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`EVERETT <br />WASHINGTON PUBLIC WORKS REVIEW WORKSHEET <br />PROJECT ADDRESS: 10621 ROSEWOOD AVE Permit M B2308-032 <br />DESCRIPTION OF WORK: BUILD NEW 2-STORY SFR WITH ATTACHED GARAGE <br />PW Reviewer to select all that apply below: <br />Utility Permits (Note: Permit Technicians to Create Utility Permit for Sewer, ater, Fire, and Irrigation, as selected below) <br />SANITARY SEWER: DOMESTIC WATER SERVICE: (Attach Calculation & Cost Est.) <br />❑ New Connection to main plus _ connections to building ® New connection, Size 3 41nch - ❑ Per Cost Estimate <br />❑ Alteration ❑ meter Only, Size - ❑ Per Cost Estimate <br />❑ Repair ® Water System Development Fee Total: $4,311.00 <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 ❑ D A <br />NOT REQUIRED ❑ NOTREQUIRED <br />Explanation/Utility Permit#,,�z-3<<�OS� <br />Explanation/Utility Permit#4Cost <br />IRRIGATION SERVICE: (Not Incluates) FIRESERVICE:( Inch Cost Estimate/Requestfor Reference) <br />❑ New Connection, Size _ ❑ New Co cti0n, Size - ❑ Per Cost Estimate <br />❑ Meter Only, Size ❑ '/." D ect Meter Only, Service Size _ <br />❑ Water stem Development Fee Total: $_ ow Prevention (Outside Building): ❑ DCDA <br />❑ Ba low Prevention (Outside Building): ❑ DCVA EQUIRED <br />VF�.OpTl."I <br />OT REQUIRED ation/Utility Permit# <br />Explanation/Utility Permit If <br />WATER DEPARTMENT COST ESTIMATE NEEDED -(If yes, PW Reviewer to send cost estimate request to Water Department) <br />❑ Yes, Q ntity See attached for reference. <br />® NOT EQUIRED <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 />® NO EQUIRED <br />wilding Permits (Note: PermitTechnicia to add all items selected below to associated Building ermit) <br />STORMWATER SYSTEM DEVELOPMENT FE <br />TRAFFIC MITIGATION FEES: <br />® YES, ®See Attached for calculations / c dit <br />®YES, Traffic Mitigation Total: $4.933.00 <br />To be added on PW 2308-020 To be added on <br />❑ See Attached for calculations/credit <br />Quaqtity charged 37S95F Quantity charged_ SF <br />$OTY is 015.16 round only�'all surfaces Q is oof only ❑all surfaces <br />❑ NOT REQUIRED <br />Z�O� - C) r1 <br />L- <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 #B2308-032 <br />Saved to Address Folder in Development Tech File <br />❑ NOT REQUIRED <br />FIRE SPRINKLERS REQUIRED? <br />❑ YES Type_ <br />® NOT REQUIRED <br />Reason:SFR <br />PUBLIC WORKS PERMIT REQUIRED? <br />® YES, Permit # PW2308-020 <br />® Stormwater NPDES Tab Completed in TRAKIT ® ADA Tab Completed in TRAKiT ® Inspections Added in TRAKIT <br />❑ NOT REQUIRED <br />,�//pp <br />WorksheetCompleted By:Tll/* 74e <br />itao Date: 09—J2-2023 <br />Worksheet Reviewed By: 744d /GeA� Date:09-J2-2023 <br />