Laserfiche WebLink
• <br /> - EVE RETT PUBLIC WORKS REVIEW WORKSHEET <br /> IIMMI WASHINGTON <br /> PROJECT ADDRESS: 1026 LOMBARD AVE Permit#: B2203-021 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: FINISH INSPECTION OF PHASE I OF EXPIRED PERMIT <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 -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 ❑ Backflow Prevention (Outside Building): ❑ RPBA or❑ DCVA <br /> .• NOT REQUIRED SNOT 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): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): 0 DCVA KNOT REQUIRED <br /> Ig NOT 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 /> It 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 /> la 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 /> ❑YES, ❑See Attached for calculations/credit 0 YES,Traffic Mitigation Total:$ <br /> To be added on PW To be added on 0 See Attached for calculations/credit <br /> Quantity charged SF Quantity charged SF S NOT REQUIRED iza •4,,, o <br /> QTY is 0 Ground only❑all hard surfaces QTY is❑ Roof only❑all hard surfaces ftJ - FiA)1505-0/4• <br /> Tit $ $ L <br /> NOT REQUIRED R rablkeS WXYlfi IrrI ,.1,L hCfreAMAIS, <br /> Additional Checklists: <br /> ADDRESS, LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br /> �/ <br /> �I,YES—TYPE: 0 SFR IKDUPLEX ❑ADU 0 INFILL DWELLING 0 MULTI-FAMILY 0 COMMERCIAL <br /> B[See Attached Letter,2 copies(Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> it Digital copy attached to permit record, Permit#PG)Z203-025 B7203--02tl <br /> lEr Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? rl� 3IV I v <br /> 0/YES—Type ,�E 1 <br /> NOT REQUIRED <br /> Reason: +t \ ck xmtrll wA tk494' KS-4 MY• <br /> ❑ BLIC WORKS PERMIT REQUIRED? <br /> , YES, Permit#PW2gO5-O26 <br /> o'Stormwater NPDES Tab Completed in TRAKiT leADA Tab Completed in TRAKiT is Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: 4 r Date: ��d3 1Z)ig.2 <br /> Worksheet Checked By: � Date: <br /> REVISED 11/27/2019 <br />