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EVE R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> MINN WASHINGTON <br /> PROJECT ADDRESS: 8531 EVERGREEN WAY Permit#: B2302-096 <br /> DESCRIPTION OF WORK: NEW TWO-STORY OFFICE BUILDING-CHC OF SNOHOMISH COUNTY <br /> PW Reviewer to select all that apply below: Icy <br /> Utility Permits (Note:Permit Technicians to Create Utility Permit for Sewer, Wa er,Fire,and Irrigation,as selected below) N F � <br /> SANITARY SEWER: D• STIC WATER SERVIC�:(�ttP h C,plculation&Cost Est.) � � <br /> ® New Connection to main plus 1 connections to building v16; <br /> ction,Size Per Cost Estimate <br /> ❑ Alteration - F.y_.., I TIP 1,0 16.t3 <br /> El Repair ® Water System Developinent Fee Total:$2,889.00 C <br /> El Cap off,quantity ® Sewer System Development Fee Total:$3,738.00 <br /> ❑ Reconnection to stub El Water Service Line(behind metert Size <br /> ❑ Backwater Valve ❑ Backf4ovy Prevention(Outside Building):[❑RPBA ❑ DCVA <br /> ❑ NOT REQUIRED ❑ NOf REQUIRED <br /> Explanation/Utility Permit#U2:309—03g Explanation/Utility Permit# <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection,Size ® New Connection,Size 4-INCH-® Per CV Estimate <br /> El Meter Only,Size ® %"Detect Meter Only,Service Size <br /> El Water System Development Fee Total:$ ❑ Backflow Prevention(Outside Building):El DCDA , <br /> ® Backflow Prevention(Outside Building):® DCVA ❑ NOT REQUIRED J L30 V a](I <br /> ❑ NOT REQUIRED Explanation/Utility Permit# <br /> Explanation/Utility Permit# U2309— 0 3% <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) <br /> ® Yes,Quantity 3-Fire Conn.Fire Hyd.Meter UpmF See attached for <br /> reference. <br /> El 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): El DCVA(for Domestic service) ❑ RPBA(for Domestic service) ®DCDA(for Fire service) <br /> ❑ NOT REQUIRED -'�0 ' — <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:$63,026.00 <br /> To be added on PW2302-011 To be added on ®See Attached for calculations/credit <br /> Quantity charged 9908SF Quantity charged SF ❑ NOT REQUIRED <br /> QTY is El Ground only®all surfaces QTY is El Roof only❑all surfaces <br /> $2,611.86 $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:El 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#B2302-096 <br /> ®Saved to Address Folder in Development Tech File <br /> El NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ® YES—Type NFPA 13 <br /> El NOT REQUIRED <br /> Reason:BUILDING SIZE <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ® YES,Permit#PW2302-011 <br /> Stormwater NPDES Tab Completed in TRAKiT ®ADA Tab Completed in TRAKiT ® Inspections Added in TRAKiT <br /> El NOT REQUIRED <br /> Worksheet Completed By: 7 a- Date:O9/19/2023 <br /> Worksheet Reviewed By:,44 74e9eige Date: 099-199-2O23 <br />