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• <br /> m E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2905 MAPLE ST Permit#: B2202-040 <br /> TENANT: M A MORTENSON STAFF <br /> DESCRIPTION OF WORK: STAFF MOBILE OFFICE,48X64 WITH 2 RESTROOMS HOOKED TO <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 /> ❑ Reconnection to stub ❑ Water Service Line(behind meter), Size <br /> -Backwater Valve ❑ Backflow Prevention (Outside Building): ❑RPBA ❑ DCVA <br /> NOT REQUIRED KNOT 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 System Development Fee Total:$ ❑ Backflow Prevention(Outside Building): ❑DCDA <br /> ❑ Backflow Prevention(Outside Building): ❑DCVA Y-NOT REQUIRED <br /> .NOT REQUIRED Explanation/Utility Permit# <br /> Explanation/Utility Permit# <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PWReviewerto send cost estimate request to Water Department) <br /> ❑ Yes, Quantity , See attached for reference. <br /> V 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): ❑DCVA(for Domestic service) ❑RPBA(for Domestic service) ❑DCDA(for Fire service) <br /> Di-NOT 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 /> a_YES, [ See Attached for calculations/credit ❑YES,Traffic Mitigation Total: $ <br /> To be added on PW To be added on 'F2202-640 ❑See Attached for calculations/credit <br /> Quantity charged SF Quantity charged 3o7 -SF RIOT REQUIRED <br /> QTY is❑ Ground only❑ all surfaces QTY is 54 Roof only❑ all surfaces <br /> $ 4g22_[,.8 <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 /> M. NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑ YES-Type <br /> [A],NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> [,YES, Permit#PW 2.202-o i2 <br /> [ Stormwater NPDES Tab Completed in TRAKiT DADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: Date: 4-1I1211422 <br /> Worksheet Completed By: Date: <br /> REVISED 12/22/2021 <br />