Laserfiche WebLink
• • <br /> 11_,.. EVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> iimm WASHINGTON <br /> PROJECT ADDRESS: 130 W INTERCITY AVE Permit#: B2012-026 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: ADD BONUS ROOM WITH BAR/OFFICE/GAME AREA/BATH <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 Sy em Development Fee Total: $ <br /> ❑ Reconnectio o stub 0 Water rvice Line(behind meter), Size <br /> RBackwater alve 0 Back w Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> NOT RE RED .4-NO REQUIRED <br /> Explanati /Utility Permit#: Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size 0 New Connection, Size -0 Per Cost Estimate <br /> ❑ Meter Only, ' e ❑'/"Det t Meter Only, Service Size <br /> ❑Water Syst Development Fee Total:$ q Backf w Prevention (Outside Building): 0 DCDA <br /> ackflow revention(Outside Building): 0 DCVA Dicii0 EQUIRED <br /> OT R UIRED Explanation/Utility Permit#: <br /> Explana on/Utility Per it#: <br /> WATER DEPART NT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> KNOT REQU ED <br /> Plumbing P mits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ Backflow Pr ention(Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> IX NOT RE IRED <br /> tuilding Permits (Note:Permit Technicians to add all i: s selected below to ssociated Building Pe lit) <br /> S�STIORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITI TION FEES: <br /> MYES, Il See Attached for calculations/credit 2 J t Z`U�6 0 YES,Tra Mitigation Total: $ <br /> To be added on PW T. •e added on 0 Se ttached for calculations/credit <br /> Quantity charged SF a uantity charged 440 SF ht NOT EQUIRED <br /> QTY is 0 Ground only 0 all hard surfac: QTY is I1ARoof only 0 all hard surfaces <br /> $ $ i2 , 35 <br /> NOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTE REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> ❑YES—TYPE: SFR 0 DUPLEX 0 ADU ❑ INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> ❑See ttached Letter,2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> ❑ Di tal copy attached to permit record, Permit# <br />- ❑ ved Address Folder in Development Tech File <br /> KNOT R UI D <br /> FIRE SPRI LERS REQUIRED? <br /> YES—T pe <br /> Afliq NOT EQUIRED <br /> Reas : <br /> PUBLIC WORK PERMIT REQUIRED? <br /> ❑YES, Permi PW <br /> ❑ ormwater NPDES Tab Completed in TRAKiT 0 ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> )(NOT R UIRED <br /> Worksheet Completed By: hi Date: *404 <br /> Worksheet Checked By: Date: <br /> REVISED 11/27/2019 <br />