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EVE RETT PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 7929 BEVERLY BLVD Permit#: B2405-041 <br /> DESCRIPTION OF WORK: REMODEL BATHROOM,ENLARGE WINDOWS&DOORS,ADA ACCESS.,RAMP <br /> PW Reviewer to select all that apply below: <br /> Utility Permits (Note:Permit Technicians to Create Utility Permit forSewer, Water,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 - ❑Per Cost Estimate <br /> ❑ Alteration El meter Only,Size -❑Per Cost Estimate <br /> ❑ Repair I ❑ Water System Development Fee Total:$ <br /> ❑ Ca}' ff,quantity ❑ Se dr System Development Fee Total:$ <br /> ❑ dconnection to stub ❑ ater Service Line(behind meter),Size <br /> Backwater Valve Backflow Prevention(Outside Building):❑RPBA ❑DCVA <br /> NOT REQUIRED XNOT REQUIRED <br /> Explanation/Utility Permit# Explanation/Utility Permit# <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Requestfor Reference) <br /> ❑ New Connection,Size ❑ New Connection,Size -❑Per Cost Estimate <br /> ❑ Meter Only,Size ❑ %" etect Meter Only,Service Size <br /> ❑ Water System Development Fee Total:$ ❑ ckflow Prevention(Outside Building):❑DCDA <br /> ❑ B ckflow Prevention(Outside Building):❑DCVA NOT REQUIRED <br /> OT REQUIRED Explanation/Utility Permit# <br /> Explanation/Utility Permit# <br /> WATER gEPARTMENT COST ESTIMATE NEEDED-(If yes,PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Y 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 /> TS 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 /> ® YES,®See Attached for calculations/credit ❑ YES,Traffic Mitigation Total:$ <br /> To be added on PW To be added on B2405-041 ❑See Attached for calculations/credit <br /> Quantity charged SF Quantity charged 115SF ® NOT REQUIRED <br /> QTY is❑Ground only❑all surfaces CITY is❑Roof only®all surfaces <br /> $ $34.36 <br /> ❑ NOT REQUIRED <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address),print out Address Letter from TRAKiT Print Menu and include) <br /> 5&YES—TYPE:❑SFR [—]DUPLEX t4 ADU ❑INFILL DWELLING ❑MULTI-FAMILY [—]COMMERCIAL <br /> ❑See Attached Letter,2 copies(Permit Techs to issue one copy to applicant with permits,scan one copy to PWClerical@everettwo.gov) <br /> H..Digital copy attached to permit record,Permit#_?L .`40s' 0 41 <br /> Saved to Address Folder in Development Tech File <br /> �.NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑ YES Type <br /> ® NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ❑ YES,Permit#PW <br /> ❑Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT ❑Inspections Added in TRAKiT <br /> ® NOT REQUIRED <br /> Worksheet Completed By: e"e Date:0$I2SI20Z4 <br /> Worksheet Reviewed By:, Date: S_�__— A —;KD'Ly <br />