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EVERETT PUBLIC WORKS REVI <br /> WASHINGTON EW WORKSHEET <br /> PROJECT ADDRESS: 9920 18TH AVE W UNIT C Permit#: B2308-079 <br /> DESCRIPTION OF WORK: NEW TOWNHOUSE COMMUNITY-BENTON SQUARE BUILDING D,UNIT C <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (Note:Permit Technicians to Create Utility Permit for Sew e, 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 1-INCH DOM/FIRE- <br /> ❑ Repair ❑Per Cost Estimate <br /> ® Water System Development Fee Total:$4,311.00 <br /> ❑ Cap-off,quantity <br /> ElSewer System Development Fee Total:$ <br /> ❑ Reconnection t stub ❑ Water Service Line(behind meter),Size <br /> ❑ Backwate alve ❑ Backflow Prevention(Outside Building):❑RPBA ❑DCVA <br /> ® NOT UIRED ❑ NOT REQUIRED 2 ^�{ — <br /> E anation/Utility Permit#MUKILTEO SEWER Explanation/Utility Permit#�2-LkoJ r�� ` <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 ❑ %"Dete eter Only,Service Size <br /> ❑ Water S tem Development Fee Total:$ ❑ Ba ow Prevention(Outside Building):❑ DCDA <br /> ❑ Bac Vow (Outside Building):❑DCVA OT REQUIRED <br /> ® T REQUIRED Explanation/Utility Permit# <br /> Explanation/Utility Permit# <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes,PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Yes,Qu ity ,See attached for reference. <br /> ® NOT QUIRED <br /> PlumbinSQUIRED <br /> "ts(Note.Permit Technicians to add all items selected below to Plumbing Permit for items inside building only) <br /> Back-flowtion(Inside Building): ❑DCVA(for Domestic service) ❑RP BA(for Domestic service) ❑ DCDA(for Fire service) <br /> ® NO <br /> Building Permits(Note:Permit Technicians to add all items selected below to associatedrtz <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: 5 y <br /> ❑ YES,❑See Attached for calculations/credit Traffic Mitigation Total:$-4?343Q0 <br /> To be added on PW To be added on See Attached for calculations/credit <br /> Quantity charged SF Quantity charged SF REQUIRED <br /> QTY is❑Ground only❑all surfaces CITY is❑Roof only❑all surfaces q <br /> ® NOT REQUIRED 3bg <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#B2308-079 <br /> ®Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ® YES—Type NFPA 13D <br /> ❑ NOT REQUIRED <br /> Reason:TOWNHOUSE FLOW THROUGH <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: 71tad Date:Or1/OP/2023 2-o2-4 FPS <br /> Worksheet Reviewed By:" ' Date:Oct-Ol-2023 <br />