5613 WEST DR 2024-04-12 - Laserfiche WebLink

S a sE V E R E T T PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: 5613 WEST DR Permit#: B2202-036 TENANT: [TenName] DESCRIPTION OF WORK: REMODEL(2) NEW DORMERS/FINISH BASEMENT/ADD NEW DECK ON 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) SANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation& Cost Est.) ❑ New Connection to main plus connections to building 0 New Connection, Size -0 Per Cost Estimate ❑Alteration ❑ Meter Only, Size - 0 Per Cost Estimate ❑ Repair / 0 Water System Development Fee Total: $ ❑ Cap-off, quantity 0 Sewer Sy m Development Fee Total: $ O Reconn 6tion to stub 0 Water rvice Line (behind meter), Size ❑ Back ter Valve ❑ Bac ow Prevention (Outside Building): 0 RPBA or 0 DCVA NOT EQUIRED 4 N REQUIRED Expl ation/Utility Permit#: Exp anation/Utility Permit#: IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) ❑ New Connection, Size 0 New Connection, Size - 0 Per Cost Estimate ❑ Meter Only, Size 0 3/4" De ct Meter Only, Service Size ❑ Wat System Development Fee Total: $ 0 Bac ow Prevention (Outside Building): 0 DCDA ❑ Ba flow Prevention (Outside Building): 0 DCVA SN REQUIRED f T REQUIRED Ex anation/Utility Permit#: E planation/Utility Permit#: WATER D PARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) ❑ Yes, uantity , See attached for reference. gt NO REQUIRED PI mbin Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) ❑ Backfl Prevention (Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA (for Fire service) 51 NOT EQUIRED wilding Permits (Note:Permit Technicjery to add all items selected b-ereiw,tosociated Building Pert) STORMWATER SYSTEM DEVELOPMENT EES:(1 �-.,TRAFFIC MITIGATION FEES: YES, 0 See Attached for calculations/credit DYES,TraffOitigation Total: $ To be added on PW j To be added on 1jZ2D2.-D3(v See �tached for calculations/credit Quantity charged SF Quantity charged 6\1 SF SNOT QUIRED QTY is 0 Ground only 0 all hard surfaces QTY is cit Roof only 0 all hard surfaces $ $ 2-4 .� NOT REQUIRED A itional Checklists: ADDRESS LETTER REQUIRED? (If yes (ne rassigri d address), print out Address Letter from TRAKiT Print Menu and include) ❑YES-TYP : ❑ SFR ❑ DUPLEX ❑ADU ❑ INFILL DWELLING ❑ MULTI-FAMILY ❑ COMMERCIAL ❑ S e Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) ❑ igital copy attached to permit record, Permit# Saved to Address Folder in Development Tech File �d NOT QU RED FIRE RI LERS REQUIRED? ❑YES-T e fif NOT R QUIRED Reason: / PUBLIC WOR PERMIT REQUIRED? ❑ YES, Permi.# PW ❑ S ormwater NPDES Tab Completed in TRAKiT 0 ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT SNOT RE UIRED Worksheet Completed By: AINYVV/1/V1 Date: ; 1 4l,?iO ZZ Worksheet Checked By: Date: 3 l' 7)7- REVISED 11/27/2019