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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 2217 GRAND AVE Permit M B2101-029 <br />TENANT: [TenName] <br />DESCRIPTION OF WORK: CONSTRUCT NEW DETACHED GARAGE <br />Utility Permits (Note: Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and Irrigation, as selected below) <br />SANITARY SEWER: <br />❑ New Connection to main plus <br />❑ Alteration <br />❑ Repair <br />❑ Cap -off, quantity <br />❑ Reconnection to stub <br />❑ Backwater Valve <br />b(NOT REQUIRED <br />Explanation/ Utility Permit #: <br />connections to building <br />IRRIGATION SERVICE: (Not Including Cost Estimates) <br />❑ New Connection, Size <br />❑ Meter Only, Size <br />❑ Water System Development Fee Total: $ <br />❑ Backflow Prevention (Outside Building): <br />',NOT REQUIRED <br />Explanation/ Utility Permit #: <br />❑ DCVA <br />DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) <br />❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Meter Only, Size - ❑ Per Cost Estimate <br />❑ Water System Development Fee Total: $ <br />❑ Sewer System Development Fee Total: $ <br />❑ Water Service Line (behind meter), Size <br />p)3ackflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA <br />KNOT REQUIRED <br />Explanation/ Utility Permit #: <br />FIRE SERVICE: (Attach Cost Estimate /Request for Reference) <br />❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ 3/4' Detect Meter Only, Service Size <br />❑ Backflow Prevention (Outside Building): ❑ DCDA <br />0NOT REQUIRED <br />Explanation/ Utility Permit #: <br />WATER DEPARTMENT COST ESTIMATE NEEDED -(If yes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, Quantity See attached for reference. <br />Plumbing Permits (Note. Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) <br />j❑�Backfiow Prevention (Inside Building): ❑ DCVA (for Domestic service) ❑ RPBA (for Domestic service) ❑ DCDA (for Fire service) <br />IJ,NOT REQUIRED <br />Building Permits (Note: Pen -nit Technicians to add all items selected below to associated Building Permit) <br />SSJORMWATER SYSTEM DEVELOPMENT FEES: <br />C3 YES, O,See Attached for calculations / credit <br />To be added on PW To be added on � zi 0i - 0 zt� <br />Quantity charged SF Quantity charged �M 1 SF <br />QTY is ❑ Ground only ❑ all hard surfaces QTY is j rRoof only ❑ all hard surfaces <br />$ $ ,b7 <br />❑ NOT REQUIRED <br />Additional Checklists: <br />❑ YES, Traffic Mitigation Total: $ <br />❑ See Attached for calculations / credit <br />4 NOT REQUIRED <br />ADDRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) <br />DYES —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 # <br />❑ Saved to Address Folder in Development Tech File <br />NOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />❑ YES —Type <br />NOT REQUIRED <br />Reason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />❑ YES, Permit # PW <br />❑ Stormwater NPDES Tab Completed in TRAKiT ❑ ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br />NOT REQUIRED <br />Worksheet Completed By: A%� <br />Date:��l�i� <br />Worksheet Checked By: <br />Date: <br />O <br />