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E V E R E T T PUBLIC WORKS REVIEW WORKSHEET <br /> WASHINGTON <br /> PROJECT ADDRESS: 9510 7TH AVE SE Permit M B2402-071 <br /> DESCRIPTION OF WORK: NEW SINGLE FAMILY HOME-RB2306-005 LENNON-CHELSEA HEIGHTS47 <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 /> E New Connection to main plus 1 connections to building ❑ New Connection,Size - ❑Per Cost Estimate <br /> ❑ Alteration ® Meter Only,Size 1 inch- ❑ Per Cost Estimate I <br /> ❑ Repair ® Water System Development Fee Total:$4.577.00 ��W'� <br /> ❑ Cap-off,quantity ® Sewer System Development Fee Total:$4,028.00 Y 1(-¢ <br /> ❑ Reconnection to stub ® Water Service Line(behind meter),Size 1 inch <br /> ❑ Backwater Valve ❑ Backflow Prevention(Outside Building):❑ RPBA ❑ DCVA <br /> ❑ NOT REQUIRED ❑ NOT REQUIRED <br /> Explanation/Utility Permit# V74V5-' 0 Explanation/Utility Permit# UZJV5- 037 <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Request forReference) <br /> ❑ New Connection,Size ❑ New Connection,Size -❑Per Cost Estimate <br /> ❑ Meter Only,Size ❑ %"Detect Meter Only,Service Size <br /> ❑ Water System Development Fee Total:$ ❑ Backflow Prevention(Outside Building):❑DCDA <br /> ❑ Backflow Prevention(Outside Building):❑ DCVA ® NOT REQUIRED <br /> ® 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) ❑RP BA(for Domestic service) ❑DCDA(for Fire service) <br /> E 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, E See Attached for calculations/credit ®YES,Traffic Mitigation Total:$5,592.00 <br /> To be added on PW To be added on B2402-071 E See Attached for calculations/credit <br /> Quantity charged SF Quantity charged 1408SF ❑ NOT REQUIRED <br /> CITY is❑Ground only❑all surfaces QTY is E Roof only❑all surfaces <br /> $ $420.71 <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 /> E YES-TYPE:E 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#B2402-071 <br /> E Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ® YES-Type 13D <br /> ❑ NOT REQUIRED <br /> Reason:Per note on civil plan <br /> I <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> E YES,Permit#PW2404-048 <br /> E Stormwater NPDES Tab Completed in TRAKiT E ADA Tab Completed in TRAKiT []inspections Added in TRAKiT <br /> ❑ NOT REQUIRED <br /> Worksheet Completed By:7ew Date:0411619024 <br /> Worksheet Reviewed By:&* Date: 0 IZo 2' i <br />