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1_, E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 514 WAVERLY AVE Permit#: B2210-054 <br /> TENANT: <br /> DESCRIPTION OF WORK: SFR REMODEL AND ADDITION <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, q ntity 0 Sewer System Development Fee Total: $ <br /> ❑ Reconne ion to stub ❑ Water Se ice Line (behind meter), Size <br /> ❑ Backw er Valve 0 Backfl Prevention (Outside Building): 0 RPBA or❑ DCVA <br /> PC-NOT QUIRED 1100 EQUIRED <br /> Explan tion/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 0 3/4" De ct Meter Only, Service Size <br /> ❑ Water System Development Fee Total: $ 0 Bac ow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow revention (Outside Building): 0 DCVA REQUIRED <br /> lNOT R UIRED Explanation/Utility Permit#: <br /> =xplanati n/Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-Of yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Yes, Qu tity , See attached for reference. <br /> 10T QUIRED <br /> Plumbing P rmits (Note: Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> Wackflow P evention (Inside Building): 0 DCVA(for Domestic service) RPBA (for Domestic service) DCDA (for Fire service) <br /> ❑ ❑OT RE IRED <br /> Building Permits (Note:Permit Technici s to add all items selected b. o associated Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT EES: TRAFFIC MITIGATION FEES: <br /> te-VES, 17�See Attached for calculations/c dit YES, Traffic Mitigation Total: $ <br /> To be added on PW To be added on 1322-1 o '05 'r 0 See Attached for calculations/credit <br /> Quantity charged SF Quantity charged 533 SF : NOT REQUIRED <br /> QTY is ❑ Ground only 0 all hard surfac QTY is 4(Rogf only❑ all hard s ace �� <br /> 42. -td �\1 <br /> ❑ NOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Addres Letter from TRAKiT Print Menu and include) <br /> ❑ YES-TYPE: 0 SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING ❑ M TI-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 /> (KNOT REQUIRE <br /> FIRE SPRINK RS REQUIRED? <br /> ❑ YES-Ty <br /> NOT R UIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ❑ YES, Permit#PW <br /> ❑ Stormwater NPDES Tab Completed in TRAKiT 0 ADA Tab Completed in TRAKiT 0 Inspections Added in TRAKiT <br /> SNOT REQUIRED <br /> Worksheet Completed By: Date: /0 /Z9 j to2Z- <br /> Worksheet Checked By: Date: <br /> REVISED 11/27/2019 <br />