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EVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 5306 ROCKEFELLER AVE Permit#: B2205-038 <br /> DESCRIPTION OF WORK: ADD NEW 24X24 DETACHED GARAGE/REMOVE CONCRETE PAD AND <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 /> ❑ 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 ❑ Water Service Line (behind meter), Size <br /> ❑ Backwater Valve ❑ Backflow Prevention ( tside Building): ❑RPBA ❑ DCVA <br /> ® NOT REQUIRED ® NOT REQUIRED <br /> Explanation/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 -❑ Per Cost Estimate <br /> ❑ Meter Only, Size ❑ 3/4" Detect Meter Only, Service Size <br /> ❑ Water System Development Fee Total: $ ❑ Backflow Prevention ( tside Building) ❑DCDA <br /> ❑ Backflow Prevention utside Building) ❑DCVA ® NOT REQUIRED V <br /> ® NOT REQUIRED • Explanation/Utility Permit# <br /> Explanation/Utility Permit# <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(lf 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 (Ins. a Building): ❑DCVA(for Domestic service) ❑RPBA(for Domestic service) ❑DCDA (for Fire service) <br /> ® NOT REQUIRED i <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 B2205-038 ❑See Attached for cal lations/credit <br /> Quantity charged SF Quantity charged 576 SF ® NOT REQUIRED , <br /> QTY is ❑ Ground only❑ all surfaces QTY is ❑ Roof only❑ all surfaces <br /> $ $ 154.25 <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 Fo er in Development Tech File <br /> ® NOT REQUIRED <br /> FIRE SPRINKLERS REQUI ED? <br /> ❑ YES—Type V/ <br /> ® NOT REQUIRED <br /> Reason: <br /> REVISED 10/07/2022 <br />