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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 1420 80TH ST SW#D Permit#: B2002-028 <br /> TENANT: BIRDWELL MACHINE LLC <br /> DESCRIPTION OF WORK: TI-DEMO NON STRUCT WALLS AND CONSTRUCT NEW WALLS AND <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 ❑ Meter Only, Size - 0 Per Cost Estimate <br /> ❑ Repair ❑ 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 /> p NOT REQUIRED eff NOT 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 - 0 Per Cost Estimate <br /> ❑ Meter Only, Size ❑ '/<" Detect Meter Only, Service Size <br /> ❑Water System Development Fee Total: $ ❑ Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): ❑ DCVA 0-NOT REQUIRED <br /> RIOT REQUIRED Explanation/Utility Permit#: <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 /> E'NOT REQUIRED <br /> Plumbing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ Backflow Prevention (Inside Building): 0 DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> dNOT 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 /> ❑YES, Stormwater Total: $ 0 YES,Traffic Mitigation Total: $ <br /> ❑ Roof Only Fee on Bldg Permit(ground hard surfaces fee on PW Permit) 0 See Attached for calculations/credit <br /> ❑All Hard Surface Fees to be added to Permit# d_NOT REQUIRED <br /> ❑ See Attached Spreadsheet for calculations/credit <br /> %LOT 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: 0 SFR 0 DUPLEX ❑ADU ❑ INFILL DWELLING ❑ MULTI-FAMILY 0 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 /> Iii,1\10T REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑YES—Type <br /> OT REQUIRED <br /> Re son: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> G_Y_ES, Permit#PW 2 c L - c° S - <br /> , -Stormwater NPDES Tab Completed in TRAKiT [rXADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By Y a Date: UZ/2f/2-0 to <br /> Worksheet Checked By: Date: 07,i `I(1J26 <br /> REVISED 11/27/2019 1i <br />