1516 RUCKER AVE 2024-06-25 - Laserfiche WebLink

E V E R E T T PUBLIC WORKS REVIEW WORKSHEET WASHINGTON PROJECT ADDRESS: 1516 RUCKER AVE Permit#: PW2209-003 TENANT: DESCRIPTION OF WORK: DEMO CARPORT/GARAGE ADDN/UNFINISHED BASEMENT TO ADU/ROOF 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 0 Meter Only, Size -0 Per Cost Estimate ❑ Repair 0 Water Sy em Development Fee Total: $ ❑ Cap-off, uantity 0 Sewer stem Development Fee Total: $ ❑ Recon ction to stub ❑Water ervice Line(behind meter), Size ❑ Back ter Valve ❑ Bac ow Prevention (Outside Building): 0 RPBA or 0 DCVA 111) NOT EQUIRED .N REQUIRED Expl ation/Utility Permit#: Explanation/Utility Permit#: IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) ❑ New Connection, Size 0 New Con ection, Size -❑ Per Cost Estimate ❑Meter nly, Size 0 3/4" Dete Meter Only, Service Size ❑Water ystem Development Fee Total: $ 0 Backflo Prevention (Outside Building): 0 DCDA ❑ Back ow Prevention (Outside Building): 0 DCVA la NOT QUIRED tid NOT REQUIRED Expla tion/Utility Permit#: Expla atio Utility Permit#: WATER EPARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) ❑Yes, uantity , See attached for reference. '151 N REQUIRED PI mbi ' Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) ❑ Backfl Prevention (Inside Building): 0 DCVA(f Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) {I NOT EQUIRED u ding Permits (Note:Permit Technici s to add items selected below to associated Building Permit) STORMWATER SYSTEM DEVELOPMENT F ES: TRAFFIC MITIGATION FEES: ICI YES,IR See Attached for calculations/cre it ❑YES,Traffic Mitigation Total: $ To be added on PW ?, 041.003 To be added on. ❑ See Attached for calculations/credit Quantity charged (�� SF Quantity charged SF ffiy NOT REQUIRED QTY is 0 Ground only RI all hard surfaces QTY is 0 Roof o ly 0 all hard surfaces $ 2-it. Ale $ NOT REQUIRED Additional ecklists: ADDRESS L. TER REQUIRED? (If yes (new assigned a dress), print out Address Letter from TRAKiT Print Menu and include) Ili YES—TY`E: 0 SFR 0 DUPLEX ®ADU 0 I ILL DWELLING ❑ MULTI-FAMILY 0 COMMERCIAL A See Attached Letter,2 copies (Permit Techs to issue one coy to applicant with permits, scan one copy to Jeffrey Marks) c Digital copy attached to permit record, Permit# 0).2.0b-MO Saved to Address Folder in Development Tech File ❑ NO REQUIRED FIRE SPRINKLERS REQUIRED? ❑YES—Type 9 NOT REQUIRED Reason: PUBLIC WORKS PERMIT REQUIRED? I8 YES, Permit#PW tiZpq-0 b I ®Stormwater NPDES Tab Completed in TRAKiT J ADA Tab Completed in TRAKiT rat Inspections Added in TRAKiT ❑ NOT REQUIRED Worksheet Completed By j- (4 ► /Y Lfw.' Date: 1.111Z0 27i Worksheet Checked By: Date: O1/OZ//Zo22 REVISED 11/27/2019