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• • <br /> iiim E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2127 100TH ST SE Permit#:B2306-058 <br /> DESCRIPTION OF WORK: ENCLOSING FRONT ENTRY COURTYARD AND NEW ROOF <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 /> ❑ N• ew Connection to main plus connections to building ❑ New Connection,Size - 0 Per Cost Estimate <br /> ❑ Alteration 0 Meter Only,Size -❑Per Cost Estimate <br /> ❑ R• epair 0 Water System Development Fee Total:$ <br /> ❑ Cap-off,quantity ❑ Sewer System Development Fee Total:$ <br /> ❑ R• ec nection to stub 0 Water Service Line(behind meter),Size <br /> ❑ Ba water Valve 0 B flow Prevention(Outside Building):❑RPBA ❑DCVA <br /> ® T REQUIRED OT REQUIRED <br /> xplanation/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 -0 Per Cost Estimate <br /> ❑ Meter nly,Size 0 %" 4 etect Meter Only,Service Size <br /> ❑ Wate ystem Development Fee Total:$ ❑ :.ckflow Prevention(Outside Building):❑DCDA <br /> ❑ Bac low Prevention(Outside Building):❑DCVA /1 OT REQUIRED <br /> ® REQUIRED Explanation/Utility Permit# <br /> xplanation/Utility Permit# <br /> WATER DEP RTMENT COST ESTIMATE NEEDED-(If yes,PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Yes, antity ,See attached for reference. <br /> ® NOT EQUIRED <br /> Plumbing Per its(Note:Permit Technicians to add all items selected below to Plumbing Permit for items inside building only) <br /> Backflow Pr ention(Inside Building): ❑DCVA(for Domestic service) ❑RPBA(for Domestic service) ❑DCDA(for Fire service) <br /> ® NOT QUIRED <br /> Building Permits(Note:Permit Technicians to add all items selected below to a ociated ' ing Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIG N FEES: <br /> ® YES,®See Attached for calculations/c dit ❑YES,Tra ' Mitigation Total:$ <br /> To be added on PW To be added on B2306-058 ❑ e Attached for calculations/credit <br /> Quantity charged SF Quantity charged 379SF ® NO EQUIRED <br /> QTY is❑Ground only❑all surfaces QTY is®Roof only❑all surfaces <br /> $ $101.50 , <br /> ® NOT REQUIRED <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 /> ® NOT REQUIRED <br /> Worksheet Completed By: -74eimeya, floutm4l2 Date: 061291202.3 <br /> Worksheet Reviewed By: 74etee <br /> Zeokoitte " Date: O6/29I2O23 <br />