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EVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 2501 W CASINO RD Permit#: PW2202-006 <br /> TENANT: <br /> DESCRIPTION OF WORK: SITE WORK FOR PROPOSED VEHICLE STORAGE&TRAINING FACILITY <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (Note:Permit Technicians to Create Utility Permit for Sewer, Water, Fire, and rrigation, as selected below) <br /> SANITARY SEW R: DOMESTIC WATER VICE: (Attach Calculation& Cost Est.) <br /> ❑ New Conne on to main plus connections to building 0 New Connectio ize - 0 Per Cost Estimate <br /> ❑Alteration 0 Meter Only, 1e - 0 Per Cost Estimate <br /> ❑ Repair 0 Water Sy m Development Fee Total:$ <br /> ❑ Cap- , quantity 0 Sewer stem Development Fee Total: $ <br /> ❑ Re nnection to stub 0 Wat Service Line(behind meter), Size <br /> ❑ ckwater Valve 0 kflow Prevention (Outside Building): 0 RPBA or 0 DCVA <br /> OT REQUIRED OT REQUIRED <br /> Explanation/Utility Permit#: Explanation/Utility Permit#: <br /> IRRIGATION SERVICE: (Not Inclu ing Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> 3, New Connection, Size en ❑ New Connection, Size 0Per Cost Estimate <br /> ❑ Meter Only, Size 14%" Detect Meter Only, Service Size inL-� <br /> .....) <br /> jl3(Water System Development Fee Total: $ 7, Zo 0 A Backflow Prevention (Outside Building): lit DCDA <br /> j [.Backflow Prevention (Outside Building):'DCVA 0 NOT REQUIRED > Q <br /> ❑ NOT REQUIRED Explanation/Utility Permit#: U\L- \ '0 2--2) <br /> Explanation/Utility Permit#: <br /> 1 ATER DEPARTMENT COST ESTIMATE NEEDED-(If yes, PW Rev er to send cost estimate request to Water Department) <br /> ;Er Yes, Quan ity I , See attached for reference. <br /> ❑ NOT RUIRED <br /> If <br /> Plu ing Permits (Note:Permit Technicians to add all items selected below to Plumbing Permit-for items inside building only) <br /> ❑ ckflow Prevention (Inside Building): ❑ DCVA(for Domestic service) 0 RPBA(for Domestic service) 0 DCDA(for Fire service) <br /> OT REQUIRED <br /> Building Permits (Note:Permit Technicians to add all items selected below to associated Building Permit) <br /> ISTORMWATER SYSTEM DEVELOPMENT FE • TRAFFIC MITIGATION FEES: <br /> 'ES,aSee Attached for calculations/credit ❑YES,Traffic Mitigation Total: $ <br /> To be added on PW 2ZD Z- OO , To be dded on ❑,See Attached for calculations/credit <br /> Quantity charged / 2 2,3 Z9 SF Quanti charged SF AN& REQUIRED <br /> QTY isIKGround only 0 all hard surfaces QTY is ❑ Roof only 0 all hard surfaces <br /> $ 32 753. 7/ $ <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: 0 SFR 0 DUPLEX 0 ADU 0 INFILL DWELLING 0 MULTI-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 /> O Saved t Address Folder in Development Tech File <br /> X NOT REQUIR <br /> FIRE SPRI LERS REQUIRED? <br /> ❑YES- pe <br /> KNOT EQUIRED <br /> Rea n: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ,AYES, Permit#PW 2 7 07- OO 4, <br /> -El Stormwater NPDES Tab Completed in TRAKiT ilgtADA Tab Completed in TRAKiT Dir Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED /�/ <br /> Worksheet Completed By: .., `� 'S-Go -;•,r i.�. Date: O 9 - 2 Z - �7 7....._Worksheet Checked By: < ( Date: <br /> REVISED 11/27/2019 <br />