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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 1511 OAKES AVE Permit#: PW1906-057 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: REMODEL/ADDITION OF EXTG SFR <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 - 0 Per Cost Estimate <br /> ❑Alteration 0 Meter Only, Size - 0 Per Cost Estimate <br /> ❑ Repair 0 Water System Development Fee Total $ <br /> ❑ Cap-off, quantity 0 Sewer System Development Fee Total: $ <br /> ❑ Reconnection to stub 0 Water Service Line (behind meter), Size <br /> ❑ B ckwater Valve 0 B ckflow Prevention (Outside Building): 0 RPBA or❑ DCVA <br /> B-NOT REQUIRED tOT 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 0 '/" Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total: $ ❑ Bffickflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building) 0 DCVA IOT REQUIRED <br /> IOT 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 /> ❑Y s, Quantity , See attached for reference <br /> RN-0T REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ B3ckflow Prevention (Inside Building): 0 DCVA (for Domestic service) 0 RPBA (for Domestic service) 0 DCDA(for Fire service) <br /> @1VOT 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 /> L ES, Stormwater Total: $ 410, P5- ❑YES, Traffic Mitigation Total. $ <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surfac fe on PW Permit) ,EI See Attached for calculations/credit <br /> [i`Hard Surface Fees to be added to Permit# 1 nu - 003 Et-NOT REQUIRED <br /> ❑ See Attached Spreadsheet for calculations/credit <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: 0 SFR 0 DUPLEX ❑ADU ❑ INFILL DWELLING 0 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 Folder in Development Tech File <br /> Eirl OT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YY S—Type <br /> Q'NOT REQUIRED <br /> Reason: <br /> PUBJIC WORKS PERMIT REQUIRED? <br /> a-YES, Permit#PW AN/ -off <br /> ❑ Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By- Date. G—2. —(c( <br /> Worksheet Checked By: Date: <br /> REVISED 4/24/2019 <br />