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E V E R E T T <br />PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 9634 19TH AVE SE UNIT A Permit #: B2207-058 <br />TENANT: GRAYSON SQUARE TOWNHOUSE BLDG K <br />DESCRIPTION OF WORK: NEW TOWNHOUSE - GRAYSON SQUARE BLDG K <br />PW Reviewer to select all that apply below - <br />Utility Permits (Note: Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) <br />SANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) <br />® New Connection to main plus 1 connections to building ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Alteration ® Meter Only, Size 1 inch - ❑ Per Cost Estimate <br />❑ Repair ❑ Water System Development Fee Total: $-I!�r_ <br />❑ Cap -off, quantity ❑ Sewer System Development Fee Total: $ 0 <br />❑ Reconnection to stub ❑ Water Service Line (behind meter), Size <br />❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑RPBA ❑ DCVA <br />❑ NOT REQUIRED ❑ NOT REQUIRED <br />Explanation/Utility Permit # Explanation/Utility Permit # <br />IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate / Request for Reference) <br />❑ New Connection, Size ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Meter Only, Size ❑ 3/4' Detect Meter Only, Service Size <br />❑ Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building) ❑DCDA <br />❑ Backflow Prevention (Outside Building): ❑DCVA ® NOT REQUIRED <br />® NOT REQUIRED Explanation/Utility Permit # <br />Explanation/Utility Permit # <br />WATER DEPARTMENT COST ESTIMATE NEEDED -(If yes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, Quantity , See attached for reference. <br />® NOT REQUIRED <br />Plumbing Permits (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) <br />Backflow Prevention (Inside Building): ❑DCVA (for Domestic service) ❑RPBA (for Domestic service) ❑DCDA (for Fire service) <br />® NOT REQUIRED <br />Building Permits (Note: Permit Technicians to add all items selected below to associated <br />Building Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: <br />TRAFFIC MITIGATION FEES: <br />❑ YES, ❑ See Attached for calculations / credit <br />❑ YES, Traffic Mitigation Total $ <br />To be added on PW To be added on <br />❑See Attached for calculations/credit <br />Quantity charged SF Quantity charged SF <br />® NOT REQUIRED <br />QTY is ❑ Ground only ❑ all surfaces QTY is ❑ Roof only ❑ all surfaces <br />® NOT REQUIRED GYWV✓Afj M--YW t }� <br />Additional Checklists: <br />ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br />® YES —TYPE: ® SFR ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY ❑ COMMERCIAL <br />® See Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br />® Digital copy attached to permit record, Permit # $12c'j'o5t <br />® Saved to Address Folder in Development Tech File <br />❑ NOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />® YES —Type 13D <br />❑ NOT REQUIRED <br />Reason <br />PUBLIC WORKS PERMIT REQUIRED? <br />® YES, Permit # PW 2202-010 <br />❑ Stormwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />❑ NOT REQUIRED <br />Worksheet Completed By � i y Date: 7-2_ <br />Worksheet Completed By: Date. <br />REVISED 1212212021 <br />