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EVEF� ETT • r <br /> WASHINGTON <br /> PUBLIC WORKS REVIEW WORKSHEET <br /> PROJECT ADDRESS: 3003 W CASINO RD BLDG 40-26 Permit#: B2404-039 <br /> DESCRIPTION OF WORK: TI EMERGENCY GENERATOR BOLLARDS,CONCRETE 13'X 28'X 1.5 <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 ❑ New Connection,Size - ❑Per Cost Estimate <br /> ❑ Alteration ❑ Meter Only,Size -❑Per Cost Estimate <br /> ❑ Repair ❑ Water System Development Fee Total:$ <br /> ❑ Cap-off,quantity ❑ Sewer System Development Fee Total:$ <br /> ❑ Reconn tion to stub 0 Water S ice Line(behind meter),Size <br /> ❑ Bac ater Valve ❑ Bac.: .w Prevention(Outside Building):❑RPBA ❑DCVA <br /> ® T REQUIRED IT 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 ❑ %"Detect Meter Only,Service Size <br /> ❑ Water Sy m Development Fee Total:$ ❑ Backf Prevention(Outside Building):❑DCDA <br /> ❑ Backfl Prevention(Outside Building):❑DCVA ® REQUIRED <br /> ® NO EQUIRED xplanation/Utility Permit# <br /> planation/Utility Permit# <br /> WATER DEPA MENT COST ESTIMATE NEEDED-(If yes,PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Yes,Q ntity ,See attached for reference. <br /> ® NO EQUIRED <br /> Plumbing Per its(Note:Permit Technicians to add all items selected below to Plumbing Permit for items inside building only) <br /> Backflow evention(Inside Building): ❑DCVA(for Domestic service) ❑RPBA(for Domestic service) ❑DCDA(for Fire service) <br /> • N REQUIRED <br /> Building Permits(Note:Permit Technicians to add i ems selected below to ass. fated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIG ION FEES: <br /> ® YES,®See Attached for calculations/ edit ❑YES,Tra ' Mitigation Total:$ <br /> To be added on PW To be added on B2404-039 ❑ e Attached for calculations/credit <br /> Quantity charged OSF Quantity charged 1355SF ® NO REQUIRED <br /> QTY is❑Ground only❑all surfac-s QTY is❑Roof only®all surfaces <br /> $0.00 $404.87 <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 PWClerical@everettwa.gov) <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 /> • <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: 7kteeVivizepre Date:04/27/2024 <br /> 4 Worksheet Reviewed By:,4& I4P9� Date:04/27/2024 <br />