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EVE R E T T PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 4328 CRESCENT AVE Permit #: B2403-137 <br />DESCRIPTION OF WORK: NEW 3 BEDROOM SFR (RB2307-001) <br />PW Reviewer to select all that aDaly below: <br />Utility Permits (Note: Permit Technicians to Create Utility <br />SANITARY <br />rmit for sewer, Water, Fire, and Irrigation, as selected below) <br />SEWER: <br />® New Connection to main plus 1 connections to building <br />DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) <br />❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Alteration <br />❑ Repair <br />® Meter Only, Size 1-inch Dom/Fire Combo - ❑ Per Cost Estimate <br />® Water System Development Fee Total: $4,577.00 <br />❑ Cap -off, quantity <br />® Sewer System Development Fee Total: $4,028.00 <br />❑ Reconnection to stub <br />❑ Water Service Line (behind meter), Size <br />❑ Backwater Valve <br />❑ Backflow Prevention (Outside Building): ❑ RPBA ❑ DCVA <br />❑ NOT REQUIRED �I -� <br />Explanation/Utility Permit� <br />❑ NOT REQUIRED <br />Explanation/Utility Permit#o(os <br />IRRIGATION SERVICE: (Not Including Cost Estimates) <br />❑ New Connection, Size <br />❑ Meter Only, Size <br />❑ Water Sy em Development Fee Total: $ <br />❑ Backf Prevention (Outside Building): ❑ DCVA <br />® NXREQUIRED <br />Explanation/Utility Permit # <br />FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br />❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ %" Detect Meter Only, Service Size <br />❑ Backflo revention (Outside Building): ❑ DCDA <br />® NO EQUIRED <br />planation/Utility Permit # <br />ATER DEPARTMENT COST ESTIMATE NEEDED -(If yes, PW Reviewer to send cost estimate request to Water Department) <br />] Yes, Q ntity _See attached for reference. <br />] NOUIRED <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) ❑ RP BA (for Domestic service) ❑ DCDA (for Fire service) <br />® NOT QUIRED <br />Building Permits (Note: Permit Technicians to add all items selected below to associated Building P mit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br />® YES, ❑ See Attached for calculations / credit ® YES, Traffic Mitigation Total: $5,592.00 <br />To be added on PW2405-026 To be added o ❑ See Attached for calculations/credit <br />Quantity charged-1840SF Quantity rged OSF ❑ NOT REQUIRED <br />CITY is ❑ Ground only ® all surfaces QTY i Roof only ❑ all surfaces <br />$747.00 8 2 O <br />❑ NOT REQUIRED <br />Checklists: <br />)RESS 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 PWClerical@everettwa.gov) <br />® Digital copy attached to permit record, Permit #B2403-137 <br />® Saved to Address Folder in Development Tech File <br />NOT REQUIRED <br />RED <br />YES —Type <br />NOT REQUIRED <br />Reason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />® YES, Permit # PW 2-4o - v4.La <br />® Stormwater NPDES Tab Completed in TRAKiT ® ADA Tab Completed in TRAKiT ® Inspections Added in TRAKiT <br />❑ NOT REQUIRED <br />Worksheet Completed By: 74a �&� Date: 05/17/2024 <br />Worksheet Reviewed By: �&r 1 Date: 0-5 -?L - 2O 2-11 <br />