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ilim EVERETT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 3620 W MUKILTEO BLVD, UNIT F Permit#: B2304-043 <br /> DESCRIPTION OF WORK: NEW"HARBOR'S EDGE"TOWNHOMES,UNIT F <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 El New Connection,Size - 0 Per Cost Estimate <br /> O Alteration ® Meter Only,Size 1"DOM/FIRE COMBO-❑Per Cost Estimate <br /> ❑ Repair ® Water System Development Fee Total:$4,311.00 IJ <br /> ❑ Cap-off,quantity ® Sewer System Development Fee Total:$5,580.00 <br /> ❑ Reconnection to stub ❑ Water Service Line(behind meter),Size <br /> ❑ Backwater Valve 0 Backflow Prevention(Outside Building):❑RPBA El DCV <br /> ❑ NOT REQUIRED ❑ NOT REQUIRED <br /> Explanation/Utility Permit# Z30 1_co Explanation/Utility Permit# U.23041 1'©0 <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection,Size El New Connection,Size -El Per Cost Estimate <br /> ❑ Meter Only,Size El %"Detect Meter Only,Service Size <br /> El Water System Development Fee Total:$ El 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-Of 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) ❑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 Buildin Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ❑ YES,El See Attached for calculations/credit ®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❑Ground only❑all surfaces QTY is❑Roof only El all surfaces <br /> $ $ i?j 2 SO4 r".°q3 <br /> ® NOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address),print out Address Letter TRAKiT Print Menu and include) <br /> ® YES—TYPE:®SFR El DUPLEX ❑ADU El INFILL DWELLING El 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#B2304-043 <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 /> El NOT REQUIRED <br /> Worksheet Completed By:S'4��U t Date:05/11/2023 <br /> Worksheet Reviewed By: /c?lealPia Date:05/11/2023 <br />