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ES ESE R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> MINN WASHINGTON <br /> PROJECT ADDRESS: 7718 CASCADE DR Permit#: B2309-030 <br /> DESCRIPTION OF WORK: REMODEL,KITCHEN ELEVATION CHANGE,REBUILD WALLS,PAINT <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 0 New Connection,Size - ❑Per Cost Estimate <br /> ❑ Alteration 0 Meter Only,Size -0 Per Cost Estimate <br /> El Repair ❑ Water System Development Fee Total:$ <br /> ❑ Cap-off,qua ity ❑ Sewer System Development Fee Total:$ <br /> ❑ Reconnec ' n to stub ❑ Water ServeLine(behind meter),Size <br /> ❑ Backw er Valve 0 Backflo revention(Outside Building):❑ RPBA ❑DCVA <br /> ® NOT EQUIRED ® NO EQUIRED <br /> E lanation/Utility Permit# E planation/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,S'ze ❑ %"Det Meter Only,Service Size <br /> ❑ Water Sys Development Fee Total:$ ❑ Bac w Prevention(Outside Building):❑DCDA <br /> ❑ Backfl Prevention(Outside Building):0 DCVA ® REQUIRED <br /> ® NO EQUIRED Explanation/Utility Permit# <br /> E lanation/Utility Permit# <br /> WATER DEPAR ENT COST ESTIMATE NEEDED-(/f yes,PW Reviewer to send cost estimate request to Water Department) <br /> El Yes,Qu ity ,See attached for reference. <br /> ® NOT QUIRED <br /> Plumbing Perm' (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) El RPBA(for Domestic service) ❑DCDA(for Fire service) <br /> ® NOT QUIRED <br /> Building Permits(Note:Permit Technicians to d all items selected below to asso '.ted Buil. ng Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FE : TRAFFIC MITIG ON FEES: <br /> ® YES,®See Attached for calculations/credit ❑YES,Traff' itigation Total:$ <br /> To be added on PW To be added on B2309-030 ' ❑ e Attached for calculations/credit <br /> Quantity charged SF Quantity charged 96SF ' ® NO EQUIRED <br /> QTY is❑Ground only 0 all surfac s QTY is® Roof only❑all surface' <br /> $ $25.71 1r Cr <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 0 DUPLEX 0 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 PWClerical@everettwa.gov) <br /> ❑ Digital co sy attached to permit record,Permit# <br /> ❑Saved o Address Folder in Development Tech File <br /> ® NOTR iUIRED <br /> FIRE SP• I KLE 5 RE UIRED? <br /> ❑ YES Typ <br /> ® NOT R UIRED <br /> Reas : <br /> PUBLIC WORKS PERMIT RE UIRED? <br /> ❑ YES,Permit#P <br /> ❑Stormw er NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT ❑Inspections Added in TRAKIT <br /> ® NOT REQU ED <br /> Worksheet Completed By: 'MadZezoofte Date:i7210512023 <br /> Worksheet Reviewed By: Date: <br />