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• <br /> .■ EVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 5900 36TH AVE W BLDG C Permit#: B2204-051 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: CONST NEW 122,388 SF CONCRETE TILT-UP-BLDG C <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 1 connections to building ❑ New Connection, Size -❑ Per Cost Estimate <br /> ❑Alteration ® Meter Only,Size 2"-❑ Per Cost Estimate <br /> ❑ Repair ® Water System Development Fee Total:$22979.00 <br /> ❑ Cap-off,quantity ® Sewer System Development Fee Total: $29739.00 <br /> ❑ Reconnection to stub ❑ Water Service Line(behind meter), Size <br /> ❑ Backwater Valve ❑ Backflow Prevention(Outside Building): ❑RPBA ❑DCVA <br /> 111 NOT REQUIRED /� Lk NOT REQUIRED � <br /> Explanation/Utility Permit# u 22 Gr vim' Explanation/Utility Permit# �22 \2 <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size 1J 2 New Connection Size 8"-❑ Per Cost Estimate <br /> ® Meter Only, Size 2" 4 etect Meter Only, Service Size 8" <br /> ® Water System Development Fee Total:$22979.00 ❑ Backflow Prevention (Outside Building): 541tDCDA <br /> • Backflow Prevention (Outside Building): ®DCVA ❑ NOT REQUIRED ' n <br /> ❑ NOT REQUIRED Explanation/Utility Permit# <br /> Explanation/ 'lity Permit# 22-k2 0°`� - <br /> WATER PARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Ye , Quantity , See attached for reference. <br /> • OT 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) EIRPBA(for Domestic service) gDCDA(for Fire service) <br /> ❑ 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 EES: <br /> ®YES, ® See Attached for calculations/credit ®YES,Traffic Mitiga on Total:$22,ll1. 2_?.o <br /> To be added on PW To be added on 2204-051 ®See Attach d for calculations/credit <br /> Quantity charged SF Quantity charg d 122388SF ❑NOT REQUIRE <br /> QTY is❑ Ground only❑all surfaces QTY is® Ro f only❑ all surfaces <br /> $ 32775.51 <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#B2204-051 <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#PW1612-024 <br /> ❑ Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT ❑ Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: Date: *(21(to 2-2- <br /> Worksheet Completed By: Date: <br /> REVISED 12/22/2021 <br />