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EVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> Nom WASHINGTON <br /> PROJECT ADDRESS: 9502 18TH AVE W UNIT P Permit#: B2310-031 <br /> DESCRIPTION OF WORK: NEW SFR-REF RB2306-001 UNIT P <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (Note:Permit Technicians to Create tility Permit for Sewer, ater,Fire,and Irrigation,as selected below) <br /> SANITARY SEWER: DOMESTIC WATER SERVICE:(Attach Calculation&Cost Est. <br /> ® New Connection to main plus 1 connections to buil 'rig ❑ New Connection,Size - ❑Per Cost Estimate <br /> ❑ Alteration ® Meter Only,Size 3/4-inch-❑Per Cost Estimate <br /> ❑ Repair ® Water System Development Fee Total:$4,311.00 <br /> ❑ Cap-off,quantity ® Sewer System Development Fee Total:$5,580.00 <br /> ❑ Reconnection to stub / ❑ Water Service Line(behind meter),Size <br /> stEi <br /> ❑ Backwater Valve ❑ Backflow Prevention(Outside Building):❑ RPBA ❑D A <br /> NOT REQUIRED Ai, <br /> nn n t ❑ NOT REQUIRED O( <br /> Explanation/Utility Permit#U_2.3(2_ `� Explanation/Utility Permit# (JV 2 *0( ` <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection,Size ❑ New Connection,Size -❑Per Cost Estimate <br /> ❑ Meter Only,Size ❑ %"Detect Meter Only,Service Size <br /> ❑ Water System Development Fee Total:$ 0 Backflo revention(Outside Building):❑DCDA <br /> ❑ Backflo revention(Outside Building):❑DCVA ® N EQUIRED <br /> ® NOT EQUIRED Explanation/Utility Permit# <br /> E anation/Utility Permit# <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes,PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Yes,Qu ity ,See attached for reference. <br /> ® NO EQUIRED <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 /> ® NOT REQUIRED <br /> Building Permits(Note:Permit Technicians to add all items selected below to associated Building ermit) \ <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ❑ YES,❑See Attached for calculations/credit ®YES,Traffic Mitigation Total:$4,993.00 <br /> To be added on PW To be added on ❑See Attached for calculations/credit <br /> Quantity charged SF Quantity charged SF ❑ NOT REQUIRED <br /> ' QTY is❑Ground only❑all surfaces QTY is❑Roof only❑all surfaces <br /> $ $ <br /> P, 23co•03k. <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#82310 •0 3 l <br /> ®Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑ YES—Type <br /> ® NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ❑ YES,Permit#PW <br /> ❑Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT ❑Inspections Added in TRAKIT <br /> ® NOT REQUIRED <br /> Worksheet Completed By: 7ettite%4 a Date:01212023 <br /> Worksheet Reviewed By: ! 71,e400,te Date:101121202.3 <br />