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EVE R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 4330 CRESCENT AVE Permit#: B2403-139 <br /> DESCRIPTION OF WORK: NEW 3 BEDROOM SFR(RB2307-001) <br /> PW Reviewer to select all that apply below: <br /> (Utility Permits (Note:Permit Technicians to Create 'ity 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 building 0 New Connection,Size - ❑Per Cost Estimate <br /> ❑ Alteration ® Meter Only,Size 1-inch Dom/Fire Combo-❑Per Cost Estimate <br /> ❑ Repair ® Water System Development Fee Total:$4,577.00 <br /> 0 Cap-off,quantity ® Sewer System Development Fee Total:$4,028.00 <br /> 0 Reconnection to stub 0 Water Service Line(behind meter),Size <br /> El Valve 0 Backflow Prevention(Outside Building):❑RPBA ❑DCVA <br /> NOT REQUIRED ❑ NOT REQUIRED COxplanation/Utility Permit# akoS,lo Explanation/Utility Permit# �2Mc cX IRRIGATION SERVICE:(Not Including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Request for Reference) <br /> 0 New Connection,Size El New Connection,Size -El Per Cost Estimate <br /> ❑ Meter Onl ize 0 %"Detect Meter Only,Service Size <br /> El Water tem Development Fee Total:$ 0 Backflow Prevention(Outside Building):❑ DCDA <br /> ❑ Bac ow Prevention(Outside Building):❑DCVA ® NOT REQUIRED <br /> ® T REQUIRED Explanation/Utility Permit# <br /> Explanation/Utility Permit# <br /> WATER DEPART T COST ESTIMATE NEEDED-(If yes,PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Yes,Quan . ,See attached for reference. <br /> ® NOT R UIRED <br /> Plumbing Permit ote:Permit Technicians to add all items selected below to Plumbing Permit for items inside building only) <br /> Backflow Pre tion(Inside Building): ❑DCVA(for Domestic service) 0 RPBA(for Domestic service) ❑ DCDA(for Fire service) <br /> ® NOT UIRED , <br /> Building Permits(Note:Permit Technicians to add all items selected below to associated Building/hermit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ® YES,El See Attached for calculations/credit ® YES,Traffic Mitigation Total:$5,592.00 <br /> To be added on P 405-027 To be add on ❑See Attached for calculations/credit <br /> Quantity charg 1840SF Quanti charged OSF El NOT REQUIRED <br /> QTY is❑G and only®all surfaces QTY' Roof only❑all surfaces <br /> $747.00 $at03 ~9 <br /> ❑ NOT R UIRED <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 El 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#B2403-139 <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 Z..4O S-c)277 <br /> ®Stormwater NPDES Tab Completed in TRAKiT ®ADA Tab Completed in TRAKiT ®Inspections Added in TRAKiT <br /> El NOT REQUIRED <br /> Worksheet Completed By: 74 Zeeoeptr Date:0.5/77/2024 <br /> Worksheet Reviewed By:Abiy---gto ot, Date: 0c/1W 0 Zif <br />