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EVERETT PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 2501 W CASINO RD <br />TENANT: <br />Permit #: PW2202-006 <br />DESCRIPTION OF WORK: SITE WORK FOR PROPOSED VEHICLE STORAGE & TRAINING FACILITY <br />'W 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 />❑ New Conne9don to main plus connections to building <br />❑ Alteration <br />❑ Repair <br />❑ Cap- quantity <br />❑ Re nnection to stub <br />❑ ckwater Valve <br />OT REQUIRED <br />Explanation/ Utility Permit <br />DOMESTIC WATER VICE: (Attach Calculation & Cost Est.) <br />❑ New Connectio ize - ❑ Per Cost Estimate <br />❑ Meter Only, ie - ❑ Per Cost Estimate <br />❑ Water Sy m Development Fee Total: $ <br />❑ Sewer stem Development Fee Total: $ <br />❑ Wat Service Line (behind meter), Size <br />❑ kflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA <br />OT REQUIRED <br />xplanation/ Utility Permit#: <br />"IRRIGATION SERVICE: (Not Inclu ing Cost Estimates) FIRE SERVICE: (Attach Cost Estimate /Request for Reference) <br />JR New Connection, Size !t ❑ New Connection, Size - ❑Per Cost Estimate <br />❑ Meter Only, Size "3/4" Detect Meter Only, Service Size ;nL-t <br />X Water System Development Fee Total: $ Z� o ,� Backflow Prevention (Outside Building): �[DCDA <br />gLBackflow Prevention (Outside Building): )A DCVA ❑ NOT REQUIRED > Q <br />❑ NOT REQUIRED Explanation/ Utility Permit #: �2:� \ �� <br />Explanation/ Utility Permit #: <br />'WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Rev er to send cost estimate request to Water Department) <br />OYes, Quan ity 'I, See attached for reference. <br />❑ NOT RF�UIRED <br />Plum,bing Permits (Note: Permit Technicians to add all items selected below to Plumbing Permit -for items inside building only) <br />❑ ekflow Prevention (Inside Building): ❑ DCVA (for Domestic service) ❑ RPBA (for Domestic service) ❑ DCDA (for Fire service) <br />T REQUIRED <br />Building Permits (Note: Permit Technicians to add all items selected below to associated Building Permit) <br />STORMWATER SYSTEM DEVELOPMENT FE TRAFFIC MITIGATION FEES: <br />�'ES, 79See Attached for calculations /credit ❑ YES, Traffic Mitigation Total: $ <br />To be added on PW 2ZO Z- 004 To be dded on ❑fee Attached for calculations / credit <br />Quantity charged / 2 1 r 3 Z9 SF Quanti charged SF I T REQUIRED <br />QTY isXGround only ❑ all hard surfaces QTY is ❑ Roof only ❑ all hard surfaces <br />$ 32 _ 753� / $ <br />❑ NOT REQUI�— <br />Additional Checklists: <br />ADDRESS LETTER REQUIRED? (If yes (new assigned address), print out Address Letter from TRAKiT Print Menu and include) <br />DYES -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 # <br />❑ Saved t Address Folder in Development Tech File <br />>( NOT REQUIR <br />FIRE SPRI LERS REQUIRED? <br />❑ YES - pe <br />>tNOT EQUIRED <br />Rea n: <br />PUBLIC WORKS PERMIT REQUIRED? <br />AYES, Permit # PW 2 Z o 1- 00 16 <br />,9 Stormwater NPDES Tab Completed in TRAKiT ADA Tab Completed in TRAKiT ITInspections Added in TRAKiT <br />❑ NOT REQUIRED /�/ <br />Worksheet Completed By: /'-+ `� Date: (0 Z Z <br />Worksheet Checked By: Date: <br />REVISED 1112712019 <br />