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EVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 3620 W MUKILTEO BLVD,UNIT E Permit#: B2304-042 <br /> DESCRIPTION OF WORK: NEW"HARBOR'S EDGE"TOWNHOMES,UNIT E <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 1"DOM/FIRE COMBO-❑Per Cost Estimate <br /> El Repair ® Water System Development Fee Total:$4,311.00 <br /> ❑ Cap-off,quantity ® Sewer System Development Fee Total:$5,580.00 <br /> El Reconnection to stub ❑ Water Service Line(behind meter),Size <br /> ❑ Backwater Valve ❑ Backflow Prevention(Outside Building):El RPBA ❑ D A <br /> NOT REQUIRED r©oC El NOT REQUIRED .�,,.p <br /> Explanation/Utility Permit# 23� Explanation/Utility Permit# u2av t"c,O <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection,Size El New Connection,Size -El Per Cost Estimate <br /> O Meter Only,Size ❑ %"Detect Meter Only,Service Size <br /> El Water System Development Fee Total:$ ❑ Backflow Prevention(Outside Building):❑DCDA <br /> ❑ Backflow Prevention(Outside Building):❑DCVA ® NOT REQUIRED <br /> ® NOT REQUIRED Explanation/Utility Permit# <br /> Explanation/Utility Permit# <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes,PW Reviewer to send cost estimate request to Water Department) <br /> El Yes,Quantity ,See attached for reference. <br /> ® NOT 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) El RPBA(for Domestic service) ❑DCDA(for Fire service) <br /> ® NOT REQUIRED <br /> Building Permits(Note:Permit Technicians to add all items selected below to associated Building Per it) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> El YES,El See Attached for calculations/cred• ®YES,Traffic Mitigation Total:$4,993.00 <br /> To be added on PW To be added on ❑See Attached for calculations/credit <br /> Quantity charged SF Quantity charged SF ❑ NOT REQUIRED <br /> QTY is El Ground o• • I all surfaces QTY is❑Roof only El all surfaces <br /> ® NOT R UIRED $ d.)25og.-oFZ , <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 El MULTI-FAMILY El 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#B2304-042 <br /> ®Saved to Address Folder in Development Tech File <br /> El NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ® YES—Type NFPA 13D <br /> ❑ NOT REQUIRED <br /> Reason:CODE REQUIRED <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ® YES,Permit#PW2205-022 <br /> ®Stormwater NPDES Tab Completed in TRAKiT ®ADA Tab Completed in TRAKiT ®Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By:S allePtet 9-Cod Date:05/11/2023 <br /> Worksheet Reviewed By: 7kietDate:05/11/2023 <br />