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IEVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 7008 COLBY AVE Permit II: B2304-005 <br /> DESCRIPTION OF WORK: NEW SFR,LOT 2 <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 lconnections to building ❑ New Connection,Size - ❑Per Cost Estimate <br /> ❑ Alteration ® Meter Only,Size 1"COMBO-❑Per Cost Estimate <br /> ❑ Repair ® Water System Development Fee Total:14 911:Od -ram <br /> ❑ Cap-off,quantity ® Sewer System Development Fee Total:$5,58&89-• T <br /> El Reconnection to stub ❑ Water Service Line(behind meter),Size <br /> ❑ Backwater Valve ❑ Backflow Prevention(Outside Building):❑RPBA ❑DCVA <br /> ❑ NOT REQUIRED r ❑ NOT REQUIRED <br /> Explanation/Utility Permit N U236 V -031- Explanation/Utility Permit ntJ i3 06- 034- <br /> IRRIGATION SERVICE:(Not including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection,Size ❑ New Connection,Size -❑Per Cost Estimate <br /> El Meter Only,Size ❑ ' "Detect Meter Only,Service Size <br /> ❑ Water System Development Fee Total:$ ❑ Backflow Prevention(Outside Building):❑DCDA <br /> ❑ Backflow Prevention(Outside Building):El DCVA ® NOT REQUIRED <br /> ® NOT REQUIRED Explanation/Utility Permit ff <br /> Explanation/Utility Permit ft <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-Of 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(Inside Building): ❑DCVA(for Domestic service) ❑RPBA(for Domestic service) ❑DCDA(for Fire service) <br /> ® NOT REQUIRED <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:44,8834M—T-4 <br /> To be added on PW2304-016 To be added on ❑See Attached for calculations/credit <br /> Quantity charged 3879SF Quantity charged SF ❑ NOT REQUIRED <br /> QTY is❑Ground only®all surfaces QTY is El Roof only❑all surfaces <br /> $1,047.30 $0.00 <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 El 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 NB2304-005 <br /> ®Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ® YES—Type NFPA 13D <br /> ❑ NOT REQUIRED <br /> Reason:PRIVATE DRIVE DISTANCE <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ® YES,Permit N PW2304-016 <br /> ®Stormwater NPDES Tab Completed in TRAKiT ®ADA Tab Completed in TRAKiT ®Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: tad feeigivre Date:04/17/2023 <br /> Worksheet Reviewed By: — ., i Date: C15 ZD?i7 <br />