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im E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 200 W MARINE VIEW DR Permit#: B2011-018 <br /> TENANT: [TenName] <br /> DESCRIPTION OF WORK: CONSTRUCT NEW TILT-UP CONCRETE SEMI-CONDITIONED SHELL <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 X Meter Only, Size 2" - 0 Per Cost Estimate <br /> ❑ Repair 0 Water System Development Fee Total: $ 22,332.00 <br /> ❑ Cap-off, quantity XSewer System Development Fee Total: $ 28,901.00 <br /> ❑ Reconnection to stub ❑ Water Service Line (behind meter), Size <br /> ❑ Backwater Valve ❑ Backflow Prevention (Outside Building): 0 RPBA or❑ DCVA <br /> ❑ NOT REQUIRED ❑ NOT REQUIRED I ^ � 11 <br /> Explanation/Utility Permit#: \A2\p�_ UL Explanation/Utility Permit#: vlZI l -t' U2q <br /> IRRIGATION SERVICE: (Not Including Cost Estimates) FIRE SERVICE: (Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection, Size 0 New Connection, Size -0 Per Cost Estimate <br /> ❑ Meter Only, Size 03/4" Detect Meter Only, Service Size 8" <br /> ❑ Water System Development Fee Total: $ 0 Backflow Prevention (Outside Building): 0 DCDA <br /> ❑ Backflow Prevention (Outside Building): ❑ DCVA 0 NOT REQUIRED II^^Z O o2 <br /> )2(NOT REQUIRED Explanation/Utility Permit#: V� k �' - I <br /> Explanation/ Utility Permit#: <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes, PW Reviewer to send cost estimate request to Water Department) <br /> )S(Yes, Quantity 1 , See attached for reference. 1-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):j 0 DCVA(for <br /> jDomestic <br /> service) ❑ BA(for Domestic service) X DCDA (for Fire service) <br /> ❑ NOT REQUIRED WAULk l D 1 l�I//I '1\16o1 fI y,p <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 /> EYES, See Attached for calculations/credit X YES,Traffic Mitigation Total: $ 337,385.00 <br /> To be added on PW PW201 1-021 To be added on B2011-018 0 See Attached for calculations/credit <br /> Quantity charged 359,792 SF Quantity charged 234,177 SF ❑ NOT REQUIRED <br /> QTY is Ground only❑ all hard surfaces QTY is X Roof only❑ all hard surfaces n l I I G, <br /> $ 94,733.23 $ 61,658.80 . l�j <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 0 ADU ❑ INFILL DWELLING 0 MULTI-FAMILY )2 COMMERCIAL <br /> X See Attached Letter, 2 copies (Permit Techs to issue one copy to applicant with permits, scan one copy to Jeffrey Marks) <br /> )8(Digital copy attached to permit record, Permit# PW201 1-021 <br /> Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> EYES-Type NFPA 13 <br /> ❑ NOT REQUIRED <br /> Reason: FIRE CODE <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> EYES, Permit# PW PW201 1-021 <br /> �(Stormwater NPDES Tab Completed in TRAKiT )8(ADA Tab Completed in TRAKiT E Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED ,- O <br /> Worksheet Completed By: 7�^01e 7161" Date: 64/r e42,01.. <br /> Worksheet Checked By: jjoSZurt.tu igirret Date: 4/26/2021 <br /> REVISED 11/27/2019 <br />