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EVERETT PUBLIC WORKS REVIEWVVORKSHEET <br /> immi WASHINGTON <br /> PROJECT ADDRESS: 3702 W MUKILTEO BLVD, UNIT B Permit#: B2304-047 <br /> DESCRIPTION OF WORK: NEW"HARBOR'S EDGE"TOWNHOMES,UNIT B <br /> PW Reviewer to select all that apply below: <br /> U lity Permits (Note:Permit Technicians to Create Utili ermit for Sewer, ater,Fire,and Irrigation,as selected below) <br /> ANITARY SEWER: DOMESTIC WATER SERVICE:(Attach Calculation&Cost Est.) <br /> ZI New Connection to main plus 1 connections to building ❑ New Connection,Size - ❑ Per Cost Estimate <br /> ❑ Alteration to Meter Only,Size 1"DOM/FIRE COMBO-❑Per Cost Estimate <br /> ❑ Repair ® Water System Development Fee Total:$4,311.00 <br /> ❑ Cap-off,quantity ® Sewer System Development Fee Total:$5,580.00 <br /> 0 Reconnection to stub ❑ Water Service Line(behind meter),Size <br /> ❑ Backwater Valve , 1" � ❑ Backflow Prevention(Outside Building):❑RPBA ❑DCVA <br /> ❑ NOT REQUIRED <br /> ion/UttilityPermit# f 23C10 / ❑ NOT REQUIRED 1 <br /> �`L <br /> Explanati <br /> on/Utility Permit# u r��+ <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) \ FIRE SERVICE:(Attach Cost Estimate/Request for Reference) <br /> O New Connection,Size ❑ New Connection,Size -❑Per Cost Estimate <br /> ❑ Meter Only,Size 0 %"Detect Meter Only,Service Size <br /> ❑ Water System Development Fee Total:$ ❑ Backflow P tion(Outside Building):❑DCDA <br /> ❑ Backflow Pr tion(Outside Building):El DCVA ® NOT UIRED <br /> ® NOT R IRED E planation/Utility Permit# <br /> Exp nation/Utility Permit# <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(lf yes,PW Reviewer to send cost estimate request to Water Department) <br /> ❑ 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): El DCVA(for Domestic service) ❑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 ermit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ❑ YES,❑See Attached for calculations/credit ElYES,Traffic Mitigation Total:$4,993.00 <br /> To be added on PW o be added on ❑See Attached for calculations/credit <br /> Quantity charged SF Quantity charged SF ❑ NOT REQUIRED <br /> QTY is❑Ground only❑all s ces QTY is❑Roof only❑all surfaces r ..tl'� <br /> $ $ 2)2' <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:®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#B2304-047 <br /> ®Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ® YES Type NFPA 13D <br /> El 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:Ia4iIs 4 940d Date:05/P1/2023 <br /> Worksheet Reviewed By: 7ktee Zeezooirt Date:05/11/2023 <br />