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

E V E R E T T PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: V JZ 19TH AVE SE UNIT Permit #: TENANT: GRAYSON SQUARE TOWNHOMES BLDG 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) VITARY SEWER: New Connection to main plus connections to building U Alteration ❑ Repair ❑ Cap -off, quantity ❑ Reconnection to stub ❑ Backwater Valve ❑ NOT REQUIRED Explanation/Utility Permit # IRRIGATION SERVICE: (Not Including Cost Estimates) ❑ New Connection, Size ❑ Meter Only, Size ❑ Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): ❑DCVA IZ NOT REQUIRED Explanation/Utility Permit # DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) ❑ New Connection, Size - ❑ Per Cost Estimate b4 Meter Only, Size - ❑ Per Cost Estimate ® Water System Development Fee Total: $ 1.OD Sewer System Development Fee Total: $ • 00 ❑ 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 ❑ %" Detect Meter Only, Service Size ❑ Backflow Prevention (Outside Building): ❑DCDA NOT REQUIRED Explanation/Utility Permit # WATER DEPARTMENT COST ESTIMATE NEEDED-(/fyes, PW Reviewerto send cost estimate request to Water Department) ❑ Yes, Quantity , See attached for reference. Q 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 fZ NOT REQUIRED Q,�� (t�pl�/`p�� GYt dditional Checklists: ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) YES — TYPE: [g 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 #122-06- 1 2,1 Saved to Address Folder in Development Tech File ❑ NOT REQUIRED b]( YES —Type 1 '�b I ❑ NOT REQUIRED Reason. PUBLIC WORKS PERMIT REQUIRED? YES, Permit# PW 2-2-6'0 10 ❑ Stormwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT ❑ NOT REQUIRED Worksheet Completed By: V" ,6'v�r�/vl. k l'I rlV�l j ,�yu2 Date: ©g I.s'1 12-z 22 Worksheet Completed By: REVISED 1212212021 Date: