Cost Estimate �f Water System Development Fee Total: $24 - [� Sewer System Development Fee Total: $ 558D ❑ Water Service Line (behind meter), Size ❑ Backflow Prevention (Outside Building)- ❑RPBA ❑ DCVA ❑ NOT REQUIRED Explanation/Utility Permit # FIRE SERVICE: (Attach Cost Estimate /Request for Reference) ❑ New Connection, Size - ❑ Per Cost Estimate ❑ 1/4" Detect Meter Only, Service Size ❑ Backflow Prevention (Outside Building): ❑DCDA ® NOT REQUIRED Explanation/Utility Permit # WATER DEPARTMENT COST ESTIMATE NEEDED -(If 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) UNOT 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 $ n V1 NOT REQUIRED IA II dila",11 fA4 'Y L_4V01 / W'4, Iditional Checklists: ' DRESS LETTER REQUIRED? (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 # n 1_- �-j Saved to Address Folder in Development Tech File OT REQUIRED FIRE SPRINKLERS ® YES -Type__j_'11_, ❑ NOT REQUIRED Reason: PUBLIC WORKS PERMIT REQUIRED? YES, Permit # PW 0 - pl D ❑ Stormwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT ❑ NOT REQUIRED Worksheet Completed By.jNAqA. �WWOM Date: Z)bI��I� r Worksheet Completed By REVISED 12/22/2021 Date: