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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 505 LAUREL DR Permit M B2208-090 <br />TENANT: [TenName] <br />DESCRIPTION OF WORK: INSTALL ENGINEERED FIBERGLASS POOL, IN -GROUND POOL W/ COVER <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 Syst m Development Fee Total: $ <br />❑ Cap-/nneG <br />ntity ❑Sewer Sy em Development Fee Total: $ <br />❑ Recn to stub ❑ WKaf <br />rvice Line (behind meter), Size <br />❑ BackalveBPrevention (Outside Building): ❑RPBA ❑DCVA <br />NOTRED NUIRED <br />Explanaty Permit # Ex latility Permit # <br />IRRIGATIONS VICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate / Request for Reference) <br />❑ New Conn ction, Size ❑ New Co ection, Size - ❑ Per Cost Estimate <br />❑ Meter O , Size ❑ 1/4" Det t Meter Only, Service Size <br />❑ Water stem Development Fee Total: $ ❑ Bac ow Prevention (Outside Building): ❑DCDA <br />❑ Back w Prevention (Outside Building): ❑DCVA [R NV REQUIRED <br />® NO REQUIRED ' E planation/Utility Permit # <br />E lanation/Utility Permit # <br />WATER DEPA MENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, Quan ' See attached for reference. <br />FU NOT RE IRED <br />Eumanrg r rm/tS (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) <br />ckflow Prev tion (Inside Building): ❑DCVA (for Domestic service) ❑RPBA (for Domestic service) ❑DCDA (for Fire service) <br />NOT REQ0IRED _ <br />ut inC r Permits (Note: Permit Technicians to add all items selected below to associated Building Per91 <br />TORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br />YES, ® See Attached fgg,r calculations / credit ❑ YES, Tra Mitigation Total: $ <br />To be added on PW =5-01 S- To be added on ❑ e Attached for calculations/credit <br />Quantity charged 11�F Quantity charged F ®NO EQUIRED <br />TY is Ground only ❑all surfaces QTY is ❑Roof only El surfaces <br />. 4a <br />MOT REQUIRED <br />Additional Checklists: <br />ADDRESS LETTER REQUIRED? (If yes (new assigned address), printout Address Letter from TRAKiT Print Menu and include) <br />❑ YES — TYPE: SFR ❑ DUPLEX ❑ ADU ❑ INFILL DWELLING ❑ MULTI -FAMILY ❑ COMMERCIAL <br />❑ See Att hed Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br />❑ Digita opy attached to permit record, Permit # <br />❑ Sav d to Address Folder in Development Tech File <br />NOT QUIR <br />FIRE SPRINK RS REQUIRED? <br />❑ YES —Ty <br />R NOT REOUIRED <br />(Reason: / <br />YW, Permit # PM—01 j <br />KI Stormwater NPDES Tab Completed in TRAKiT ADA Tab Completed in TRAKiT <br />NOT REQUIRED <br />Worksheet Completed By� t,� ��fi"� , - ', 1 <br />Worksheet Completed By: .1r M 44N' <br />inspections Added in TRAKiT <br />Date: 1 <br />4 1'U 22-/ <br />Date: <br />REVISED 1212212021 <br />