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EVE R E TT PUBLIC WORKS REVIEW WORKSHEET <br />WASHINGTON <br />PROJECT ADDRESS: 3618 W MUKILTEO BLVD Permit #: PW2205-022 <br />TENANT: <br />DESCRIPTION OF WORK: SITE WORK FOR HARBORS EDGE (UNIT LOT SUBDVISION) <br />PW Reviewer to select all that appIV 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 />C' New Connection to main plus 1 connections to building ❑ New Connection, Size - ❑ Per Cost Estimate <br />❑ Alteration ❑ Meter Only, Size - ❑ Per Cost Estimate <br />❑ Repair ❑ Water System Development Fee Total: $ <br />❑ Cap -off, quantity ❑ Sewer System Development Fee Total: $ <br />❑ Reconnection to stub ❑ Water Service Line (behind meter), Size <br />❑ Backwater Valve ❑ Backflow Prevention (Outside Building): ❑ RPBA or ❑ DCVA <br />❑ NOT REQUIRED ID NOT REQUIRED <br />Explanation/ Utility Permit #: Explanation/ Utility Permit #: <br />IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate /Request for Reference) <br />❑ New Connection, Size ❑ New Connection, Size - ❑ Per Cost Estimate <br />Meter Only, Size 1-inch ❑ 3/" Detect Meter Only, Service Size <br />Water System Development Fee Total: $ 7,200.00 ❑ Backflow Prevention (Outside Building): ❑ DCDA <br />XBackflow Prevention (Outside Building): XE)e',,'A RPBA 12-4 NOT REQUIRED <br />❑ NOT REQUIRED Explanation/ Utility Permit #: <br />Explanation/ Utility Permit #: <br />WATER DEPARTMENT COST ESTIMATE NEEDED-(/f yes, PW Reviewer to send cost estimate request to Water Department) <br />ID Yes, Quantity 1 See attached for reference. (1) 8-inch Connection to existing main. <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 Building Permit) <br />STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br />i i YES, 0 See Attached for calculations / credit ❑ YES, Traffic Mitigation Total: $ <br />To be added on PW 2205-022 To be added on ❑ See Attached for calculations / credit <br />Quantity charged 46,931 SF Quantity charged SF )(NOT REQUIRED <br />QTY is ❑ Ground only i 1 all hard surfaces QTY is ❑ Roof only ❑ all hard surfaces <br />$ 12,576.62 $ <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 # <br />❑ Saved to Address Folder in Development Tech File <br />i i NOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />❑ YES —Type <br />Q NOT REQUIRED <br />Reason: <br />PUBLIC WORKS PERMIT REQUIRED? <br />1-4 YES, Permit # PW 2205-022 <br />i i Stormwater NPDES Tab Completed in TRAKiT i i ADA Tab Completed in TRAKiT Inspections Added in TRAKiT <br />❑ NOT REQUIRED `— D <br />Worksheet Completed By: Date: 11/02/2022 <br />Worksheet Checked By: Date: <br />REVISED 11/27/2019 <br />