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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> ImMIN WASHINGTON <br /> PROJECT ADDRESS: 3003 W CASINO RD STALL 113 S2 PK LOT Permit#: B2304-082 <br /> DESCRIPTION OF WORK: CONNECT THREE NEW 24'X60'TRAILERS AND ONE 12'X25'RESTROOM <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 connections to building ❑ New Connection,Size - ❑ Per Cost Estimate <br /> IR Alteration ❑ Meter Only,Size -❑ Per Cost Estimate <br /> ❑ Repair ❑ Water System Development Fee Total:$ <br /> ❑ Cap-off,quantity ❑ Sewer System Development Fee Total:$ <br /> ❑ Reconnection to stub N Water Service Line(behind meter),Size 4 <br /> ❑ Backwater Valve ❑ Backflow Prevention(Outside Building):❑RPBA ❑ DCVA <br /> ❑ NOT REQUIRED ❑ NOT REQUIRED <br /> Explanation/Utility Permit# I.2_30S-07' Explanation/Utility Permit# 2-3(6`C"79 <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 ❑ %"Detect Meter Only,Service Size <br /> ❑ Water System Development Fee Total:$ ❑ Backflow Prevention(Outside Building):❑ DCDA <br /> ❑ Backflow Prevention(Outside Building):❑ DCVA N NOT REQUIRED <br /> © NOT REQUIRED Explanation/Utility Permit# <br /> Explanation/Utility Permit# <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-Of 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 Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ❑ YES,❑See Attached for calculations/credit ❑ YES,Traffic Mitigation Total:$ <br /> To be added on PW To be added on ❑See Attached for calculations/credit <br /> Quantity charged SF Quantity charged SF U NOT REQUIRED <br /> QTY is❑Ground only❑all surfaces QTY is❑ Roof only❑all surfaces <br /> $ $ <br /> NOT REQUIRED aVA.11er'S (tIre hZ r i pi out dh an 4. cup1,40'pit,r0 ri I o f-• <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# <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,Permit#PW <br /> ❑Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT ❑Inspections Added in TRAKiT <br /> TA NOT REQUIRED <br /> /14 ?ViVeti-e' 1pripia(M- <br /> — <br /> Worksheet Completed By: 7444,4 fleU Ztal2 Date: rj ) 0, 12.6 3 <br /> Worksheet Reviewed By: Date: 5119(io'Z,3 <br />