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`EVERETT PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 515 47TH ST SE Permit IT U2206 032 <br />O <br />DESCRIPTION OF WORN: COST ESTIMATE -RELOCATE EXISTING SVC FROM EAST SIDE OF de <br />D <br />PWRenewer toselect all that apply below: �QLy <br />Utllgy Permits (Note: Permit Te[hnkbns W ae W UtildypermitforSew ,, water, Fire, ondlrrgOfbry asselected bebw) <br />SANITARYSEWER: DOMESTIC WATER SERVICE: (Attach C ulotbn&Cost Est) <br />❑New Connection to main plus wnre[Ilons [O building ®New Connediory5ize 34' - Q Per Cost Estimate <br />❑ Alteration ❑ Meter Only, Size_-Q Per Cost Estimate <br />❑ Repair ❑ Water System Development Fee Total:$_ <br />❑ CaPoN,4uantity ❑ Sewer System Development Fee Total:$_ <br />❑ Reconnection to stub ❑ Water Sturd Line(behind meter),Slze <br />❑ Backwatervable ❑ BackROw Prevention (Outside BWding): Q RPM 0 BOVA <br />® NOT REQUIRED ❑ NOT REQUIRED <br />Explanatlan/UNIIty Permit g_ Explanation/Utility Permit g_ <br />IRRIGATION SERVICE. (Not Including Cost Fst)mates) FIRE SERVICE:(Attoch Cost Estuarine /flequestforReference) <br />❑ New Connection, Size ❑ New Connector, Size= Q Per Cast Estimate <br />❑ Meter Only' Size_ ❑ W Detect Meter only, Service Size_ <br />[-]water System Development Fee Tafak ❑ BackFlow Prevention (Outside Building): O DCDA <br />❑BdCMIOW Prevention (Outside Building): Q DCVA NOT REQUIRED <br />® NOT REQUIRED Explanation/UtIIIIy Permitk <br />Explanation/Utluty Permit a_ <br />WATER DEPARTMENT COST ESTIMATE NEEDED -Wiley PW Reviewer o send cast estimate request to Water Deportment) <br />❑ Yes, Quantity See attached for reference. <br />® NOT REQUIRED <br />Plumbing perml6(Note. PerMt Technitlans to add Ed Items selected Rogers a Plumbing Perma-farltems Inside bufWarg ony) <br />Backflow, Prevention (Inside Building): ❑ DCVA(for Doul serWce) ❑ RPM (for Oomestk service) ❑ DCM(fw Fire sernsid) <br />[9 NOT REQUIRED <br />Building permits (Note. Permit Tolerances no add oil Items selected below as associated Bvilding Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES <br />rRAFFIC MITIGATION FEES: <br />❑ YES, F1 See Attached for calculations/credit <br />❑ YES, Traffic Mlggallan Total: $ <br />To be added on Poll be added on <br />❑See Attached for recurations/credit <br />Quantltycharged SF Guaranty charged SF <br />® NOT REQUIRED <br />QTYIsE]Ground only ❑all surfaces QTY IsE)Rsof only ❑all surfaces <br />$_ <br />® NOT REQUIRED <br />Additbnal Chrood ts: <br />ADDRESS LETTER REQUIRED y (If yes (new rentaetl address), prim out Address Letter Note TRAKU Print Menu and Include) <br />❑YES—TYPE:QSFR ❑DUPLEX ❑ADU ❑INFILLDWELLING OMULTHFAMILY ❑COMMERCIAL <br />❑See Attached Leama, 2 copies (Pemdt Tells to AW are copy m applicant MEN permits, soon one wpyto Johnny Marks) <br />El Digital copy attachlged to permit record, Pemll <br />❑ Saved to Address Folder In Development Tech File <br />® NOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />❑ YES —Type _ <br />® NOT REQUIRED <br />Reason:_ <br />PUBLIC WORKS PERMIT REQUIRED? <br />❑ YES, PermIIK PW <br />❑Stormwater PEEPS Tab Completed in TRAXiT ❑ ADA Tab Completed In TWIT ❑Inspections Addedin TRAKIT <br />® NOTREQUIRED <br />Worksheet completed By: %dryaye Date: <br />Worksbeet Revieweday : 07 9�Lat3 <br />