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im EVE RE TT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2026 BAKER AVE Permit#: B2105-008 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: NEW COVERED FRONT PORCH <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 System Development Fee Total: $ <br /> ❑ Reconnection to stub 0 Water Service Line (behind meter), Size <br /> ❑ Backwater Valve 0 Backflow Prevention (Outside Building) 0 RPBA or 0 DCVA <br /> NOT REQUIRED NOT REQUIRED <br /> xplanation/Utility Permit#: Ailxplanation/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, Size_ 03/4" Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total: $ 0 Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA KNOT REQUIRED <br /> NOT REQUIRED Explanation/Utility Permit#: <br /> NOT <br /> Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(lf yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑Yes, Quantity , See attached for reference. <br /> NOT REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> fit{Backflow Prevention (Inside Building): 0 DCVA (for Domestic service) 0 RPBA (for Domestic service) 0 DCDA (for Fire service) <br /> ¢�JNOT REQUIRED <br /> (Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> yl YES, 0 See Attached for calculations/credit ❑YES,Traffic Mitigation Total: $ <br /> To be added on PW To be added on pj ZIO5-cc8 0 See Attached for calculations/credit <br /> Quanta harged �Z 66 SF Quantity charged q5 ( SF NOT REQUIRED <br /> QTY is Ground only 0 all and surfaces QTY is Roof only D all hard surfaces <br /> $ $ <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# <br /> ❑ Saved to Address Folder in Development Tech File <br /> 11,NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> NOT REQUIRED <br /> eason: <br /> P BLIC WORKS PERMIT REQUIRED? <br /> YES, ermit#PW 'IA fQ ' 0 4 Z• <br /> Stormwater NPDES Tab Completed in TRAKiT ADA Tab Completed in TRAKiT (Inspections Added in TRAKiT <br /> ❑ NOT R QUIRED / <br /> Worksheet Completed By: �� Date: 0(3/2A 2,1 <br /> Worksheet Checked By: to MI Date: b�`3�1/4ljpL\ <br /> REVISED 11/27/2019 <br />