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im EVE R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> MIN WASHINGTON <br /> PROJECT ADDRESS: 600 54TH ST SW UNIT D Permit#: B2304-057 <br /> DESCRIPTION OF WORK: SFR W GARAGE <br /> PW Reviewer to select all that apply below: <br /> tility Permits (Note:Permit Technicians to Create Ut,i =- it for Sewer, ater,Fire, and Irrigation,as selected below) <br /> SANITARY SEWER:iZ DOMESTIC WATER SERVICE:(Attach Calculation&Cost Est.) <br /> New Connection to main plus 1 connections to building ❑ New Connection,Size - ❑ Per Cost Estimate <br /> ❑ Alteration ® Meter Only,Size 3/4-inch-❑ Per Cost Estimate <br /> ❑ Repair ® Water System Development Fee Total.$4,311.00 <br /> ❑ Cap-off,quantity ® Sewer System Development Fee Total.$5,580.00 <br /> ❑ Reconnection to stub ❑ Water Service Line(behind meter),Size <br /> ❑ Backwater Valve ❑ Backflow Prevention(Outside Building):❑ RPBA ❑ DCVA <br /> ❑ NOT REQUIRED <br /> El NOT REQUIRED 2 O r� <br /> Explanation/Utility Permit# 2 2 r Explanation/Utility Permit#U2c L O0 SS/ <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection,Size ❑ New Connection,Size -❑ Per Cost Estimate <br /> ❑ Meter Only,Size ❑ %"Detect er Only,Service Size <br /> ❑ Water Syst evelopment Fee Total:$ ❑ Backfl Prevention(Outside Building):❑DCDA <br /> ❑ Backflo revention(Outside Building):❑DCVA ® N REQUIRED <br /> ® NO EQUIRED xplanation/Utility Permit# <br /> -E4lanation/Utility Permit# <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-Of yes,PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Yes,Q tity ,See attached for reference. <br /> El NOT EQUIRED <br /> Plumbing Permits(Note:Permit Technicians to add all items selected below to Plumbing Permit for items inside building only) <br /> Backflow�evention(Inside Building): III DCVA(for Domestic service) ❑ RPBA(for Domestic service) ❑ DCDA(for Fire service) <br /> ® NOTOREQUIRED <br /> Building Permits(Note:Permit Technicians to add all items selected below to associated Buildin ermit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: s TRAFFIC MITIGATION FEES: <br /> ® YES,®See Attached for calculations/credit ® YES,Traffic Mitigation Total:$4,993.00 <br /> To be added on PW2308-022 To be added ❑See Attached for calculations/cr it <br /> Quantity charged 2016SF Quantity arged SF ❑ NOT REQUIRED <br /> QTY is❑Ground only®all surfaces QTY i Roof only❑all surfaces Q <br /> $678.00 $ _ v 2C) "o S -4— <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#B2304-057 <br /> ®Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLE b RE UIRED? <br /> ❑ YES—Typ <br /> Si NOT RE UIRED <br /> Reaso : <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ® YES,Permit#PW2308-022 <br /> ®Stormwater NPDES Tab Completed in TRAKiT ®ADA Tab Completed in TRAKiT ® Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: kid Date:0,'I1912023 <br /> Worksheet Reviewed By:A,,,-,��L'-may r. Date: 0 --1 4=?-2d Z 3 <br />