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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 9506 7TH AVE SE Permit#: B2402-068 <br /> DESCRIPTION OF WORK: NEW SINGLE FAMILY HOME-RB2306-001 THELON-CHELSEA HEIGHTS 01 <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 connections to building ❑ New Connection,Size - ❑Per Cost Estimate <br /> ❑ Alteration ® Meter Only,Size 1 inch-❑Per Cost Estimate <br /> ❑ Repair ❑ Water System Development Fee Total:$0(Credit for existing) <br /> ❑ Cap-off,quantity ❑ Sewer System Development Fee Total:$0(Credit for existing) <br /> ❑ Reconnection to stub 9 Water Service Line(behind meter),Size 1 inch <br /> ❑ Backwater Valve ❑ Backflow Prevention(Outside Building):❑RPBA ❑DCVA <br /> ❑ NOT REQUIRED ❑ NOT REQUIRED <br /> Explanation/Utility Permit# bZ(p Explanation/Utility Permit# U Z`rD 5—D Z(v <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection,Size ❑ New Connection,Size -❑Per Cost Estimate <br /> ❑ Meter Only,Size ❑ %"Detect Meter Only,Service Size <br /> ❑ Water System Development Fee Total:$ ❑ Backflow Prevention(Outside Building):❑ DCDA <br /> ❑ Backflow Prevention(Outside Building):❑DCVA Z NOT REQUIRED <br /> Z NOT REQUIRED Explanation/Utility Permit# <br /> Explanation/Utility Permit# <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes,PW Reviewer to send cost estimate request to Water Department) <br /> ❑ 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 Building Permit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ® YES,®See Attached for calculations/credit ❑ YES,Traffic Mitigation Total:$0 Credit Applied <br /> To be added on PW To be added on B2402-068 ®See Attached for calculations/credit <br /> Quantity charged SF Quantity charged 1504SF ❑ NOT REQUIRED <br /> QTY is❑Ground only❑all surfaces QTY is®Roof only❑all surfaces <br /> $ $449.40 <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 PWClerical@everettwo.gov) <br /> ®Digital copy attached to permit record,Permit# <br /> ®Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> Z YES—Type NFP9Pt3 <br /> ❑ NOT REQUIRED <br /> Reason: 110�P Oh civil 0a n <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ® YES,Permit#PW2402-017 <br /> ®Stormwater NPDES Tab Completed in TRAKiT ®ADA Tab Completed in TRAKiT ❑Inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By: 7e"e �ov12 Date:3/Cl/2024 <br /> Worksheet Reviewed By: / Date:6_2 1 — ZQ Z� <br />