9632 19TH AVE SE C 2023-12-19 - Laserfiche WebLink

E V E R E T T PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: O,V -?. 19TH AVE SE UNIT Ci Permit M - 1101 TENANT: GRAYSON SQUARE TOWNHOMES BLDG DESCRIPTION OF WORK: NEW TOWNHOUSE - GRAYSON SQUARE BLDGJ PW Reviewer to select all that apply below: Utility Permits (Note: Permit Technicians to Create Utility Pen -nit for Sewer, Water, Fire, and Irrigation, as selected below) New Connection to main plus �_ connections to building ❑ Alteration ❑ Repair ❑ Cap -off, quantity ❑ Reconnection to stub ❑ Backwater Valve ❑ NOT REQUIRED Explanation/Utility Permit # DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) ❑ New Connection, Size - ❑ Per Cost Estimate Meter Only, Size_- ❑ Per Cost Estimate ® Water System Development Fee Total: $ q31 1 .06 ❑� Sewer System Development Fee Total: $�,_o.°° Water Service Line (behind meter), Size ❑ Backflow Prevention (Outside Building): ❑RPBA ❑ DCVA ❑ NOT REQUIRED 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 ❑ %" Detect Meter Only, Service Size ❑ Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building)- ❑DCDA ❑ Backflow Prevention (Outside Building): ❑DCVA NOT REQUIRED 54 NOT REQUIRED Explanation/Utility Permit # 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. f.71 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 El 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 NOT REQUIRED U i� (�{/�,}�ja ��ti♦YL(,i� Additional Checklists: ADDRESS 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 jcl Saved to Address Folder in Development Tech File ❑ NOT REQUIRED FIRE SPRINKLERS YES —Type_ ❑ NOT REQUIRED Reason: PUBLIC WORKS PERMIT REQUIRED? [�f YES, Permit # PW� 'Ol 0 ❑ Stormwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT ❑ NOT REQUIRED Worksheet Completed By: Date: g I� l ZC1 Z% Worksheet Completed By: REVISED 12/22/2021 Date: